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(Circulation. 1996;93:399.)
© 1996 American Heart Association, Inc.

Articles

Research News: Second European Stroke Prevention Study

James J. Ferguson, MD

From the Texas Heart Institute, Houston, Tex.

Correspondence to James J. Ferguson, MD, Cardiology Research (MC1-191), Texas Heart Institute, PO Box 20345, Houston, TX 77225-0345.

	Introduction

 
Prof Armand Lowenthal, the Principal Investigator and Chairman of the European Stroke Prevention Study-2 (ESPS-2), presented the findings of this large trial at the Congress of the European Federation of Neurological Societies in Marseille, France, on September 11, 1995. In ESPS-2, 6602 patients with a history of stroke or transient ischemic attack were randomized to one of four groups: aspirin alone (50 mg/d), sustained-release dipyridamole alone (400 mg/d), aspirin plus sustained-release dipyridamole, or placebo. Medication was administered for a period of 2 years. Fifty-nine clinical centers in 13 European countries participated in the study. Two principal end points were defined: stroke or death from any cause. These end points were analyzed both separately and together. The incidence of stroke (both fatal and nonfatal) was relatively reduced by 18.1% with aspirin alone, by 16.3% with sustained-release dipyridamole alone, and by 37% with aspirin plus sustained-release dipyridamole. The combined end point of stroke and death from all causes was relatively reduced by 13.2% with aspirin alone, by 15.4% with sustained-release dipyridamole alone, and by 24.4% with aspirin plus sustained-release dipyridamole.

Of note, even this very low dose of aspirin was associated with an increase in gastrointestinal bleeding events (4.6% in placebo patients and sustained-release dipyridamole-alone patients versus 8.5% in aspirin-alone patients and aspirin-plus–sustained-release dipyridamole patients). The overall incidence of gastrointestinal side effects was similar for all four groups.

Prof Lowenthal concluded that in patients with a history of stroke or transient ischemic attack, sustained- release dipyridamole alone and low-dose aspirin alone are . . . [Full Text of this Article]

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