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Antiplatelet Agents in Secondary Stroke Prevention: Selection, Timing, and Dose

  • Cerebrovascular Disorders (DG Jamieson, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

This narrative review critically evaluated the published studies regarding the systematic use of antiplatelet agents for secondary stroke prevention.

Recent findings

Stroke is a leading cause of morbidity and mortality around the world. Multimodal prevention is the most viable strategy for reducing the societal burden of stroke recurrence. For secondary stroke prevention, antiplatelet therapy is at the core of effective long-term vascular risk reduction among survivors of an ischemic stroke or transient ischemic attack (TIA). In addition to aspirin, there are several antiplatelet agents proven to be efficacious in averting recurrent vascular events after an index ischemic stroke or TIA. However, beyond the challenges of keeping up with recent advances in antiplatelet drug options for secondary stroke prevention, questions linger about the most appropriate selection, timing, and dosing of antiplatelet treatment for a given patient.

Summary

We narratively summarized the pharmacological properties of key antiplatelet drugs; discussed the evidence regarding efficacy, selection, timing, and dosing of various antiplatelet treatment regimens; and highlighted ongoing clinical trials identifying novel therapies with more favorable risk-benefit profiles than currently available antiplatelet agents for patients with a recent history of ischemic or TIA stroke. Finally, we reviewed published data on antiplatelet therapies that could potentially be applied in the management of commonly encountered challenging clinical scenarios.

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Acknowledgments

We would like to thank Mr. Colin Smith for his generous input on this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurology, Medical University of South Carolina, Charleston, SC, 29425, USA

    Tarun Girotra MD, Forrest Lowe MD, Wuwei Feng MD, MS & Bruce Ovbiagele MD, MS

Authors
  1. Tarun Girotra MD
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  2. Forrest Lowe MD
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  3. Wuwei Feng MD, MS
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  4. Bruce Ovbiagele MD, MS
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Corresponding author

Correspondence to Wuwei Feng MD, MS.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cerebrovascular Disorders

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Girotra, T., Lowe, F., Feng, W. et al. Antiplatelet Agents in Secondary Stroke Prevention: Selection, Timing, and Dose. Curr Treat Options Neurol 20, 32 (2018). https://doi.org/10.1007/s11940-018-0514-5

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  • DOI: https://doi.org/10.1007/s11940-018-0514-5

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