[Clinical efficacy of picotamide]

The effects of picotamide (300 mg b.i.d.) for secondary prevention of cerebral ischemia were compared with the effects of low-dosage aspirin (300 mg/die). Out of the 87 randomized patients, 47 completed a six month period of treatment: 29 patients in the picotamide (group P) with a mean period of 14.5 months, 18 in the aspirin group (group A) with a mean period of 15.2 months. Both showed reduced incidence of further cerebral ischemic episodes in comparison with non treated patients (literature data). Using intention-to-treat analysis, the recurrence of ischemic events (including TIA) was 5.8% in group P and 14.3% in group A. Explanatory analysis yielded similar results: 10.3% of patients in group P and 27.8% in group A had recurrence of cerebral ischemic eposides. Evaluating as endpoints only RIND and stroke, the incidence was 10.3% in group P and 16.7% in group A. In conclusion, picotamide was more effective than aspirin; however the difference was not statistically significant due to the small number of patients. The drug was well tolerated and only two patients dropped out because of side effects. Picotamide did not alter laboratory tests significantly.

Atrial fibrillation and infarct area extent in ischemic stroke. A clinical and neuroradiological study in 104 patients

The extent of infarct area (IA) on CT-scan in 104 patients with ischemic stroke (IS) was compared with the presence of atrial fibrillation (AF) and other risk factors (hypertension, dyslipidemia, alcohol abuse). Infarct size was also compared with biological and clinical parameters in acute stage (6-12 h) (blood glucose level, systolic and diastolic arterial pressure, haematocrit, consciousness, clinical picture) and with clinical outcome. Among risk factors, only AF showed a significant correlation with IA extension (p less than .0009). IA correlated also with consciousness (p = .0017), clinical picture (p = .0145) and with clinical outcome (p less than 10(-6). Patients with AF showed a more severe clinical outcome with respect to patients without risk factors. It could be hypothesized that patients with AF have a reduced capacity for increasing or sustaining cerebral blood flow in the acute phase of IS.