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Journal of the Korean Neurological Association 2011;29(4): 277-284.
한국뇌졸중진료지침에서 아스피린의 뇌졸중 일차예방 효과에 관한 내용의 부분 개정
구자성, 한상원 a 김한영 b 박종무 c 조용진 d 강규식 c 유경호 e 나정호 f 허지회 g 권순억 h 오창완 i 배희준 j 이병철 e 윤병우 j 홍근식 d
가톨릭대학교 의과대학 신경과학교실, 인제대학교 의과대학 상계백병원 신경과학교실a , 건국대학교 의학전문대학원 신경과학교실b, 을지대학교 의과대학 신경과학교실c, 인제대학교 의과대학 일산백병원 신경과학교실d, 한림대학교 의과대학 신경과학교실e , 인하대학교 의과대학 신경과학교실f, 연세대학교 의과대학 신경과학교실g, 울산대학교 의과대학 신경과학교실h, 서울대학교 의과대학 신경외과학교실i, 신경과학교실j
Focused Update on Aspirin for Primary Stroke Prevention in Korean Clinical Practice Guidelines for Stroke
Jaseong Koo
Department of Neurology, Catholic University College of Medicine, Seoul, Korea Department of Neurology a , Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea Department of Neurology b , Konkuk University College of Medicine, Seoul, Korea Department of Neurology c , Eulji University College of Medicine, Daejeon, Korea Department of Neurology d , Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea Department of Neurology e , Hallym University College of Medicine, Anyang, Korea Department of Neurology f , Inha University College of Medicine, Incheon, Korea Department of Neurology g , Yonsei University College of Medicine, Seoul, Korea Department of Neurology h , University of Ulsan College of Medicine, Seoul, Korea Departments of Neurosurgery i and Neurology j , Seoul National University College of Medicine, Seoul, Korea
Abstract
The first edition of the Korean clinical practice guidelines for primary stroke prevention reflects evidence published before June 2007. Since then, several clinical studies and meta-analyses have been conducted to determine the efficacy of aspirin for the primary prevention of cardiovascular disease including stroke. The aim of this guideline update is to provide timely recommendations taking into consideration the new evidence. Three clinical studies and four meta-analyses performed between July 2007 and November 2010 were identified and included for updating the guidelines. The main finding was a lack of aspirin efficacy for primary stroke prevention in patients with diabetes or peripheral arterial disease. We have summarized the new evidence and revised our recommendations for aspirin for primary stroke prevention. New evidence will need to be reflected continuously in future guideline updates. Key Words: Stroke, Practice guideline, Primary prevention, Aspirin, Diabetes, Peripheral arterial disease