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Brief Communications
April 12, 2004
Letter to the Editor

Antiplatelet drug discontinuation is a risk factor for ischemic stroke

April 13, 2004 issue
62 (7) 1187-1189


Antiplatelet drugs (APD) are widely used in the prevention of ischemic cardio- and cerebrovascular diseases. The authors studied the frequency of stroke occurring after APD discontinuation, the cause of discontinuation, and the delay between APD disruption and stroke. Only 4.49% of strokes were related to a recent APD discontinuation, but all cases occurred between 6 and 10 days after drug discontinuation (p < 0.0001). This temporal pattern has biologic plausibility because the inhibited platelets circulate in the blood for about 10 days.

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Letters to the Editor
8 June 2004
Reply to Bachman
I. Sibon, Service de Neurologie, CHU Pellegrin

We thank Dr Bachman for calling our attention to his letter on antiplatelet drug disruption . [1] We did not reference this in our discussion but failed to identify it in our literature review. However, we believe that defining its content as "virtually the same information" is an overstatement.

The letter by Dr Bachman anecdotally describes 13 cases, not systematically screened, from an undefined population of ischemic strokes. The delay between aspirin discontinuation and the associated ischemic strokes, which is the key point of our paper [2] is not specified in three cases and was two weeks or more in seven cases. So we suspect that, in this series, a majority of cases may not be related to the aspirin discontinuation.


1). Bachman DS. Discontinuing chronic aspirin therapy: another risk factor for stroke? Ann Neurol. 2002;51:137-8.

2). Sibon I, Orgogozo JM. Antiplatelet drug discontinuation is a risk factor for ischemic stroke. Neurology. 2004 13;62:1187-1189.

8 June 2004
Antiplatelet drug discontinuation is a risk factor for ischemic stroke
David S. Bachman MD, Wilmington Health
Wilmington, NC 28401

Regarding the recent paper reporting the risk of stopping antiplatelet drugs [1], I reported virtually the same information in the Annals in 2001, including a Title and a Table of cases which are quite similar to the current publication. [2].


1) Sibon I and Orgogozo J. Antiplatelet drug discontinuation is a risk factor for ischemic stroke Neurology 2004; 62: 1187-1189.

2) Bachman D. Discontinuing Chronic Aspirin Therapy: Another risk factor for stroke? Ann Neurol 2002; 51:137-138.

Information & Authors


Published In

Volume 62Number 7April 13, 2004
Pages: 1187-1189
PubMed: 15079022

Publication History

Received: August 25, 2003
Accepted: November 26, 2003
Published online: April 12, 2004
Published in print: April 13, 2004


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Affiliations & Disclosures

Igor Sibon, MD
From the Fédération de neurosciences cliniques, CHU Bordeaux, France.
Jean-Marc Orgogozo, MD
From the Fédération de neurosciences cliniques, CHU Bordeaux, France.


Address correspondence and reprint requests to Dr. I. Sibon, Service de neurologie, CHU Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux cedex, France; e-mail: [email protected]

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