Antithrombotic therapy for secondary stroke prevention

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose of Review: Antithrombotic therapy is a key component of any strategy for the secondary prevention of ischemic stroke. A better understanding of the various therapeutic options will lead to improved stroke prevention, better medication adherence, and fewer complications. Recent Findings: Antiplatelet agents and anticoagulants are the two major classes of antithrombotic therapy used for stroke prevention. The etiology and mechanism of the stroke must be considered in order to make the best decision regarding which agent(s) to use for secondary stroke prevention. The recent Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) study showed that clopidogrel and aspirin plus extended-release dipyridamole had similar event rates in terms of recurrent stroke, but clopidogrel was better tolerated, with fewer bleeding events. Several new anticoagulants are poised to replace warfarin for stroke prevention in the setting of atrial fibrillation. These include dabigatran (a new oral direct thrombin inhibitor) and possibly apixaban (a new oral factor Xa inhibitor). These new medications are much easier to use than warfarin and may be more effective and safer, with fewer drug and food interactions and no need for routine bloodmonitoring. Thus, these new medications may improve adherence as well as clinicians' inclination to treat with anticoagulation. Summary: Because each antiplatelet agent or anticoagulant has certain advantages and disadvantages, clinicians must choose an agent that the patient can afford and tolerate in terms of side effects and adherence. The hope and expectation is that the proper use of these medications in accordance with current guidelines will reduce the risk of a recurrent stroke.

Original languageEnglish (US)
Pages (from-to)1255-1266
Number of pages12
JournalCONTINUUM Lifelong Learning in Neurology
Volume17
Issue number6
DOIs
StatePublished - Dec 2011

Fingerprint

Secondary Prevention
Stroke
clopidogrel
Anticoagulants
Therapeutics
Platelet Aggregation Inhibitors
Warfarin
Hope
Food-Drug Interactions
Medication Adherence
Antithrombins
Proxy
Atrial Fibrillation
Guidelines
Hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

Cite this

Antithrombotic therapy for secondary stroke prevention. / Alberts, Mark J.

In: CONTINUUM Lifelong Learning in Neurology, Vol. 17, No. 6, 12.2011, p. 1255-1266.

Research output: Contribution to journalArticle

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