[Antithrombotic agents and prevention of cerebrovascular accidents].

Prevention remains a major therapeutic approach of stroke. Inhibitors of platelet aggregation are the treatment of choice in the secondary prevention of an arterial embolism stroke. Aspirin (200-300 mg/d) is the most commonly used drug, ticlopidine (500 mg/d) is advised if aspirin is contraindicated or if a recurrent stroke of arterial embolism origin occurs in spite of treatment with aspirin. We are waiting with interest for the results of the clinical trial of clopidogrel, a derivative of ticlopidine. Till now, no studies have proved the benefit of antiplatelet treatment in the primary prevention of stroke. In non rheumatic atrial fibrillation, the unanimous results of recent studies confirmed the benefit of oral anticoagulation in the primary and secondary prevention of stroke. Although coumadin is superior to aspirin in non rheumatic atrial fibrillation, aspirin is an efficient alternative when anticoagulation is contraindicated.