[Expanding the possibilities of antithrombotic therapy of cerebrovascular pathology]

Area of Science:

• Angioneurology
• Pharmacology
• Cardiovascular Medicine

Background:

• Cerebral atherosclerosis is a major cause of cerebrovascular disorders (CCD).
• Current antithrombotic therapies, including antiplatelet agents like aspirin and clopidogrel, face challenges like clinical failure and drug resistance.
• Optimizing antithrombotic strategies is crucial for preventing and managing CCD.

Purpose of the Study:

• To provide an overview of antithrombotic therapy in angioneurology, with a focus on antiplatelet agents.
• To discuss the issue of resistance to antiplatelet therapy and explore potential solutions.
• To evaluate the efficacy and safety of dipyridamole as an alternative or adjunct treatment for CCD.

Main Methods:

• Review of current recommendations for acetylsalicylic acid and clopidogrel.
• Analysis of causes and management strategies for aspirin resistance.
• Presentation of original research on dipyridamole's effectiveness and safety in CCD patients.
• Pilot study assessing dipyridamole's antiplatelet profile in patients with Ph-negative myeloproliferative diseases.

Main Results:

• Dipyridamole is proposed as a viable alternative or addition to standard antiplatelet therapy.
• Studies indicate comparable platelet aggregation levels between dipyridamole and acetylsalicylic acid.
• Personalized therapy, considering individual drug resistance, is essential for effective CCD management.

Conclusions:

• Dipyridamole demonstrates potential as a valuable agent in managing cerebrovascular disorders.
• Addressing antiplatelet resistance through alternative or combination therapies is critical.
• Personalized treatment approaches are paramount for optimizing antithrombotic therapy outcomes in angioneurology.