- The following statements about stroke are correct:
- Aspirin is helpful in the primary prevention of stroke in patients without cardiac disease
- Ticlopidine is superior to aspirin in reducing the risk of stroke following TIAs
- A progressing CVA may benefit from anticoagulation
- Carotid endarterectomy is superior to medical treatment in symptomatic patients with significant carotid artery stenosis
- Aspirin, used alone, reduces the risk of stroke in patients with non-rheumatic atrial fibrillation
- (F, T, T, T, T) Aspirin increased the risk of haemorrhagic stroke when used in a primary prevention trial but it is of proven benefit in secondary prevention (following TIAs or a stroke). In patients with atrial fibrillation or rheumatic valve disease, aspirin does reduce the risk of embolic stroke but anticoagulation with warfarin is preferable. Ticlopidine is a platelet antagonist that is more effective than aspirin but its side-effects (neutropenia in up to 10%) limit its use in the UK although it is widely used in Europe and the USA. Embolic strokes may benefit from anticoagulation and/or thrombolysis; warfarin is more effective than aspirin which is better than nothing. There is no proven benefit of anticoagulation for patients with `Lone AF’ below the age of 50 years.