Antiplatelet therapy

Evidence-based neurology checklist on antiplatelet therapy: Antiplatelet therapy This reduces the risk of major stroke The benefit is highest in the first two weeks after stroke The benefit out-weighs the risk of bleeding Clopidogrel may be used instead of Aspirin Dual antiplatelet therapy…

Antiplatelet therapy

  • This reduces the risk of major stroke
  • The benefit is highest in the first two weeks after stroke
  • The benefit out-weighs the risk of bleeding
  • Clopidogrel may be used instead of Aspirin

Dual antiplatelet therapy

Antiplatelet regime for minor stroke or high-risk TIA (ABCD2 ≥4)

Antiplatelet regime for low-risk TIA (ABCD2 <4)

Risk factors for major antiplatelet bleeding

References

  1. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011; 42:227-276.
  2. Derdeyn CP, Chimowitz MI, Lynn MJ, et al; Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial Investigators. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet 2014; 383:333-341. 
  3. Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention. Stroke 2006; 37:577-617.
  4. Johnston SC, Easton JD, Farrant M, et al; Clinical Research Collaboration, Neurological Emergencies Treatment Trials Network, and the POINT Investigators. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N Engl J Med 2018; 379:215-225. 
  5. Pan Y, Jing J, Chen W, et al; CHANCE investigators. Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE. Neurology 2017; 88:1906-1911.
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