The effect of aspirin, ticlopidine and their low-dose combination on platelet aggregability in acute ischemic stroke:: a short duration follow-up study

We investigated the effects of aspirin (300 mg/d), ticlopidine (500 mg/d) and their low-dose combination (aspirin 100 mg/d plus ticlopidine 250 mg/d) on the platelet aggregability using the Wu and Hoak method. Each treatment group consisted of 25 patients with acute ischemic stroke. Platelet aggregation ratios (PAR) were measured on the 1St (before treatment), 10th and 90th days in the treatment groups and compared with those of 25 control cases. On the first day, comparison of PAR in each treatment group with the control was significant, while the differences between treatment groups were not significant. On the 90th day, differences of PAR between aspirin and control were significant, but differences between the other treatment groups and the control group were not significant, indicating a lower anti-aggregant efficacy of aspirin. Our study suggests that PAR determination can be used to assess the efficacy of anti-aggregant drugs. Our crude observation also suggests a higher anti-aggregant efficacy of ticlopidine, and aspirin plus ticlopidine, than aspirin. In addition, proper doses of aspirin plus ticlopidine may be a good choice for the prevention of ischemic stroke. Further studies are required to assess whether PAR determination could be useful for assessing patients at risk of stroke, and for drug selection for the prevention of stroke. fur J Neurol 6:57-61 (C) 1999 Lippincott Williams & Wilkins.