A comparative study of the prevention of recurrences of cerebral transient ischemic attacks during a 6-month observation period was conducted in 73 patients treated with a combination of acetylsalicylic acid and dipyridamole (ASAD, 1,050 mg + 150 mg/day) and in 65 patients treated with pentoxifylline (PTX 1,200 mg/day, Trental® 400 t.d.s). The patients were randomly assigned to the treatments. Risk factor analysis showed high prevalence of arterial hypertension, hyperlipidemia and smoking in these patients. The two groups were matched in terms of age, sex, blood pressure and site of TIA origin (carotid 63% in the ASAD, 65% in the PTX group). 23 ASAD patients and 9 PTX patients suffered a recurrence. There were 4 nonfatal stroke events with ASAD and 2 with PTX. 80 recurrent TIAs were recorded in 19 ASAD patients compared with 19 such episodes in 9 PTX subjects. The morbidity rates (life table analysis) were significantly lower (p < 0.05) in the PTX group. The results of the study point to a preventive effect of PTX in terms of the reduction in TIA recurrences.

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Out of 235 patients with recent cerebral transient ischaemic attacks, 208 subjects were available for final evaluation after 6 months' randomised treatment with either pentoxifylline (PTX 1200 mg/day) or a combination (ASAD) of acetylsalicylic acid (ASA, 1050 mg/day) and dipyridamole (D, 150 mglday). Prevention of TIA, stroke or death attributable to previous events were endpoint criteria.The pentoxifylline group (n = 100) exhibited no recurrent episodes in 86 patients (86010). TIA occurred in 9 patients, stroke in 5 patients and there was 1 death. In the ASAD group (n = 108) no recurrence of ischaemic episodes was recorded in 82 cases (75.9%). TIA occurred in 20 patients, stroke in 6 patients and there were 3 deaths of vascular origin. Side effects were recorded in 4 ASAD and 1 PTX patients. The total rate of recurrence was 14% with PTX as compared to 24.1% with ASAD treatment.

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