Recurrent Stroke while on Antiplatelet Therapy

Of the ≈795,000 strokes in the United States annually, 185,000 are recurrent. A third to half of them occur while on antiplatelet therapy. Multiple reasons could explain breakthrough stroke while on antiplatelet therapy. Management of recurrent stroke requires a meticulous search for the cause and mechanism of stroke. At present, there is no indication for antiplatelet resistance testing in ischemic stroke, or adjusting medications based on its results. Recent trials have shown the effectiveness of dual antiplatelet therapy in the acute period after an ischemic event, but no benefit has been found with this regimen for long-term secondary prevention.