Τόμος 21 (2003) – Τεύχος 2+2Σ – Άρθρο 1 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 21 (2003) – Issue 2+2Σ – Article 1 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Από | | Α.Ι. Χατζητόλιος,A.I. Hatzitolios, Άρθρο - Article, Β. Μήρτσου-Φιδάνη,V. Mirtsou-Fidani, Πλήρες Κείμενο στα Ελληνικά - Full Text in Greek, Φ. Παπαδιδασκάλου,F. Papadidaskalou, Χ.Γ. Σαββόπουλος,Ch.G. Savopoulos

 

Τίτλος – Title

Αγγειακό Εγκεφαλικό Επεισόδιο (ΑΕΕ) – Πρωτογενής Πρόληψη και Δευτερογενής Προφύλαξη

Stroke: Primary and Secondary Prevention
Συγγραφέας – Author

Χ.Γ. Σαββόπουλος, Α.Ι. Χατζητόλιος, Φ. Παπαδιδασκάλου, Β. Μήρτσου-Φιδάνη

Ά Προπαιδευτική Παθολογική Κλινική,  Αριστοτέλειο Πανεπιστήμιο, Νοσοκομείο ΑΧΕΠΑ, Θεσσαλονίκη, Ελλάς

Ch.G. Savopoulos, A.I. Hatzitolios, F. Papadidaskalou, V. Mirtsou-Fidani

1st Medical Propedeutic Dept of Aristotles Univer­sity of Thessaloniki, AHEPA Hospital, Thessalo­niki, Greece
Παραπομπή – Citation

  Σαββόπουλος,Χ.Γ., Χατζητόλιος,Α.Ι., Παπαδιδασκάλου,Φ.,Μήρτσου-Φιδάνη,Β. : Αγγειακό Εγκεφαλικό Επεισόδιο (ΑΕΕ) – Πρωτογενής Πρόληψη και Δευτερογενής Προφύλαξη, Επιθεώρηση Κλιν. Φαρμακολ. Φαρμακοκινητ. 21: 61-72 (2003)

Savopoulos,Ch.G., Hatzitolios,A.I., Papadidaskalou,F., Mirtsou-Fidani,V. : Stroke: Primary and Secondary Prevention, Epitheorese Klin. Farmakol. Farmakokinet. 21: 61-72 (2003)
Ημερομηνία Δημοσιευσης – Publication Date
30 Μαρτίου 2003 – 2003-03-30
Γλώσσα Πλήρους Κειμένου –
Full Text Language

Ελληνικά – Greek
Παραγγελία – Αγορά –
Order – Buy
Ηλεκτρονική Μορφή: pdf (15 €) –
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Λέξεις κλειδιά – Keywords
Αγγειακό εγκεφαλικό επεισόδιο, πρωτογενής πρόληψη, δευτερογενής πρόληψη, καρδιαγγειακοί παράγοντες κινδύνου
Stroke, primary prevention, secondary prevention, cardiovascular risk factors
Λοιποί Όροι – Other Terms

Άρθρο

Article
Περίληψη – Summary

Τα Αγγειακά Εγκεφαλικά Επεισόδια (ΑΕΕ) αποτελούν τη συνηθέστερη εκδήλωση της εγκεφαλοαγγειακής νόσου, όντας η τρίτη κατά σειρά αιτία θανάτου στις δυτικές χώρες και η συνηθέστερη αιτία βαριάς αναπηρίας. Εκτός από την άμεση βλάβη του ασθενούς και του περιβάλλοντός του, προκαλούν και σημαντικότατη κοινωνικοοικονομική επιβάρυνση, ενώ μέχρι σήμερα δεν υπάρχουν κατάλληλες και αποτελεσματικές φαρμακευτικές δυνατότητες για την αντιμετώπισή τους. Ιδιαίτερη σημασία αποκτά η αναγνώριση τροποποιήσιμων παραγόντων που προδιαθέτουν στην εμφάνιση ή υποτροπή ΑΕΕ, καθώς και της αντιμετώπισής τους στα πλαίσια της πρωτογενούς και δευτερογενούς πρόληψης. Παράγοντες κινδύνου για ΑΕΕ που έχουν ήδη τεκμηριωθεί είναι αρτηριακή υπέρταση, κολπική μαρμαρυγή και άλλες καρδιακές παθήσεις, υπερλιπιδαιμία, σακχαρώδης διαβήτης, κάπνισμα, έλλειψη σωματικής άσκησης, παχυσαρκία, προηγούμενο εγκατεστημένο ή παροδικό ισχαιμικό εγκεφαλικό και καρωτιδική στένωση, ενώ η έρευνα συνεχίζεται και για άλλους δυνητικά παράγοντες κινδύνου, όπως κατάχρηση αλκοόλ, αντισυλληπτικά, αντιφωσφολιπιδαιμικά αντισώματα, υπερομοκυστεϊναιμία, αύξηση της C-RP και λοίμωξη με Helicobacter Pylori ή Chlamydia pneumoniae. Η αρτηριακή υπέρταση αποτελεί σύμφωνα με στοιχεία μεγάλων επιδημιολογικών μελετών (π.χ. Framing­ham, Roches­ter, PROCAM, MRFIT) τον ισχυρότερο τροποποιήσιμο παράγοντα, αφού απαντάται περίπου στο 70% όλων των περιπτώσεων ΑΕΕ. Η πρωτογενής πρόληψη πρέπει να έχει ως στόχο τόσο τη μείωση της συχνότητας των τροποποιήσιμων παραγόντων κινδύνου στο σύνολο του πληθυσμού, όσο και την αναγνώριση των ατόμων που διατρέχουν υψηλό κίνδυνο εμφάνισης ΑΕΕ. Δευτερογενής πρόληψη εφαρμόζεται σε άτομα που έχουν ήδη υποστεί ΑΕΕ και έχει στόχο την αποφυγή νέων επεισοδίων με τη χορήγηση αντιαιμοπεταλιακών (ασπιρίνη, διπυριδαμόλη, τικλοπιδίνη, κλοπιδογρέλη ή συνδυασμό τους), υπολιπιδαιμικών (κυρίως στατινών) και αντιϋπερτασικών φαρμάκων. Πρόσφατες μελέτες ερευνούν τυχόν πλεονεκτήματα διαφόρων κατηγοριών νεοτέρων φαρμάκων έναντι των συμβατικών αγωγών, λόγω ευνοϊκών φαρμακολογικών ιδιοτήτων και  πλειότροπων δράσεων που εμφανίζουν αυτά (συνδυασμοί αντιαιμοπεταλιακών, στατίνες, α-ΜΕΑ και ΑΤ1 ανταγωνιστές).

Strokes are the most usual manifesta­tion of cerebrovascular disease, being the third in order of cause of death in the Western countries and the most usual cause of severe disability. Apart from a major health problem of the patient and his rela­tives, strokes also cause significant socio-economic burden. Up to today there have not been established any effective therapy for the treatment of the acute event. So the recognition of modifiable risk factors, which predispose to the appearance or recurrence of stroke, as well as their treatment in primary and secondary preven­tion obtain a particular importance. Well-estab­lished risk factors are arterial hyperten­sion, atrial fibrillation and other heart diseases, hy­perlipi­daemia, diabetes mellitus, smoking, lack of physical exercise, obesity, previous installed or tran­sient ischaemic stroke and carotid stenosis, while the research is also continued for other possible factors, such as excessive alcohol con­sumption, contraceptives, antiphospholipid anti­bodies, hyper­homocysteinemia, increased CRP and Helicobacter Pylori or Chlamydia pneumo­niae infection. The hy­pertension constitutes ac­cording to evidence of large epidemiologic stud­ies (eg Framingham, Roch­ester, PROCAM, MRFIT) the major risk factor, as it is found almost in the 70% of all cases stroke. The primary pre­vention target should be the treatment by medi­cines or changes of lifestyle of the modifiable risk factors in the whole population and also the rec­ognition of individuals who appear a higher risk to develop a stroke. Secondary prevention is ap­plied to individuals who have already suffered from stroke and its objective is the avoidance of new episodes with the prescription of antiplatelets (aspirin, dypiridamole, ticlopidine, clopidogrel or their combi­nation), hypolipidaemics (mainly stat­ins) and anti­hypertensive drugs. Recent studies search possible advantages of various categories of newer drugs versus conventional therapy based on favourable pharmacological properties and their so called plio­tropic actions (antiplatelet drugs combinations, stat­ins, ACE inhibitors and AT1 antagonist).

Αναφορές – References
 1. Sacco R.L., Benjamin E.J., Broderick J.P. PA,et al.: Ameri­can Heart Association Prevention Conference. IV. Prevention and Rehabilitation of Stroke. Risk factors. Stroke 28: 1507-1517 (1997)

2. Broderick J., Brott T., Kothari R., et al.: The Greater Cincin­nati/Northern Kentucky Stroke Study: preliminary first-ever and total incidence rates of stroke among blacks. Stroke 29: 415-421 (1998)

3. Grundy S.M., Balady G.J., Criqui M.H., et al.: Guide to pri­mary prevention of cardiovascular diseases. A statement for healthcare professionals from the Task Force on Risk Reduc­tion. American Heart Association Science Advisory and Coordi­nating Committee. Circulation 95: 2329-2331 (1997)

4. Thomas A.P., Steven N.B., Stephen R.D., et al.: AHA Guide­lines for primary prevention of cardiovascular disease and stroke: 2002 Update. Circulation 106: 388-391 (2002)

5. Bronner L.L., Kanter D.S., Manson J.E.: Primary preven­tion of stroke. N. Engl. J. Med. 333: 1392-1400 (1995)

6. Warlow C.: Secondary prevention of stroke. Lancet 339: 724-727 (1992)

7. Barnett H.J., Eliasziw M., Meldrum H.E.: Drugs and surgery in the prevention of ischemic stroke. N. Engl. J. Med. 332: 238-248 (1995)

8. Futterman L.G., Lemberg L.: Stroke risk, cholesterol and statins. Am. J. Crit. Care 8: 416-419 (1999)

9. Kjeldsen S.E., Julius S., Hedner T., Hansson L.: Stroke is more common than myocardial infarction in hypertension: analysis based on 11 major randomized intervention trials. Blood Press 10: 190-210 (2001)

10. Joint National Committee on Detection, Evaluation, and Treatment of Blood Pressure. The sixth report of the NJC VI on Detection, Evaluation, and Treatment of Blood Pres­sure JNC VI. Arch. Intern. Med. 157: 2413-2446(1997)

11. Rahman K.M., Sarker C.B., Mohammad Q.D., et al.: Risk factors and clinical presentations-a study of eighty-five hospital admitted stroke cases. Mymensingh Med. J. 11: 113-115 (2002)

12. Ziakas G., Hatzitolios A., Savopoulos C., et al.: Correlation of dementia. Clinical manifestations with CT find­ings of cerebral atrophy in elderly patients with stroke. Gerontology Suppl 1: 37 (1998)

13. Stergiou G.S., Thomopoulou G.C., Skeva I.I., Mountokalakis T.D.: Prevalence, awareness, treatment, and con­trol of hypertension in Greece: the Didima study. Am. J. Hypertens. 12: 959-965 (1999)

14. Black H.R.: Isolated systolic hypertension in the elderly: lessons from clinical trials and future directions. J. Hypertens. 17(Suppl 5): S49-54 (1999)

15. Wolf P.A., D’Agostino R.B., O’Neal M.A., et al.: Secular trends in stroke incidence and mortality. The Framingham Study. Stroke 23: 1551-1555 (1992)

16. SHEP Cooperative Research Group: Prevention of stroke by antihypertensive drug treatment in older persons withisolated systolic hypertension. Final results of the Sys­tolic Hypertension in the Elderly Program (SHEP). JAMA. 265: 3255-3264 (1991)

17. Staessen J.A., Fagard R., Thijs L.: Randomised dou­ble-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Sys­tolic Hy­pertension in Europe (Syst-Eur) Trial Investigators. Lancet 350: 757-764 (1997)

18. MacMahon S., Peto R., Cutler J.. et al.: Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differ­ences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 335: 765-774 (1990)

19. Neaton J.D., Wentworth D.N., Cutler J.,.et al.: Risk factors for death from different types of stroke. Multiple Risk Factor Intervention Trial Research Group. Ann. Epidemiol. 3: 493-499 (1993)

20. Fagard R.H., Staessen J.A.: Treatment of isolated systolic hypertension in the elderly: the Syst-Eur trial. Sys­tolic Hyper­tension in Europe (Syst-Eur) Trial Investigators. Clin. Exp. Hypertens. 21(5-6): 491-497 (1999)

21. Brown M.J., Ca Staigne A., de Leenw P.W., et al.: Study population and treatment titration in the Indernational Nifedipine GITS Study: Intervention as a Goal in Hyperten­sion Treatment (INSIGHT). J. Hypertens. 16 (12Pt2): 2113-2116 (1998)

22. Stegmayr B., Asplund K., Kuulasmaa K., et al.: Stroke incidence and mortality correlated to stroke risk factors in the WHO MONICA Project. An ecological study of 18 population. Stroke 28: 1367-1374 (1997)

23. Dahlof B., Devereux R.B., Kieldsen S.E., et al.: Cardio­vascular morbidity and mortality in the Losartan Interven­tion For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 59: 995-1003 (2002)

24. Gorelick P.B.: Stroke prevention. Arch. Neurol. 52: 347-355 (1995)

25. Sandercock P.: Statins for stroke prevention? Lancet 357: 1548-1549 (2001)

26. Pedersen T.R., Kjekshus J., Pyorala K., et al.: Effect of simvastatin on ischemic signs and symptoms in the Scan­dina­vian Simvastatin Survival Study(4s): Am. J. Cardiol. 81: 333-336 (1998)

27. Iso H., Jacobs D.R.,Jr, Wentworth D., et al.: Serum choles­terols level and six years mortality from stroke in 350977 men screened for the multiple risk factor interven­tion trial. N. Eng. J. Med. 320: 904-910 (1989)

28. Executive Summary of The Third Report of The Na­tional Cholesterol Education Program (NCEP) Expert Panel on De­tection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 285: 2486-2497 (2001)

29. Lin H.J., Wolf P.A., Kelly-Hayes M., et al.: Stroke sever­ity in atrial fibrillation. The Framingham Study. Stroke 27: 1760-1764 (1996)

30. Fuster V., Ryden L.E., Asinger R.W., et al.: ACC/AHA/ ESC Guidelines for the Management of Patients With Atrial Fibrilla­tion: Executive Summary A Report of the American College of Cardiology/American Heart Associa­tion Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North Ameri­can Soci­ety of Pacing and Electrophysiology. Circulation 104: 2118-2150 (2001)

31. Peila R., Rodriguez B.L., Launer L.J.: Type 2 diabetes, APOE gene, and the risk for dementia and related patholo­gies: The Honolulu-Asia Aging Study. Diabetes 51: 1256-1262 (2002)

32. Berger K., Schulte H., Stogbauer F., et al.: Incidence and Risk Factors for Stroke in an Occupational Cohort: The PRO­CAM-Study. Stroke 29: 1562-1566 (1998)

33. American Diabetes Association: clinical practice rec­om­mendations 1999. Diabetes Care 22(Suppl 1): S1-S114 (1999)

34. Lasker R.D.: The diabetes control and complications trial. Implications for policy and practice. N. Engl. J. Med. 329: 1035-1036 (1993)

35. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 22(suppl 1): S32-S41 (1999)

36. Grundy S.M., Benjamin I.J., Burke G.L., et al.: Diabetes and cardiovascular disease: a statement for healthcare profession­als from the American Heart Association. Circu­lation 100: 1134-1146 (1999)

37. Wolf P.A., D’Agostino R.B., Kannel W.B., et al.: Ciga­rette smoking as a risk factor for stroke. The Framingham Study. JAMA 259: 1025-1029 (1988)

38. Agency for Healthcare Policy and Research. Treating To­bacco Use and Dependence: US Department of Health and Human Services Public Health Services Report. Was­ington DC: US Government Printing Office; 2000

39. Kawachi I., Colditz G.A., Stampfer M., et al.: Smoking Ces­sation and Decreased Risk of Stroke in Women. JAMA 269: 232-236 (1993)

40. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults:The Evi­dence Report. National Institutes of Health. Obes. Res. 6 (Suppl. 2): S51-S209 (1998)

41. Hatzitolios A.I., Savopoulos Ch.G., Markoglou N.Ch., et al.: Correlation between abdominal obesity with other Car­diovas­cular Risk Factors in patients over 65 years with ischaemic stroke. Proceedings of 2nd International Con­gress on Cardio­vascular Diseases, Kosice Slovakia 2002. Cardiovascular Dis­eases 2002. (P. Mitro et al., eds) Mon­duzzi Editore International Proceedings Division, Bologna, 2002,pp 343-346. (Abstract) Int. J. Cardiol. 82 (Suppl): S36 (2002)

42. Kiely D.K., Wolf P.A., Cupples L.A., et al.: Physical activity and stroke risk: the Framingham Study. Am. J. Epidemiol. 140: 608-620 (1994)

43. American College of Sports Medicine. ACSM’s Guide­lines for Exercise Testing and Prescription 6th ed., Balti­more, Md: Lippincott Williams and Wilkins; 2000

44. Py M.O., Andre C., Azevedo F.S., et al. : Comparison be­tween the NASCET method and subjective visual im­pression in the evaluation of internal carotid artery stenosis. Arq. Neurop­siquiatr. 59(3-B): 672-567 (2001)

45. Zanchetti A., Bond M.G., Hennig M., et al.: Calcium antago­nist lacidipine slows down progression of asymptomatic carotid atherosclerosis: principal results of the European Lacidipine Study on Atherosclerosis (ELSA), a randomized, double-blind, long-term trial. Circulation 106: 2422-2427 (2002)

46. Bellosta S., Ferri N., Arnaboldi L., et al.: Pleiotropic effects of statins in atherosclerosis and diabetes. Diabetes Care 23 (Suppl 2): 72-78 (2000)

47. Comparato C., Altana C., Bellosta S., et al.: Clinically rele­vant pleiotropic effects of statins: drug properties or effects of profound cholesterol reduction? Nutr. Metab. Cardiovasc. Dis. 11: 328-343 (2001)

48. Moore R.D., Pearson T.A.: Moderate alcohol consump­tion and coronary artery disease. A review. Medicine (Bal­timore) 65: 242-267 (1986)

49. Thornton J.R.: Atrial fibrillation in healthy non-alcoholic people after an alcoholic binge. Lancet 2: 1013-5 (1984)

50. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception: Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: re­sults of an international, multicentre, case-control study. Lancet : 505–510 (1996)

51. Mosca L., Grundy S.M., Judelson D., et al.: AHA/ACC sci­entific statement: consensus panel statement. Guide to preven­tive cardiology for women. American Heart Associa­tion/American College of Cardiology. J. Am. Coll. Cardiol. 33: 1751-1755 (1999)

52. Ridker P.M., Glynn R.J., Hennekens C.H.: C-reactive pro­tein adds to the predictive value of total and HDL cho­lesterol in determining risk of first myocardial infarction. Circulation 97: 2007-2011 (1998)

53. Ziakas G., Hatzitolios A., Kounanis A., et al.: Fibrino­gen, C-Reactive Protein and Albumin-Globulin ratio as risk factors in stroke 1st International Congress on Heart Dis­ease: New trends in research,diagnosis and treatment, Wasington DC, USA, 1999

54. Hatzitolios A., Eleftheriadis N., Chatzidimitriou M., et al.: The role of Helicobacter Pylori infection in Ischemic Cere­brovascular Disease. 4th World Stroke Conference, Mel­bourne, Australia, 2000

55. Hatzitolios A.I., Savopoulos Chr.G., Chatzidimitriou M.A. et al. Cardiovascular Diseases 2002 2nd International Congress on Cardiovascular Diseases. P. Mitro et al (eds). Monduzzi Editore International Proceedings Division, Bolo­gna, 2002, pp 347-349. (Abstract) Intern. J. Cardiol. (IJ/C) 82 (Suppl): 56 (2002)

56. Evers S., Koch K.H., Grotemeyer K.H., et al.: Features, Symptoms, and neurophysiological Findings in Stroke Associ­ated with Hyperhomocysteinemia. Arch. Neurol. 54: 1276-1282 (1997)

57. Clarke R., Daly L., Robinson K., et al.: Hyperomocys­teine­mia: An independent risk factor for vascular disease. N. Engl. J. Med. 324: 1149-1155 (1991)

58. MacMahon M., Kirkpatrick C., Cummings C.E. et al.: A pilot study with simvastatin and folic acid/vitamin B12 in preparation for the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH). Nutr. Metab. Car­diovasc. Dis. 10: 195-203 (2000)

59. Ocke M.C., Bueno-de-Mesquita H.B., Feskens E.J. et al.: Repeated measurements of vegetables, fruits, beta-carotene, and vitamins C and E in relation to lung cancer. The Zutphen Study. Am.J. Epidemiol. 145: 358-365 (1997)

60. Hertog M.G., Feskens E.J., Hollman P.C., et al.: Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 342: 1007-1011 (1993)

61. Tribble D.L.: AHA Science Advisory. Antioxidant con­sump­tion and risk of coronary heart disease: emphasison vitamin C, vitamin E, and beta-carotene: A statement for healthcare pro­fessionals from the American Heart Associa­tion. Circulation 99: 591-595 (1999)

62. Peto R., Gray R., Collins R., et al.: Randomized trial of prophylactic daily aspirin in British male doctors. Med. J. (Clin. Res. Ed.) 296: 313-316 (1988)

63. Manson J.E., Stampfer M.J., Colditz G.,et al.: A pro­spective study of aspirin use and primary prevention of cardiovascular disease in women. JAMA 266: 521-527 (1991)

64. Final report on the aspirin component of the ongoing Physi­cians’ Health Study. Steering Committee of the Physi­cians’ Health Study Research Group. N. Engl. J. Med. 32: 129-135 (1989)

65. Lee I.M., Hennekens C.H., Berger K, et al.: Exercise and risk of stroke in male physicians. Stroke 30: 1-6 (1999)

66. Shinton R., Sagar G: Lifelong exercise and stroke. BMJ 307: 231-234 (1993)

67. Hacke W., Kaste M., Fieschi C., et al.: Randomized double-blind placebo-controlled trial of thrombolytic therapy with intra­venous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lan­cet 352:1245-1251 (1998)

68. Sacco R.L., Shi T., Zamanillo M.C., Kargman D.E.: Predic­tors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study. Neurology 44: 626-634 (1994)

69. Viitanen M., Eriksson S., Asplund K.: Risk of recurrent stroke, myocardial infarction and epilepsy during long-term follow-up after stroke. Eur. Neurol. 28: 227-31 (1988)

70. Χατζητόλιος Α.Ι.: Πρώτα αποτελέσματα από την αντιμετώπιση ασθενών σε ειδικό Τμήμα Αγγειακών Εγκεφαλικών Επεισοδίων σε Παθολογική Κλινική. 1ο Πανελλήνιο Συνέδριο Αγγειακών Εγκεφαλικών Νόσων, Θεσσαλονίκη 1999 (Εισήγηση)

71. Coccheri S., Palareti G., Fortunato G.: Antithrombotic drugs in peripheral obliterative arterial diseases. Haemo-stasis 24: 118-127 (1994)

72. Diener H.C.: Antiplatelet drugs in secondary prevention of stroke: lessons from recent trials. Neurology 49(5Suppl 4): S75-S81 (1997)

73. Diener H.C.: Aspirin dose in secondary prevention of stroke. Cerebrovasc. Dis. 8: 360; 361-362 (1998)

74. Lowenthal A.: Secondary prevention of myocardial infarc­tion in the first European Stroke Prevention Study. Thromb. Res. Suppl. 12: 59-63 (1990)

75. Sivenius J., Cunha L., Diener H.C., et al.: Second European Stroke Prevention Study: antiplatelet therapy is effective re­gardless of age. ESPS2 Working Group.
Acta Neurol. Scand. 99: 54-60 (1999)

76. Nagore E., Perez-Ferriols A., et al.: Photosensitivity associ­ated with treatment with triflusal. J. Eur. Acad. Dermatol. Venereol. 14: 219-221 (2000)

77. Hass W.K., Easton J.D., Adams H.P.,Jr et al.: A ran­domized trial comparing ticlopidine hydrochloride with aspi­rin for the prevention of stroke in high-risk patients. Ti­clopidine Aspirin Stroke Study Group. N. Engl. J. Med. 321: 501-507 (1989)

78. Gent M., Blakely J.A., Easton J.D., et al.: The Canadian American Ticlopidine Study (CATS) in thromboembolic stroke. Lancet 1: 1215-1220 (1989)

79. A randomized, blinded, trial of clopidogrel versus aspi­rin in patients at risk of ischaemic events (CAPRIE). CA­PRIE Steer­ing Committee. Lancet. 1996; 348: 1329-1339

80. Grotemeyer K.H., Evers S., Fischer M., et al.: Pi­racetam versus acetylsalicylic acid in secondary stroke prophylaxis. A double-blind, randomized, parallel group, 2 year follow-up study. J. Neurol. Sci. 181: 65-72 (2000)

81. Yusuf S., Phil D., Sleight P., et al.: Effects of an Angio­tensin-converting-enzyme inhibitor, Ramipril, on cardiovas­cular events in high-risk patients. N. Engl. J. Med. 342: 145-153 (2000)

82. Psaty B.M., Weiss N.S., Furberg C.: The PROGRESS trial: questions about the effectiveness of angiotensin con­verting enzyme inhibitors. Perindopril pROtection aGainst REcurrent Stroke Study. Am. J. Hypertens. 15: 472-474 (2002)

83. Hansson L., Lithell H., Skoog I., et al.: Study on Cogni­tion and Prognosis in the Elderly (SCOPE): Baseline Char­acteris­tics. Blood Press. 9: 146-151 (2000)

84. Schrader J., Luders S., Kulschewski A., et al: ACCESS-Study: Acute Candesartan Cilexetil Evaluation in Stroke Survi­vors-final results. Deutsche Medizinische Wochen-schrift 126 (Suppl 3): S155, Abs V 1-2 (2001)

85. Hatzitolios Α., Savopoulos Chr., Kounanis A., et al.: Bene­fits of combined antihypertensive treatment in patients with heart disease, nephropathy, diabetes melitus and stroke. Proceeding of 2nd International Congress on Heart Disease. International Academy of Cardiology. Heart Dis­ease: New trends in re­search, diagnosis and treatment. Washington DC, 2001. Asher Kimchi (ed), Medimond Pub­lishing Co, Englewood, NJ, 2001

86. Asplund K.: Care for stroke patients in Scandinavia and in the neighboring countries. Nord. Med. 112: 310-311 (1997)

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