We examined the baseline characteristics of patients in the
Ticlopidine Aspirin Stroke Study (TASS) to determine if the effects of the two treatments in preventing
stroke differed in various subgroups. Patients with the following characteristics did less well on
aspirin: elevated
creatinine,
hypertension or diabetes requiring treatment, or treatment with
anticoagulant or
antiplatelet drugs prior to their qualifying TIA or
stroke. Women and patients with vertebrobasilar symptoms did particularly well on
ticlopidine. We performed arteriography in 1,188 patients with carotid qualifying events. The frequency of
stroke in patients with abnormal arteriograms ipsilateral to their symptoms was slightly higher than in those with normal carotid arteries.
Ticlopidine was more effective in patients without
carotid stenosis.
Ticlopidine is more effective than
aspirin in preventing
strokes in patients having warning TIAs. The patients who benefit most from
ticlopidine may be women, those who have vertebrobasilar symptoms, those with cerebral ischemic symptoms while on
aspirin or
anticoagulant therapy, and patients with diffuse atherosclerotic disease rather than high-grade
carotid stenosis.