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

Purpose: To determine the efficacy of three therapeutic regimens for the treatment of amaurosis fugax secondary to embolic sources from the heart Methods: 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. Results: 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). Conclusion: The results show that warfarin has better efficacy for the treatment of amaurosis fugax than Aspirin or Aspirin plus dipyridamole.