Retrospective analysis of aspirin and ticlopidine in preventing recurrent stroke following an initial lacunar infarct.

Of 73 patients with initial lacunar stroke subsequently treated with aspirin, 13 (18%) developed recurrent stroke (11 lacunar infarcts and 2 nonlacunar infarcts), and 4 (5%) died within 1 year. Of the aspirin-treated lacunar infarct patients, 58 received 325 mg or lower-dose aspirin, and 15 received 600-1,300 mg of aspirin. Thirteen aspirin-treated patients who developed recurrent ischemic stroke received 80 mg or 325 mg of aspirin, whereas recurrent stroke did not occur in 15 patients treated with 600-1,300 mg of aspirin daily. Of 25 patients with lacunar stroke who were subsequently treated with 250 mg of ticlopidine twice daily, 1 patient (4%) developed recurrent lacunar infarct, and none died within 1 year. Of 10 patients who had an initial lacunar stroke and subsequently received no antiplatelet medication, 4 (40%) developed recurrent lacunar stroke, and 1 (10%) died within 1 year.