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Antiplatelet Treatment in Stroke: New Insights

[ Vol. 22 , Issue. 29 ]

Author(s):

Haralampos Milionis, Angelos Liontos, Kostantinos Vemmos and Konstantinos Spengos   Pages 4617 - 4626 ( 10 )

Abstract:


Background: Stroke is a feared vascular event among healthy people and those with cardiovascular disease, and holds a leading position as a cause of disability and death worldwide. Antiplatelet therapy is central in the management of patients with ischemic nonembolic stroke and transient ischemic attacks. Methods: In this narrative review, we provide an overview and update of evidence regarding antiplatelet treatment in the primary and secondary prevention of stroke. Results: Aspirin, clopidogrel and aspirin plus dipyridamole are the mainstays of antiplatelet treatment post-stroke, while promising agents include triflusal, cilostazol and ticagrelor. Available data are in favor of dual antiplatelet treatment in the early treatment of atherosclerotic large vessel disease. Long-term dual antiplatelet treatment should be individualized keeping in mind the higher rates of bleeding complications. Conclusion: Treatment with an antiplatelet agent is recommended to reduce recurrent stroke and death in patients with a non-cardioembolic ischemic stroke or transient ischemic attack. Moreover, clinicians should carefully assess the pros and cons in each case and individualize the need for prolonged dual antiplatelet therapy.

Keywords:

Antiplatelet treatment, dual therapy, ischemic stroke, transient ischemic attack, prevention, recurrence.

Affiliation:

1st Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Greece.



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