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Q In patients with symptomatic intracranial arterial stenosis, how does aspirin compare with warfarin?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Neurology ★★★★★★★ Cardiology ★★★★★★☆
randomised controlled trial (Warfarin-Aspirin Symptomatic Intracranial Disease [WASID] Trial).
blinded (patients and outcome assessors).*
Follow up period:
mean 1.8 years.
59 sites in North America.
569 patients ⩾40 years of age (mean age 64 y, 61.5% men) with transient ischaemic attack or non-disabling stroke in the previous 90 days caused by 50–99% stenosis of a major intracranial artery and a modified Rankin score ⩽3. Exclusion criteria included tandem 50–99% stenosis of the extracranial carotid artery, non-atherosclerotic stenosis of an intracranial artery, and a cardiac source of embolism.
aspirin, 1300 mg/day (n = 280), or warfarin, 5 mg/day initial dose, which was adjusted to achieve an international normalised ratio (INR) of 2.0–3.0 (n = 289).
primary composite endpoint of ischaemic stroke, brain hemorrhage, and death from vascular causes other than stroke; and adverse events.
Patient follow up:
98% (intention to treat analysis).
Aspirin and warfarin did not differ for …