salicylates and Cerebrovascular-Disorders

To compare the efficacy and tolerability of the antiplatelet agent triflusal with aspirin in the prevention of cardiovascular events following acute myocardial infarction.. In this double-blind, multicentre, sequential design study, patients were randomized within 24 h of acute myocardial infarction symptom onset to receive triflusal 600 mg or aspirin 300 mg once daily for 35 days. The primary end-point was death, non-fatal myocardial reinfarction or a non-fatal cerebrovascular event. The incidences of these individual outcomes and urgent revascularization were secondary end-points. The null hypothesis of no difference between treatments in the primary combined end-point was accepted with 80% power after recruiting 2124 validated patients (odds ratio (OR) for failure [95% confidence interval (CI)]: 0.882 [0.634-1.227]). Non-fatal cerebrovascular events were significantly less frequent with triflusal (OR [95% CI]: 0.364 [0.146-0.908]; P = 0.030). There was no significant difference between treatments for death (OR [95% CI]: 0.816 [0.564-1.179]; P = 0.278), non-fatal reinfarction (OR [95% CI]: 1.577 [0.873-2.848]; P = 0.131) or revascularization (OR [95% CI]: 0.864 [0.644-1.161]; P = 0.334). Overall, both drugs were well tolerated, although there was a trend towards fewer bleeding episodes with triflusal; significantly fewer central nervous system bleeding episodes were observed in triflusal-treated patients (0.27% vs. 0.97%; P = 0.033).. Triflusal and aspirin have similar efficacy in preventing further cardiovascular events after acute myocardial infarction, but triflusal showed a more favourable safety profile. Triflusal significantly reduced the incidence of non-fatal cerebrovascular events compared with aspirin.

Topics: Aged; Aspirin; Cerebrovascular Disorders; Double-Blind Method; Female; Humans; Male; Middle Aged; Myocardial Infarction; Platelet Aggregation Inhibitors; Recurrence; Salicylates; Spain; Treatment Outcome

Vascular dementia is the second commonest cause of dementia after Alzheimer's disease. The most important risk factor for this is previous cerebral vascular accident.. To eliminate the risk factors and/or progression of this illness would be of considerable benefit to these patients. Triflusal, a platelet anti-aggregant chemically related to the salicylates, whose clinical efficacy has been shown in cardiac and cerebrovascular pathology, has been used in the treatment of patients with vascular dementia.. An open study was done a sample of 73 patients with vascular dementia randomly distributed into two groups (control and undergoing treatment with triflusal).. To check the efficacy of treatment with triflusal, the percentage of variation in the scoring of the Cognitive Mini Examination was used after a clinical course of 12 months (IVP 12), considering the critical point of no efficacy to be a loss equal or greater than 10%. In the control group, 33% (8/24) and in the group treated with triflusal 8% (3/35) had a negative course which was greater than this critical point.. The difference in the IVP 12 between the two groups was statistically significant (p = 0.0375), with a statistical power of 87% (beta = 0.13). This gives triflusal a therapeutic activity which is sufficient to limit cognitive deterioration of patient with vascular dementia.

Topics: Aged; Cerebrovascular Disorders; Dementia, Vascular; Female; Humans; Male; Platelet Aggregation Inhibitors; Retrospective Studies; Risk Factors; Salicylates

Topics: Cerebrovascular Disorders; Clinical Trials as Topic; Clopidogrel; Coronary Artery Disease; Humans; Platelet Aggregation Inhibitors; Salicylates; Ticlopidine

Aspirin reduces the size of infarcts after ischaemic stroke. Although this fact has been attributed to its antiplatelet actions, direct neuroprotective effects have been also reported. We have demonstrated that aspirin is neuroprotective by inhibiting glutamate release in "in vitro" models of brain ischaemia. A pharmacological dissection of the components involved, using cell cortical culture exposed to oxygen-glucose deprivation, indicated that aspirin selectively inhibits the increase in extracellular glutamate concentration which results from reversal of the glutamate transporter, a component of release which is due to ATP depletion. Moreover, the neuroprotection afforded by aspirin occurred in parallel to a lesser decay in ATP levels after OGD. Aspirin not only elevated ATP levels in intact cortical neurones, but also in isolated brain mitochondria. On the other hand, using a whole-animal model of permanent focal brain ischaemia (MCAO; middle cerebral artery occlusion), wed have also demonstrated that aspirin (30 mg/Kg i.p. administered 2 h before the occlusion) produced a significant reduction in infarct volume, effect that correlated with the inhibition caused by aspirin on ischaemia-induced increase in brain and serum glutamate concentrations after the onset of the ischaemia. Aspirin also inhibited ischaemia-induced decrease in brain ATP levels. Finally, clinical studies showed that prior treatment with aspirin was associated with a lower risk of neurological deterioration after acute ischemic stroke which was related to a reduction of glutamate release. Our present findings show a novel mechanism for the neuroprotective effects of aspirin, that takes place at concentrations in the antiaggregant-analgesic range, useful in the management of patients with risk of ischaemic events.

Topics: Adenosine Triphosphate; Algorithms; Amino Acid Transport System X-AG; Animals; Aspirin; Brain Ischemia; Cell Death; Cerebrovascular Disorders; Clinical Trials as Topic; Disease Models, Animal; Glucose; Glutamic Acid; Humans; Indomethacin; Mitochondria; Neuroprotective Agents; Oxygen; Salicylates

Topics: Aged; Cerebrovascular Disorders; Drug Eruptions; Humans; Male; Platelet Aggregation Inhibitors; Salicylates; Skin Tests

Ginkgo biloba possesses fruits that have caused numerous cases of allergic contact dermatitis. Low amounts of the ginkgolic acids occur in the leaves as well.. Leaf extracts are used to treat cerebrovascular and peripheral vascular disorders. The question arises whether skin hypersensitivity reactions may be adverse effects because the pharmaceutical preparations contain low amounts of ginkgolic acids.. Guinea pigs were sensitized experimentally with pure ginkgolic acids as well as with leaf extracts containing approximately 1,000 ppm of ginkgolic acids.. The guinea pigs could be sensitized successfully with the pure ginkgolic acids. The animals could not be sensitized with the leaf extract.. Leaf extracts of Ginkgo biloba taken orally or given by infusion to treat diffuse cerebral disturbances can be considered safe, even when they might contain up to 1,000 ppm of the sensitizing ginkgolic acids.

Topics: Administration, Oral; Allergens; Animals; Cerebrovascular Disorders; Dermatitis, Allergic Contact; Dermatitis, Irritant; Disease Models, Animal; Female; Ginkgo biloba; Guinea Pigs; Immunization; Infusions, Intravenous; Peripheral Vascular Diseases; Phytotherapy; Plant Extracts; Plant Leaves; Plants, Medicinal; Salicylates

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Aspirin; Cerebrovascular Disorders; Cyclooxygenase Inhibitors; Female; Free Radical Scavengers; Gentisates; Humans; Hydroxybenzoates; Male; Neuroprotective Agents; Platelet Aggregation Inhibitors; Salicylates; Salicylic Acid

Within 60 sec after intracarotid injection of 0.33 mg/kg arachidonic acid, a pronounced attenuation of electrocortical activity, approaching electrocerebral silence, was induced in the ipsilateral hemisphere of anesthetized and heparinized rats. This effect was a consequence of the cerebrovascular occlusion due to platelet aggregates induced by arachidonic acid. This model has been used to evaluate the protective effect of acetylsalicylic acid (ASA) and of triflusal 2 hr after a single oral dose of 50 mg/kg or after 50 mg/kg, for 5 days. Pentylenetetrazol at 10 mg/kg, i.v. exerts a stimulant effect on CNS, and was used as a positive control. ASA and triflusal exhibit a protective effect in about 35% of animals when acutely administered. After chronic treatments (5 days), the effect of triflusal (60% protection) was superior to that of ASA (27% protection) (p less than 0.01).

Topics: Animals; Arachidonic Acid; Arachidonic Acids; Aspirin; Cerebrovascular Disorders; Electroencephalography; Male; Platelet Aggregation; Rats; Rats, Inbred Strains; Salicylates

Topics: Brain Neoplasms; Cerebrovascular Disorders; Dermatitis, Atopic; Humans; Lupus Erythematosus, Systemic; Orosomucoid; Polarography; Psoriasis; Salicylates