Cardiovasc Prev Pharmacother.  2021 Oct;3(4):86-94. 10.36011/cpp.2021.3.e10.

Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack

• Lee KY

• KMID: 2536935
• DOI: http://doi.org/10.36011/cpp.2021.3.e10

Abstract

The risk of stroke recurrence is highest in the acute phase after transient ischemic attack (TIA) or ischemic stroke. Therefore, patients with TIA or ischemic stroke should be treated with antiplatelet medication for stroke prevention. The short-term use of dual antiplatelet therapy between 21 and 90 days may be considered in those with acute minor stroke or TIA and highrisk of recurrence. However, the long-term use of dual antiplatelet therapy is not recommended due to the risk of bleeding. The current stroke guideline does not specify the administration of an antiplatelet for the secondary prevention of ischemic stroke. However, as clinical studies progress, antiplatelet therapy may become a personalized treatment in the future.

Keyword

Ischemic stroke; Platelet aggregation inhibitors; Secondary prevention; Stroke

Figure

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  Figure 1. Antiplatelet therapy for non-cardioembolic stroke and transient ischemic attack. *Dual antiplatelet is ideally initiated within 24 hours of symptom onset but can be given within 7 days of stroke onset; †Intracranial artery stenosis is defined as stenosis >50%; ‡High-risk TIA is defined as an ABCD2 score ≥4; §The benefit of dual antiplatelet therapy was primarily observed during the first 21 days after symptom onset in major clinical trials; llDual antiplatelet means the combination of aspirin and clopidogrel (modified from the Figure of Stroke 2021;52:e364-46715)). TIA = transient ischemic attack; NIHSS = National Institutes of Health Stroke Scale.

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