(Stroke. 2000;31:1001.)
© 2000 American Heart Association, Inc.
Addendum to AHA Scientific Statement |
Addendum to the Supplement to the Guidelines for the Management of Transient Ischemic Attacks
From Stanford Stroke Center, Stanford University School of Medicine, Palo Alto, Calif (G.W.A.); Department of Medicine/Neurology, The University of Texas Health Science Center at San Antonio (R.G.H.); Oregon Stroke Center, Oregon Health Sciences University, Portland, Ore (H.L.L.); Department of Neurological Surgery, University of Washington School of Medicine, Seattle, Wash (D.W.N.); and Neurological Institute, Columbia–Presbyterian Medical Center, New York, NY (R.L.S.).
Correspondence to Gregory W. Albers, MD, Director, Stanford Stroke Center, 701 Welch Road, Building B, Suite 325, Palo Alto, CA 94304.
In the November 1999 issue of Stroke, an ad hoc committee of the Stroke Council of the American Heart Association published a supplement to the guidelines for the management of transient ischemic attacks. In this update, we failed to comment on a potentially important subgroup analysis of the Ticlopidine Aspirin Stroke Study (TASS) and neglected to mention a National Institutes of Health–sponsored stroke prevention study evaluating ticlopidine in African Americans.
The beneficial effects of ticlopidine relative to aspirin were more pronounced in nonwhite, predominantly African American patients.2 Furthermore, the incidence of adverse effects among the nonwhite population was 10% lower, and there were no reports of severe neutropenia. The African American Antiplatelet Stroke Prevention Study (AAASPS) is currently enrolling 1800 African Americans into a multicenter, randomized, double-blind clinical trial.3 This trial is testing ticlopidine (500 mg/d) versus aspirin (650 mg/d) for the prevention of recurrent stroke, vascular death, and myocardial infarction among middle-aged and elderly African American patients with noncardioembolic ischemic stroke.
References
1.
Albers GW, Hart RG, Lutsep HL, Newell DW, Sacco RL.
Scientific Statement: Supplement to the Guidelines for the Management
of Transient Ischemic Attacks. Stroke.. 1999;30:2502–2511.
2.
Weisberg LA for the Ticlopidine Aspirin Stroke Study
Group. The efficacy and safety of ticlopidine and aspirin in
non-whites: analysis of a patient subgroup from the Ticlopidine
and Aspirin Stroke Study. Neurology.. 1993;43:27–31.
3. Gorelick PB, Leurgans S, Richardson D, Richardson D, Harris Y, Billingsley M, and the AAASPS Investigators. African American Antiplatelet Stroke Prevention Study: clinical trial design. J Stroke Cerebrovasc Dis.. 1998;7:426–434.[Medline] [Order article via Infotrieve]
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