[Side effects of antithrombotic treatment in the secondary prevention of cerebrovascular disease].
OBJECTIVE
To determine the incidence of adverse effects of antithrombotic drugs (platelet anti-aggregants and anticoagulants) in patients with transient ischemic attacks (TIA) and mild ischemic strokes (IL).


METHODS
Clinical follow-up data on the patients with TIA and IL included in a community-based observational study undertaken in the province of Segovia. Adverse effects which led to suspension of treatment or were a potential danger for the patient's life were recorded.


RESULTS
The groups studied included 235 patients and the average initial age was 70.8 years. The average follow-up time was 3.6 years. The treatment initially given included: aspirin (75.7%), ticlopidine (12.8%) and acenocumarol (9.4%). Adverse effects led to suspension of treatment in 6% (5% with aspirin and acenocumarol, 17% with ticlopidine). The adverse effects of ticlopidine were mild and patients did not need admission to hospital (cutaneous exanthema, diarrhoea and reversible leucopenia). Aspirin was associated with digestive tract bleeding (2.8%) and cerebral hemorrhage (1.7%) which required hospital admission in most cases. One patient treated with acenocumarol presented with a retroperitoneal hematoma.


CONCLUSIONS
In general antithrombotic drugs are well-tolerated by patients with TIA and LI. Hemorrhagic complications, particularly of the digestive tract, associated with aspirin limit tolerance to it.
Sempere
A P
AP
Servicio de Neurología, Hospital General de Segovia, España. aperezs@meditex.es
Ferrero
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M
Tahoces
M L
ML
Duarte
J
J
Tabernero
C
C
Cabezas
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C
Guerrero
P
P
Clavería
L E
LE
D000074:Acenocoumarol / Q000009:adverse effects*; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D012307:Risk Factors; D012720:Severity of Illness Index; D013988:Ticlopidine / Q000009:adverse effects*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000074:Acenocoumarol; D013988:Ticlopidine; D001241:Aspirin