To reduce the risk of stroke, partial blockage of arteries in the brain (intracranial stenosis) has for decades been treated with drugs such as aspirin and warfarin that reduce blood clotting. However, doctors have never had good evidence for choosing one therapy over the other. Now, results of a double-blind, randomized clinical trial show for the first time that aspirin works as well as warfarin with fewer side effects. The study was funded by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health (NIH).

"This trial is good news. A simple low-cost drug works just as well as one that requires complicated and expensive monitoring and dose adjustments," says John R. Marler, M.D., the Associate Director for Clinical Trials at NINDS. The study appears in the March 31, 2005, issue of the New England Journal of Medicine.*

Intracranial stenosis is caused by atherosclerosis -- fatty deposits that build up on the inner walls of the arteries and restrict blood flow. Intracranial stenosis causes about 10 percent of the 900,000 strokes and transient ischemic attacks (TIAs) in the United States each year. TIAs are transient strokes that last only a few minutes and occur when the blood supply to part of the brain is briefly interrupted. People with a stroke or TIA due to intracranial stenosis have a greatly increased risk of a second stroke as much as 15 percent per year. Studies in the 1950s suggested that anticoagulants (a class of drugs that reduce blood clotting), such as warfarin, can reduce the risk of stroke in people with this disease.

In the new study, called the Warfarin Aspirin Symptomatic Intracranial Disease (WASID) trial, investigators at 59 medical centers across the United States, led by Marc I. Chimowitz, M.D., of Emory University in Atlanta, compared warfarin to 1300 milligrams (mg) per day of aspirin in a total of 569 patients for an average of 1.8 years. All of the pat
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Contact: Natalie Frazin or Paul Girolami
301-496-5924
NIH/National Institute of Neurological Disorders and Stroke
30-Mar-2005

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