[Role of antiplatelet agents in the prevention of cerebral ischemic accidents].

This is a critical review of controlled therapeutic trials concerned with the use of anti-platelet agents in the prevention of cerebral ischaemic accidents due to atherosclerosis (CIADA). Amongst the 4 substances studied in 9 trials, dipyridamole, clofibrate, sulfinpyrazone and aspirin, only aspirin at the dose of 1 g brought about a statistically significant reduction in the risk of cerebral infarction and death in patients who had suffered an initial transient or rapidly regressive cerebral ischaemic accident. Nevertheless, this preventive action was seen in only one of the 5 studies devoted to aspirin and was found only in men, in particular where there was no history of diabetes or myocardial infarction. Although encouraging, this result requires confirmation by other studies before any definite conclusion is drawn as to the efficacy of aspirin in the secondary prevention of CIADA.