Stroke, Vol 24, 1125-1128, Copyright © 1993 by American Heart Association
B Lindblad, NH Persson, R Takolander and D Bergqvist
BACKGROUND AND PURPOSE: The aim of this randomized double-blind,
placebo-controlled trial was to evaluate whether neurological deficits
could be prevented with low-dose acetylsalicylic acid (ASA) as an adjunct
to carotid endarterectomy. METHODS: A total of 232 patients were randomized
to two groups, 75 mg/d ASA starting preoperatively and continued for 6
months (n = 117) or placebo (identical tablets) (n = 115). The patients
were followed up regularly for 1 year. RESULTS: The groups were well
matched regarding laboratory data and indication for operation. The number
of patients with intraoperative or postoperative stroke without complete
recovery within 1 week were 0 and 2 at 30 days and 6 months, respectively,
in the ASA group, compared with 7 and 11 in the placebo group (P = .01).
Including all neurological events within 6 months, this was found in 15
patients in the ASA group compared with 24 in the placebo group (P = .12).
Mortality was 0.8% and 3.4% at 30 days and 6 months, respectively, in the
ASA group. In the placebo group, the corresponding figures were 4.3% and
6.0%, respectively (P = .12). The intraoperative bleeding did not differ
between the groups nor did the number of reoperations due to bleeding or
other complications related to pharmacology. CONCLUSIONS: This study
indicates that low-dose ASA (75 mg/d) reduces the number of postoperative
strokes without complete recovery within 1 week. Overall neurological
events are insignificantly reduced, as also mortality. The use of low-dose
ASA (75 mg) seems safe and effective in reducing cerebrovascular events
after carotid endarterectomy.
ARTICLES
Does low-dose acetylsalicylic acid prevent stroke after carotid surgery? A double-blind, placebo-controlled randomized trial
Department of Surgery, Malmo General Hospital, Lund University, Sweden.
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