The prevention of ischemic stroke with antithrombotic drugs

Current antithrombotic drugs reduce the risk of stroke, heart attack and death from vascular causes by 25 % in patients with cerebral ischemic events resulting from disease of small or large cerebral arteries. In the primary prevention, Acetylsalicylic acid (ASA) reduces the risk of stroke by 19 % in women but not in men. In patients with nonvalvular atrial fibrillation the risk of stroke treating with ASA is reduced by 20 %. Oral anticoagulants significantly reduce stroke risk due to nonvalvular atrial fibrillation by 65-70 % compared with placebo and by 40 % compared with ASA alone. At the same time they cause more major bleedings. Recently studied new antiplatelet drugs and anticoagulants might alter the current course of stroke prevention treatment. Research is also needed on the benefits and risks of combination antiplatelets and anticoagulants in patients with nonvalvular atrial fibrillation in combination with arterial cerebral disease.