ROLE OF TICLOPIDINE FOR PREVENTION OF STROKE

Background: Ticlopidine, an antiplatelet agent with a unique mechanism of action, is now available for clinical use in the United States and Canada. Summary of Comment: Recently two large randomized trials demonstrated that ticlopidine can reduce the risk of subsequent stroke in patients presenting with a transient ischemic attack or stroke. One study found that ticlopidine was more effective than aspirin for stroke prevention; however, it was less well tolerated than aspirin and was associated with severe but reversible neutropenia in almost 1% of patients. Conclusions: Ticlopidine is effective for both primary and secondary stroke prevention. It has a favorable risk/benefit ratio and is a particularly attractive option for patients who are unable to take aspirin.