Anticoagulant vs anti-platelet therapy as prophylactic against cerebral infarction in transient ischemic attacks.

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Abstract
Patients (156) with transient ischemic attacks (TIA) or reversible ischemic neurological deficit (RIND) were given prophylactic anticoagulant (AC) treatment against cerebral infarction in a prospective multicenter study from 5 hospitals in southern Sweden. After 2 mo. of AC treatment 135 patients remained in the study and were randomized into 2 groups; 1 continued with AC treatment and 1 changed to anti-platelet therapy. The patients were followed for 12 mo. No significant difference was seen between the 2 groups but 3 completed cerebral infarctions occurred during anti-platelet therapy against 1 during AC treatment. One cerebral hemorrhage was seen during AC treatment. All completed strokes occurred in men who initially had carotid symptoms. The number of patients with TIA/RIND was higher in the anti-platelet group whereas myocardial infarctions occurred more often during AC treatment. Compared to the natural history of untreated TIA/RIND both treatments had a prophylactic effect against cerebral infarction.