Comparison of the Efficacy of Aspirin, Aspirin+Dipyridamole, Warfarin in Patients with Amaurosis Fugax Secondary to Mitral Valve Prolapse

To determine the efficacy of three therapeutic regimens for the treatment of amaurosis fugax secondary to embolic sources from the heart Sixty patients randomly divided into 3 groups (20 patients in each group). Group 1 received 100 mg Aspirin/day, group 2 received the same dose of Aspirin plus dipyridamole 75 mg twice daily and group 3 received 10 mg warfarin for 3 days followed 5 mg thereafter. All patients were followed every 6 months for relapse of amaurosis fugax and cardiac status. Data were collected and analysed. Forty-nine patients (81.6%) were female and 11 patients (18.4%) were males. The mean ages of patients in group 1, 2, 3 were 44.85±14.56, 45.55±15.49 and 4490±14.87, respectively (P=0.98). The mean duration of amaurosis fugax stroke was 7 minutes (ranged 4-11 minutes). 91.6% of the patients had type A personality by anxiety and neurosis. Stroke was seen in 47 (78.3%) patients in both eyes, in 10 patients (16.6%) in the left eye and in 3 cases (5.1%) in the right eye. After one year of treatment, relapse of amaurosis fugax stroke was developed in 7 (35%) patients in Aspirin group, 5 (25%) in Aspirin plus dipyridamole group and 1 (5%) in warfarin group. Warfarin group had lower relapse than those in other groups (P=0.022). The results show that warfarin has better efficacy for the treatment of amaurosis fugax than Aspirin or Aspirin plus dipyridamole.