Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial

Introduction

Design:

• double-blind, randomized multicenter clinical trial
• 569 patients with TIA or stroke from 50-99% stenosis of major intracranial artery (stenosis verified by angiography)
• mean follow-up period of 1.8 years

warfarin target INT 2.0-3.0 vs

aspirin 1300 mg per day

primary end point: ischemic stroke, brain hemorrhage, or death from vascular causes other than stroke

Results:

• death (4.3% aspirin group vs. 9.7% warfarin group hazard ratio 0.46, 95% confidence interval
• death from vascular causes was 3.2% vs 5.9% & for non-vascular causes 1.1% vs 3.8%, both favoring aspirin
• major hemorrhage (3.2% vs. 8.3%) favoring aspirin hazard ratio, 0.39; 95% confidence interval
• myocardial infarction or sudden death (2.9% vs. 7.3%) favoring aspirin, hazard ratio, 0.40; 95% confidence interval
• primary end point occurred in 22.1% of aspirin group & 21.8% of warfarin group

Conclusions:

• warfarin associated with more adverse events & provided no benefit over aspir
• aspirin preferable to warfarin for patients with intracranial arterial stenosis

More general terms

• clinical trial

Additional terms

• cerebrovascular disease/disorder
• intracranial arterial stenosis