Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917798 (cerebral ischemia)
 17,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review is given on the clinical studies performed with aspirin in patients with chronic vascular occlusions of the limbs and on studies in cerebral ischemia using aspirin and sulfinpyrazone. Aspirin reduces the risk of reocclusions in patients after vascular surgery and also reduces the risk of peripheral vascular occlusions in diabetic patients. In doses of 1.2-1.5 g/day it also reduces the frequency of transient ischemic attacks. Conclusive results of similar studies with sulfinpyrazone and dipyridamole can be expected of the ongoing studies. Aspirin has no effect on the course of glomerulonephritis in children. Warfarin plus dipyridamole seem to have some effect in patients renal allografts. Sulfinpyrazone and ASA reduced the incidence of shunt thromboses in hemodialyzed patients. Several case reports in patients with thrombocytemia or Raynaud's syndrome made it likely that treatment with antiplatelet drug reduces the incidence of vascular occlusions.
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PMID:Use of platelet inhibitor drugs in peripheral and cerebral vascular disorders. 36 58

Acetyl salicylic acid, sulfinpyrazone, dipyridamole, hydroxychloroquine, ticlopidine, clofibrate, nicergoline are the most used antiplatelet drugs. A. S. A. and sulfinpyrazone have been tested in several large scale clinical trials. A. S. A. seems beneficial in the prevention of cerebral ischemia for patients, specially men who have previously had a transient cerebral ischemic attack. Sulfinpyrazone appears to be effective in reducing cardiac deaths during the first year after myocardial infarction.
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PMID:[Antiplatelet drugs (author's transl)]. 52 34

Platelet suppressant drugs have been suggested as beneficial for patients with transient cerebral ischemic attacks and these drugs have been shown to lengthen shortened platelet survival time. In the present study platelet survival time (autologous labeling with 51Chromium) was measured in 25 patients with transient cerebral ischemia involving a carotid distribution. Platelet survival was shortened in all patients (2.5 +/- 0.10 days; AVE t 1/2 +/- SEM; Normal 3.7 +/- 0.04 days P less than 0.001). Sulfinpyrazone increased platelet survival in 9 of 19 (47%) of patients (2.4 +/- 0.10 to 2.8 +/- 0.16 days; P less than 0.01). Of the 19 treated with sulfinpyrazone, 10 had a marked reduction in the frequency of transient ischemic episodes and an increased in platelet survival (2.6 +/- 0.16 to 3.1 +/- 0.22 days; P less than 0.01) was observed in all patients. Three patients had no benefit from sulfinpyrazone and alteration of platelet survival did not occur. Results suggest that platelet survival is shortened in patients with transient cerebral ischemia, that sulfinpyrazone increases platelet curvival and may decrease the frequency of ischemic episodes, and that there may be a relationship between clinical benefit and alteration of platelet survival time.
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PMID:Effect of sulfinpyrazone on platelet survival time in patients with transient cerebral ischemic attacks. 87 Oct 29

Aspirin is of proven value as an antithrombotic drug. In unstable angina it reduces the risk of death and myocardial infarction by half. After a myocardial infarction it reduces the risk of death by about 10% and of coronary incidence (coronary death or definite myocardial infarction) by about 25%. These effects appear to be additive with those of beta-blocking drugs. Aspirin also reduces the risk of occlusion of aortocoronary saphenous vein grafts by about half. In transient cerebral ischaemia, aspirin may reduce the risk of stroke and death by 50%. In most clinical trials to date the daily dose of aspirin ranges from 325 mg to 1400 mg. Interest in very low doses of aspirin (less than 60 mg daily) is considerable but has yet to be translated into proven clinical benefit. Dipyridamole has not been shown to be effective as an antithrombotic when used alone. Its antiplatelet action ex vivo may be enhanced by combination with aspirin but clinical trials have shown relatively little advantage of the combination over aspirin alone. Sulphinpyrazone has not become established as a first line antithrombotic drug. Epoprostenol is useful in extracorporeal circulations to prevent platelet consumption and possibly in severe inoperable peripheral vascular disease.
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PMID:Aspirin and other antiplatelet drugs in the prophylaxis of thrombosis. 333 89

Two randomized, double-blind clinical trials in cerebrovascular disease are described. The Controlled trial of Aspirin in Cerebral Ischemia compared aspirin (650 mg twice daily) with placebo in medically and surgically treated groups of patients who had experienced transient ischemic attacks. The Randomized Trial of Aspirin and Sulfinpyrazone in Threatened Stroke compared aspirin (325 mg four times daily), sulfinpyrazone (200 mg four times daily) and aspirin plus sulfinpyrazone with placebo in patients with transient cerebral ischemia.
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PMID:Summary of design features: clinical trials of platelet-active drugs in cerebrovascular disease. 700 55

Four antiplatelet drugs have been evaluated in cerebrovascular disease and in coronary heart disease--dipyridamole, clofibrate, sulfinpyrazone, and aspirin. There is no evidence that dipyridamole or clofibrate is beneficial in patients with stroke or myocardial infarction. Aspirin is effective in reducing stroke and death in patients with transient cerebral ischemia. Although aspirin has not been reported to significantly (statistically) reduce mortality or frequency of ischemic events in patients with acute myocardial infarction, five of six randomized trials showed a similar favorable trend. Sulfinpyrazone seems to be ineffective in the treatment of transient cerebral ischemia, but there is evidence that it decreases the incidence of sudden death in patients with myocardial infarction. In patients with prosthetic heart valves, the combined use of aspirin or dipyridamole with an oral anticoagulant is more effective in preventing systemic embolism than an oral anticoagulant alone.
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PMID:Selection and results of antiplatelet therapy in the prevention of stroke and myocardial infarction. 700 33