P2Y12 receptor inhibitors for secondary prevention of ischemic stroke

Introduction: Ischemic stroke ( IS) is a major cause of death and disability worldwide. The P2Y(12) receptor plays a critical role in the formation of a stable thrombus leading to ischemic complications. Therefore, P2Y(12) receptor inhibitors constitute a major antiplatelet strategy in the secondary prevention of IS. Areas covered: We searched articles about P2Y(12) receptor inhibitors and stroke in PubMed published until December 2014. This is a comprehensive review of the role of P2Y(12) receptor inhibitors alone and in combination with aspirin in the secondary prevention of noncardioembolic stroke. Expert opinion: The potential benefit of more potent antiplatelet therapy for secondary stroke prevention must be weighed against the risk of bleeding in patients with IS. Short-term (<= 3 months) dual antiplatelet therapy with clopidogrel and aspirin that is initiated early after IS or transient ischemic attack due to large artery atherosclerosis appears most efficient.