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To the Editor: I was surprised that the Clinical Review of oral antiplatelet therapy in vascular disease by Drs Tran and Anand¹ did not include a discussion of triflusal, for which there is evidence of efficacy in both coronary artery disease (CAD) and cerebrovascular disease in randomized, double-blinded clinical trials.^2-3

In the Triflusal vs Aspirin in Cerebral Infarction Prevention study,² 2113 patients with transient ischemic attack (TIA) or stroke were randomized to receive treatment with triflusal, 600 mg once daily, or aspirin, 325 mg once daily, for 1 to 3 years. No differences were found for the primary composite end point of vascular death, nonfatal ischemic stroke, or nonfatal myocardial infarction (MI). The incidence of major hemorrhage was significantly lower in the triflusal group. Similar results were found in the Triflusal in Myocardial Infarction study.³

Regarding clopidogrel efficacy as monotherapy, the data are from the CAPRIE study,⁴ which studied 3 . . . [Full Text of this Article]

Javier Borja, MD
fv-borja@uriach.com
Clinical Research and Development Unit
J. Uriach y Compañía, SA
Barcelona, Spain

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