Coumadin and aspirin are equally effective in preventing recurrent stroke or death among people who have already had a stroke, according to a new study published in the New England Journal of Medicine.

Many doctors have believed that Coumadin, which is the oldest blood-thinning drug available, is more effective and at the same time aspirin is safer. This study calls both of those concepts into question. Patients who have had a heart attack or stroke are often given blood-thinners to prevent the clots that can cause another one. In this study, more than 2,200 patients at 48 hospitals around the country took Coumadin or 325 mg. of aspirin for two years. Stroke or death occurred in 17.8% of those taking Coumadin and 16% of those taking aspirin; the difference is not statistically significant.

The researchers call the two drugs "reasonable therapeutic alternatives." The costs, however, are significantly different: while aspirin may cost $10 for a year's treatment, Coumadin and the blood tests that people taking it must have can cost several hundred dollars a year.

Related information Stroke - Prevention

Source:  Mohr JP, Thompson JLP, Lazar RM, et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. The New England Journal of Medicine, Nov. 15, 2001;345:1444-1451. (Abs.)