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Review: aspirin reduces the risk for stroke in patients with previous transient ischaemic attack or stroke but does not have a dose-response effect

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 QUESTION: In patients with a previous transient ischaemic attack (TIA) or stroke, does a dose-response relation exist for aspirin use and the risk for stroke?

Data sources

Studies were identified by searching Medline (to April 1996) and by scanning reference lists of relevant articles.

Study selection

Studies were selected if they were randomised, placebo-controlled, secondary prevention trials that included a comparison of aspirin alone and reported stroke as an outcome.

Data extraction

2 reviewers extracted published data on demographics, inclusion and exclusion criteria, treatment regimen, duration of follow-up, and all strokes (ischaemic and haemorrhagic). Another reviewer independently extracted data on outcomes, inclusion and exclusion criteria, and health status at entry.

Main results

11 randomised controlled trials met the selection criteria (9629 patients [5228 allocated to aspirin and 4401 to placebo], mean age 63 y, …

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  • Source of funding: Boehringer Ingelheim.

  • For correspondence: Mr E S Johnson, Epidemiology Resources Inc. 1 Newton Executive Park, Newton Lower Falls, MA 02162, USA. FAX 617-244-9669.