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Update on selecting and adjusting antiplatelet therapy for prevention of noncardiogenic, recurrent ischemic stroke

Helmi Lutsep1

  • 1Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, CR 131, Portland, OR 97239-3098, USA. lutseph@ohsu.edu

Expert Review of Cardiovascular Therapy
|October 12, 2011
PubMed

Insights

Antiplatelet therapy, including aspirin and clopidogrel, is vital for secondary stroke prevention. Recent trials and drug interactions impact treatment choices, influencing optimal agent selection for patients.

Area of Science:

  • Neurology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Antiplatelet therapy is crucial for secondary stroke prevention.
  • Recent clinical trials and drug understanding impact agent selection.
  • Aspirin resistance and intolerance necessitate alternative strategies.

Purpose of the Study:

  • To review current antiplatelet therapies for secondary stroke prevention.
  • To discuss the impact of recent clinical trials and drug advancements.
  • To explore challenges and implications of clopidogrel use and interactions.

Main Methods:

  • Review of recent clinical trials and subanalyses.
  • Discussion of drug action, metabolism, and drug-drug interactions.
  • Analysis of head-to-head comparisons and combination therapies.

Main Results:

  • Aspirin, clopidogrel, and aspirin/dipyridamole have established roles.
  • Optimal agent choice remains unclear and individualized.
  • Clopidogrel metabolism variability and PPI interactions pose clinical challenges.

Conclusions:

  • Treatment decisions require consideration of trial data, patient factors, and drug-specific issues.
  • Further research is needed to optimize antiplatelet strategies.
  • Understanding drug metabolism and interactions is key for effective secondary stroke prevention.

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