now is as effective as warfarin for this disease, since it was the only dose studied. We just don't know how other doses of aspirin would stack up," says Dr. Chimowitz. The major bleeding risk on high dose aspirin in WASID was similar to the major bleeding risk in other stroke trials that have evaluated lower doses of aspirin (e.g. 325 mg per day), he adds. Most experts believe there are no advantages to aspirin doses greater than 325 mg for stroke prevention, and the U.S. Food and Drug Administration-approved dose of aspirin for prevention of vascular events is 50-325 mg. Patients should consult their physicians before beginning any long-term or high-dose aspirin treatment regimen.

Even with treatment, the rates of ischemic stroke in this clinical trial were substantially higher than in stroke prevention trials that have evaluated aspirin and warfarin in patients with other causes of stroke. This underscores that patients with intracranial stenosis are at particularly high risk for stroke and that better therapies are needed, the investigators note.

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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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