A Clinical Update on Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke

被引：7

作者：

Marsden, Katelyn ^{[1
]}

Mak, Hannah Y. ^{[2
]}

Crooks, C. Patrick ^{[1
]}

Pankaj, Preethy ^{[1
]}

Thuhien Nguyen ^{[1
]}

Tirschwell, David ^{[1
]}

机构：

[1] Univ Washington, Dept Neurol, Seattle, WA 98195 USA

[2] Univ Washington, Dept Pharm, Seattle, WA USA

来源：

CURRENT CARDIOLOGY REPORTS | 2021年 / 23卷 / 10期

关键词：

Ischemic stroke; Secondary prevention; Antiplatelet therapy; Aspirin; Clopidogrel; PATENT FORAMEN OVALE; HEALTH-CARE PROFESSIONALS; MINOR STROKE; COLLABORATIVE METAANALYSIS; CEREBRAL-ISCHEMIA; EARLY MANAGEMENT; MEDICAL THERAPY; 2018; GUIDELINES; ASPIRIN USE; OPEN-LABEL;

D O I：

10.1007/s11886-021-01581-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose of Review Antiplatelet therapy remains the standard of care in secondary stroke prevention for non-cardioembolic ischemic stroke and transient ischemic attack. We aim to examine the use of antiplatelet agents in secondary prevention through highlighting relevant clinical trials and meta-analyses as well as providing commentary regarding our practice. Recent Findings In the POINT and CHANCE trials, dual antiplatelet therapy reduced recurrent stroke compared to aspirin monotherapy. Sub-analyses of these trials suggest that genetic polymorphisms could play a role in diminishing the effectiveness of clopidogrel. Similarly, THALES demonstrated better outcomes with ticagrelor-aspirin combination therapy over aspirin monotherapy. Combination antiplatelet therapy with aspirin and the P2Y12 inhibitors, clopidogrel and ticagrelor, reduced stroke recurrence in those presenting with mild ischemic stroke or high risk TIA. Genetic polymorphisms may play a role in determining the appropriate regimen. Questions remain regarding the optimal duration of combination antiplatelet therapy for various stroke etiologies.

引用

页数：12

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