Transient Ischaemic Attacks
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The fact that transient ischaemic attacks are a harbinger for the possible development of ischaemic stroke has been recognised for several decades. However, within the past decade, our concepts regarding transient ischaemic attacks as a distinct entity from stroke and the prognosis for transient ischaemic attack patients have been challenged. In addition, clinical trials have clarified that modem transient ischaemic attack management is more complex than in the past, with the addition of newer pharmacological options to the stroke prevention armamentarium.
Recent information regarding newer antiplatelet agents is reviewed in this article, along with results of clinical trials pertaining to warfarin in stroke prevention. The evolving role of statins, ACE inhibitors and estrogen replacement is reviewed. Finally, the appropriate use of surgery following transient ischaemic ttacks is outlined. Recent studies have shown that many patients will benefit from a multimodal pharmacological approach following transient cerebral ischaemia, and the potential for combination therapy is highlighted.
KeywordsWarfarin Ischaemic Stroke Clopidogrel Ticlopidine Stroke Prevention
Dr Chaturvedi has received honoraria in the past from Sanofi, Boehringer Ingelheim, Pfizer and Wyeth. Dr Chaturvedi also received a research grant from Pfizer. No other sources of funding were used in the preparation of this manuscript.
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