Antithrombotic Therapy for Primary and Secondary Prevention of Ischemic Stroke JACC State-of-the-Art Review

被引：37

作者：

Greco, Antonio ^{[1
]}

Occhipinti, Giovanni ^{[1
]}

Giacoppo, Daniele ^{[1
]}

Agnello, Federica ^{[1
]}

Laudani, Claudio ^{[1
]}

Spagnolo, Marco ^{[1
]}

Mauro, Maria Sara ^{[1
]}

Rochira, Carla ^{[1
]}

Finocchiaro, Simone ^{[1
]}

Mazzone, Placido Maria ^{[1
]}

Faro, Denise Cristiana ^{[1
]}

Landolina, Davide ^{[1
]}

Ammirabile, Nicola ^{[1
]}

Imbesi, Antonino ^{[1
]}

Raffo, Carmelo ^{[1
]}

Capodanno, Davide ^{[1
,2
]}

机构：

[1] Univ Catania, Div Cardiol, Azienda Osped Univ Policlin G Rodolico San Marco, Catania, Italy

[2] Azienda Osped Univ Policlin G Rodolico San Marco, Div Cardiol, Via Santa Sofia 78, I-95123 Catania, Italy

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2023年 / 82卷 / 15期

关键词：

anticoagulation; antiplatelet therapy; antithrombotic therapy; prevention; stroke; PATENT FORAMEN OVALE; CLOPIDOGREL PLUS ASPIRIN; LEFT ATRIAL APPENDAGE; EARLY NEUROLOGICAL DETERIORATION; DUAL ANTIPLATELET THERAPY; ARTERIAL ORIGIN ESPRIT; MEDICAL THERAPY; HIGH-RISK; CEREBRAL-ISCHEMIA; RANDOMIZED-TRIAL;

D O I：

10.1016/j.jacc.2023.07.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Stroke is a devastating condition with significant morbidity and mortality worldwide. Antithrombotic therapy plays a crucial role in both primary and secondary prevention of stroke events. Single or dual antiplatelet therapy is generally preferred in cases of large-artery atherosclerosis and small-vessel disease, whereas anticoagulation is recommended in conditions of blood stasis or hypercoagulable states that mostly result in red thrombi. However, the benefit of antithrombotic therapies must be weighed against the increased risk of bleeding, which can pose significant challenges in the pharmacological management of this condition. This review provides a comprehensive summary of the currently available evidence on antithrombotic therapy for ischemic stroke and outlines an updated therapeutic algorithm to support physicians in tailoring the strategy to the individual patient and the underlying mechanism of stroke. (c) 2023 by the American College of Cardiology Foundation.

引用

页码：1538 / 1557

页数：20

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