| New Combination Therapies Recommended by Stanford-led Stroke Panel |
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 Gregory Albers, director of the Stanford Stroke Center, is the author of new American College of Chest Physician guidelines on stroke treatment and prevention, which were published in the November issue of the journal Chest. The guidelines, endorsed by the National Stroke Association, recommend for the first time the combination of aspirin and extended release dipyridamole as an acceptable alternative for more established single-medication treatments for the prevention of recurrent stroke. The guidelines also recommend low doses of aspirin (50 to 325 mg per day) as an initial choice for stroke patients for the prevention of recurrent stroke. Earlier recommendations were not specific about the optimal dose of aspirin. "Aspirin has long been the standard of care for treating most patients at risk for stroke. Studies have shown that lower doses of aspirin are just as effective and cause fewer side effects," Albers said. The authors noted that the combination of aspirin and extended release dipyridamole (25 mg to 200 mg twice daily) may be more effective than clopidogrel with a similarly favorable adverse effect profile. For patients intolerant of aspirin, alternative antiplatelet therapy was recommended. Clopidogrel (75 mg once daily) was recommended in favor of ticlopidine (250 mg twice daily) because of a lower incidence of side effects. "The combination of low-dose aspirin and extended-release dipyridamole has shown significant benefits and can be a highly effective tool for preventing stroke in patients who have suffered a previous atherothrombotic stroke or TIA," said Albers, associate professor of neurology and neurological sciences. Albers' fellow authors included Donald Easton, profesor and chair of neurology at Brown University; Ralph L. Sacco, associate professor of neurology at Columbia University; and Philip Teal, director of the Vancouver Stroke Program in Vancouver, B.C. |
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