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[Antiplatelet agents in secondary prevention of stroke]

G De Gautard, A Perrier

    Revue Medicale Suisse
    |December 3, 2014
    PubMed

    Insights

    Dual antiplatelet therapy is effective for early stroke prevention but increases bleeding risk long-term. Current evidence supports its use in the short term, not for extended periods.

    Area of Science:

    • Neurology
    • Cardiovascular Medicine
    • Pharmacology

    Context:

    • Stroke significantly contributes to global morbidity and mortality.
    • Antiplatelet agents are crucial for secondary stroke prevention.
    • Current guidelines recommend aspirin, clopidogrel, or aspirin- plus-dipyridamole.

    Purpose:

    • To review the evidence on dual antiplatelet therapy (DAPT) for stroke prevention.
    • To evaluate the efficacy and safety of DAPT in different stroke phases.
    • To discuss future research directions in antiplatelet strategies.

    Summary:

    • Early-phase stroke studies (24 hours to 3 months) demonstrate DAPT's superiority over single antiplatelet therapy (e.g., aspirin).
    • Long-term DAPT is associated with an elevated risk of intracranial hemorrhage, outweighing its benefits.
    • The optimal duration and patient selection for DAPT remain areas of ongoing investigation.

    Impact:

    • Provides a concise overview of DAPT's role in secondary stroke prevention.
    • Highlights the critical distinction between short-term efficacy and long-term risks of DAPT.
    • Informs clinical decision-making regarding antiplatelet strategies for stroke survivors.

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