Abstract
To evaluate retrospectively the therapeutic usefulness of antiplatelet agents [aspirin (ASA) and ticlopidine (TP)], together with antiaggregation agents [warfarin and bucolome, which enhances the effect of warfarin], we analyzed 311 hospitalized patients (192 men aged 64.4 ± 12.9 years and 119 women aged 67.5 ± 11.1 years) suffering from initial completed strokes during the period, January 1981 to December 1984. The patients comprised 252 cases of cerebral thrombosis (154 men and 98 women) and 59 of cerebral embolism (38 men and 21 women), and were followed up for 1410.8 ± 1316.6 days in men and for 1526.5 ± 1344.6 days in women. The annual incidences of recurrence (cerebral thrombosis and embolism, TIA, RIND, cerebral homorrhage, SAH, subdural hematoma, ASO and myocardial infarction) in the patient group with cerebral thrombosis were 5.28% in the ASA group, 2.29% in the TP group, and 6.54% in the untreated control group. Statistically, recurrence was significantly lower in the TP group than in the ASA and control groups (p<0.05). In the patients with cerebral embolism, the annual incidences of recurrence were 11.16% in the ASA group. 19.31% in the TP group, 4.13% in the warfarin group, 0% in the warfarin plus bucolome group, and 24.88% in the control group. Comparative analysis among the antiplatelet (ASA, TP, and ASA plus TP) group, antiaggregation (warfarin, and warfarin plus bucolome) group and controls demonstrated that recurrence was significantly lower in the antiaggregation group than in the antiplatelet group and the controls (p<0.01). The difference between the antiplatelet group and the controls was not statistically significant. Cerebral hemorrhage occurred in 5 patients : one man each in the ASA group and the TP group, one woman in the antiaggregation group, and one man and one woman in the controls. Administration of antiplatelet or antiaggregation agents displayed no definite and serious side effects. In conclusion, a clinical efficacy in preventing secondary cerebral thrombosis was noted for TP, but not for ASA, while warfarin or warfarin plus bucolome was effective in preventing secondary cerebral embolism.
