Aspirin benefits patients with stroke–but only just

Aspirin given soon after a stroke reduces deaths and disability by 1%–a modest but noteworthy effect–while heparin fails to offer any significant clinical advantage, according to the results of the international stroke trial.

The trial is the largest to look at the acute treatment of stroke (Lancet 1997;349:1569-81). A total of 19 435 patients with suspected acute ischaemic stroke were randomly allocated aspirin (300 mg a day), heparin (5000 IU or 12500 IU twice a day), aspirin plus heparin, or no treatment within 48 hours of the start of symptoms; treatment was continued until discharge or for up to 14 days.

The results show …