Yeungnam Univ J Med.  2003 Jun;20(1):1-12. 10.12701/yujm.2003.20.1.1.

Antithrombotic Therapy for Ischemic Stroke

• Hah JS
• Lee J

• KMID: 1969348
• DOI: http://doi.org/10.12701/yujm.2003.20.1.1

Abstract

Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

Keyword

Aspirin; Heparin; Anticoagulants

MeSH Terms

Aged
Anticoagulants
Arteries
Aspirin
Blood Pressure
Brain Ischemia
Cause of Death
Constriction, Pathologic
Embolism
Food Habits
Heart
Heparin
Humans
Platelet Aggregation Inhibitors
Recurrence
Risk Reduction Behavior
Secondary Prevention
Smoking
Stroke*
Anticoagulants
Aspirin
Heparin
Platelet Aggregation Inhibitors