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Is clopidogrel a generic drug for secondary angina; the study was published in International Journal of Pharmacology. The current practice of using non-steroidal anti-inflammatory drugs to treat secondary stroke was suggested in 2002 a review of the role non-steroidal anti-inflammatory drugs in primary stroke.1 The authors defined secondary stroke as angina or subclavian thrombotic disease, which may occur in non-small vessel disease such as coronary artery disease, myocardial infarction, or cerebrovascular disease. They noted that there has been a lack of high-quality evidence regarding the association of use non-steroidal anti-inflammatory drugs (NSAIDs) with secondary stroke. As a result, they recommended the development of new guidelines and on their use, with primary stroke being the focus of this review. Patient Characteristics The overall prevalence of non-steroidal anti-inflammatory drug (NSAID) use before stroke was 4.6% among 864 patients with primary stroke. Of these patients, 2.2% reported non-steroidal anti-inflammatory drug use before stroke. The primary risk factor for NSAID use before stroke was size (≥50%, compared with ≤35%). Two risk factors were also associated with non-steroidal anti-inflammatory drug use before stroke: age ≥65 years and noncompliance to prescribed NSAID therapy (odds ratio [OR], 2.3; 95% CI, 1.3-4.4 for noncompliance, and OR, 2.2; 95% CI, 1.3-4.1 for aspirin; p=0.009). Secondary risk factors for NSAID price of generic clopidogrel use before stroke include previous myocardial infarction or congestive heart failure, history of angioplasty (in the past 5 years), or history of previous vasodilatation (no or minor prior occlusion) (OR, 1.4 for noncompliance, 1.1 previous myocardial infarction, 1.0 for angioplasty, 0.9 vasodilatation). Use of non-steroidal anti-inflammatory drugs by stroke patients prior to was associated with reduced odds for stroke recurrence (incidence rate ratio [IRR], 0.3; 95% CI, 0.2-0.5). Non-steroidal anti-inflammatory drug use by stroke patients before was associated with worse neurological function. The most common findings from neuropsychological tests included worse memory and concentration, as well slower reaction time (p < 0.001). In addition, use of non-steroidal anti-inflammatory drug was reported to be associated with decreased accuracy on the Stroop Test (p < 0.001). Use of non-steroidal anti-inflammatory drug by stroke patients before was also associated with increased odds of stroke (OR, 1.5; 95% CI, 1.2-1.9). There was an association seen between use of non-steroidal anti-inflammatory drugs and non-focal central neuropathy (p = 0.004). Patients who consumed NSAIDs before stroke were also at greater risk for cerebrovascular disease (p<0.001) or subendocardial infarction (p = 0.03). The effect of aspirin use on cerebral infarction was found to be small compared with the effect on atherosclerotic disease (p = 0.07). Implications for Stroke Prevention The finding that non-steroidal anti-inflammatory drugs (NSAIDs) are used before stroke is consistent with results from prior clinical trials. In a cohort study of 1,074 Buy esomeprazole uk patients with non-focal central neuropathy by Sacks et al,1 the use of nonsteroidal anti-inflammatory drugs was associated with an increased risk of stroke (odds ratio, 1.35 [95% CI, 1.01-1.79]). A larger study by Vestergaard et al showed an increase in the risk of stroke with aspirin use prior to stroke in 7,739 patients with coronary artery disease (OR, 1.9 [95%CI, 1.8-2.0]).2 The authors Drug stores in nyc concluded that risk of stroke was higher in participants who had used any nonsteroidal anti-inflammatory agent before the Buy tadacip 20 mg onset of stroke as compared with those who had not. They suggested that the findings were possibly explained by a lack of benefit from non-steroidal anti-inflammatory drugs (NSAIDs) in reducing stroke risk. In addition to the potential risks of non-steroidal anti-inflammatory drug use before stroke, additional risks also might exist. In a post hoc analysis of Vestergaard et al,2 the authors found that patients with history of previous myocardial infarction were at increased risk for non-focal central neuropathy. Additionally, the use of aspirin increased risk.
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