Sivenius J, Riekkinen P J, Laakso M, Smets P, Lowenthal A
Department of Neurology, University of Kuopio, Finland.
Acta Neurol Scand. 1993 Feb;87(2):111-4. doi: 10.1111/j.1600-0404.1993.tb04087.x.
The ESPS was a multicenter study comparing the effect of the combination of dipyridamole 75 mg and acetylsalicylic acid 330 mg t.i.d. to placebo in 2500 patients (intention-to-treat analysis) and 1861 patients (explanatory analysis) in the secondary prevention of stroke or death after one or more attacks of TIA, RIND or stroke of atherothrombotic origin. End-point reduction was evaluated in two age groups, those not older than 65 years (1358 patients) and those who were older than 65 years (1142 patients). End-point reduction was significantly greater in patients with active therapy than in the placebo group in both age groups. Subgroup analyses with stroke as an end-point indicated that younger patients with TIA (< or = 65 years) had lower risk of stroke than those > 65 years or patients with stroke. The overall risk reduction was best in TIA patients > 65 years of age. The risk reduction with study medication was 40-50% in both sexes and in both age groups. Thus, age of the patient does not influence the efficacy of antithrombotic therapy. However, since these results are obtained from a secondary analysis of a subgroup of patients, the results may need confirmation by further studies.
欧洲脑卒中预防研究(ESPS)是一项多中心研究,在2500例患者(意向性分析)和1861例患者(解释性分析)中,比较双嘧达莫75毫克与乙酰水杨酸330毫克每日三次联合用药与安慰剂在短暂性脑缺血发作(TIA)、可逆性缺血性神经功能缺损(RIND)或动脉粥样硬化性血栓形成性卒中一次或多次发作后预防卒中或死亡方面的效果。在两个年龄组中评估终点事件的减少情况,即年龄不超过65岁的患者(1358例)和年龄超过65岁的患者(1142例)。在两个年龄组中,积极治疗组患者的终点事件减少均显著大于安慰剂组。以卒中为终点的亚组分析表明,年龄较轻的TIA患者(≤65岁)发生卒中的风险低于年龄大于65岁的患者或卒中患者。总体风险降低在年龄大于65岁的TIA患者中最为明显。研究药物在两个年龄组的男性和女性中降低风险的幅度均为40% - 50%。因此,患者年龄不影响抗血栓治疗的疗效。然而,由于这些结果是从患者亚组的二次分析中获得的,可能需要进一步研究加以证实。