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Aspirin May Be Better Stroke Preventer Than Coumadin, Study Finds

March 31, 2005

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Patients taking Coumadin to prevent a stroke might be better off taking common aspirin, new research suggests. In a study of 569 stroke patients with narrowing of brain arteries, those on Coumadin suffered a higher death rate than those who took aspirin.

The study was published in this week's New England Journal of Medicine.

The lead author of the study, Emory University neurologist Marc Chimowitz, cautioned that patients should check with their physician before they stop taking Coumadin or add aspirin to their daily regimen.

In the study, patients who had previously suffered a stroke because of fatty deposits in their arteries were randomly given either Coumadin (warfarin) or high doses of aspirin.

During the follow-up, about one in five patients died from circulatory problems, had another stroke or suffered a brain hemorrhage regardless of which drug they took. But those taking Coumadin were more likely to die. Nearly 10 percent of the Coumadin patients died, compared with four percent of those who took aspirin.

The patients who took Coumadin also had a higher risk of major bleeding, heart attack or sudden death, the researchers said.

The aspirin dosage used in the study -- 1,300 milligrams per day -- is higher than generally recommended for heart attack and stroke prevention. It was used because previous studies indicated it was an effective dose for this particular condition. It's not clear whether other doses would work as well.

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