title: Enteric-coated aspirin versus other antiplatelet drugs in acute non-cardioembolic ischemic stroke: post-marketing study in Japan.
abstract: BACKGROUND
  Japanese guidelines recommend aspirin 160-300 mg/day, starting within 48 h, for patients with acute cerebral infarction. However, there are few reports evaluated in Japanese patients. Our objective was to examine the safety and efficacy of enteric-coated aspirin, compared with other oral antiplatelet drugs, in Japanese patients with acute ischemic stroke.
  
  
  METHODS
  We performed a prospective, non-randomized, observational and multicenter study between June 2005 and December 2007. Patients with symptomatic acute ischemic stroke, including transient ischemic attack (TIA), who started enteric-coated aspirin or other antiplatelet drugs within 7 days of hospitalization were registered. Outcome measures evaluated within 3 months were incidence of cerebral and non-cerebral hemorrhagic events, recurrence of ischemic stroke or TIA, non-cerebral ischemic events and death from any cause.
  
  
  RESULTS
  Overall, 2,548 and 830 patients treated with enteric-coated aspirin (100-300 mg/day) or other antiplatelet drugs, respectively, were registered; approximately 60% were male, mean age was 70 years, 85% had pre-existing cardiovascular disease or other complications. Enteric-coated aspirin of 100 mg was mainly prescribed, and only approximately half of the patients were started on it within 48 h after onset of ischemic stroke. Safety and efficacy population excluded patients without follow-up data were 2,521 in enteric-coated aspirin and 807 in other antiplatelets. Hemorrhagic events occurred in 46 (1.8%) in the enteric-coated aspirin group and in 13 (1.6%) in the other antiplatelet drugs group, there was not significant. Recurrent ischemic stroke or TIA occurred in 39 (1.5%) of the enteric-coated aspirin and in 18 (2.2%) of other antiplatelet drugs, and there were any-cause death in 16 (0.6%) and 8 (1.0%). Incidences were slightly lower in the enteric-coated aspirin group compared with the other antiplatelet drugs group, but not statistically significant.
  
  
  CONCLUSIONS
  It seems that these results showed the safety and efficacy of the enteric-coated aspirin in acute stroke care in Japanese patients. Incidence of hemorrhagic events was comparable between the enteric-coated aspirin group and the other antiplatelet drugs group.
authors.affiliation: Medical Affairs, Bayer Yakuhin, Ltd., 2-4-9 Umeda, Kita-ku, Osaka, 530-0001, Japan, shunichi.takahashi@bayer.com.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Mizuno
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Lyo
authors.initials: L
authors.lastname: Inuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D002544:Cerebral Infarction / Q000188:drug therapy*; D000077407:Cilostazol; D004176:Dipyridamole / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy; D013386:Succinates / Q000627:therapeutic use*; D013608:Tablets, Enteric-Coated; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D013386:Succinates; D013608:Tablets, Enteric-Coated; D013777:Tetrazoles; C064294:sarpogrelate; D004176:Dipyridamole; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin