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A Randomized Trial of Aspirin and Sulfinpyrazone in Threatened Stroke

List of authors.
  • The Canadian Cooperative Study Group

Abstract

Five hundred and eighty-five patients with threatened stroke were followed in a randomized clinical trial for an average of 26 months to determine whether aspirin or sulfinpyrazone, singly or in combination, influence the subsequent occurrence of continuing transient ischemic attacks, stroke or death.

Eighty-five subjects went on to stroke, and 42 died. Aspirin reduced the risk of continuing ischemic attacks, stroke or death by 19 per cent (P<0.05) and also reduced risk for the "harder," more important events of stroke or death by 31 per cent (P<0.05), but this effeet was sex-dependent: among men, the risk reduction for stroke or death was 48 per cent (P<0.005), whereas no significant trend was observed among women. For sulfinpyrazone, no risk reduction of ischemic attacks was observed, and the 10 per cent risk reduction of stroke or death was not statistically significant. No overall synergism or antagonism was observed between the two drugs. We conclude that aspirin is an efficacious drug for men with threatened stroke. (N Engl J Med 299:53–59, 1978)

Funding and Disclosures

Address reprint requests to Dr. H. J. M. Barnett at the Department of Neurological Sciences, University Hospital, London, ON N6A 5A5, Canada.

Supported by a grant (MA-4535) from the Medical Research Council of Canada.

The Canadian Cooperative Study Group consists of the following:

Neurologic Center: University of Western Ontario, H. J. M. Barnett, principal investigator.*

Methods Center: McMaster University, M. Gent, co-principal investigator*; D. L. Sackett, co-principal investigator*; and D. W. Taylor, chief statistician.*

Hematology: Co-ordinators: J. A. Blakely (Toronto)*; J. Hirsh (McMaster)*; J. F. Mustard (McMaster)*; and R. K. Stuart (University of Western Ontario).*

Participating Centers: Newfoundland: St. John's, W. Pryse-Phillips. Nova Scotia: Halifax, T. J. Murray. Quebec: Montreal, D. W. Baxter and J. Meloche. Quebec City, M. Drolet and D. Simard.* Ontario: Ottawa, E. Atack, R. F. Nelson and D. Preston. Kingston, H. B. Dinsdale.* Toronto, R. D. G. Blair, J. Edmeads, R. Gladstone, M. Hill, O. Kofman, B. Stewart and R. Wilson. London, H. J. M. Barnett,* C Bolton, J. Brown, N. Jaatoul, A. Kertesz, J. D. Spence and S. Stewart. Alberta: Calgary, F. Leblanc,* R. Lee, F. W. Ramsay and T. Seland. British Columbia: Vancouver, V. Sweeney and M. J. Wong. Victoria, C A. Simpson. New Westminster, R. D. Grosch and M. Knazan.

Research Staff: University of Western Ontario, P. Doucette, F. Geoghegan and S. Mann. McMaster University, J. Sicurella and G. Smith.

* Members of Executive Committee and Editorial Committee.

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