[MOL] New Stroke Guidelines stress aspirin alternatives [00619] Medicine On Line


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[MOL] New Stroke Guidelines stress aspirin alternatives



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New stroke guidelines stress aspirin alternatives


DALLAS, Nov 4 (Reuters) - New blood-thinning drugs and lower doses of
aspirin can help prevent strokes and mini-strokes in patients who cannot
tolerate aspirin, the American Heart Association said on Thursday.

The recommendation came in updated guidelines to doctors for treating
patients at risk of a stroke after suffering a mini-stroke, or a short
blockage of blood to the brain.

A full-blown stroke from a brain blood clot can cause blindness,
paralysis
or death. Someone who has experienced a mini-stroke, or transient
ischemic
attack (TIA), is about 10 times more likely to suffer a major stroke
than
someone who has not, the association said.

In updated guidelines for treating mini-stroke patients, the American
Heart
Association said it is drawing doctors' attention to several advances in
medicines and surgery that have occurred since the guidelines were
issued in
1994.

These include new antiplatelet agents, or blood thinners, that help
prevent
blood clots from forming, it said in this month's edition of the journal
``Stroke.''

The new drugs are an alternative to aspirin for patients who cannot
tolerate
aspirin, which can cause gastrointestinal bleeding or allergic reactions
in
some people, and those who have had a mini-stroke despite aspirin
therapy.

The new antiplatelet drugs are clopidogrel, sold by Bristol Myers Squibb
under the name Plavix, which can be used alone, and dipyridamole, which
is
most effective when used in combination with aspirin. Dipyridamole is
sold
by privately held Boehinger Ingelheim under the name Persantine.

``The addition of these two new antiplatelet medications offers
physicians
more options for treating stroke and TIA patients,'' Dr. Gregory Albers,
who
chaired the panel that updated the guidelines, said in a statement.

Albers is director of the Stanford Stroke Centre and associate professor
of
neurology and neurological sciences at Stanford University, Palo Alto,
Calif.

Albers said another significant change in the guidelines is the lowering
of
the recommended dosages of aspirin to prevent stroke.

Some experts recommend doses as high as 1,300 milligrams per day,
according
to the article in Stroke.

``Recent studies indicate that aspirin can be just as effective for
stroke
prevention at lower doses ranging from 50 to 325 milligrams (a day).
This
means fewer side-effects for patients,'' Albers said.

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