Oral antithrombotic therapy for the prevention of recurrent cerebrovascular events

Area of Science:

• Neurology
• Cardiology
• Pharmacology

Background:

• Stroke is a leading cause of disability and death, with ischemic events being the most common.
• Transient ischemic attack (TIA) signifies increased risk for major cardiovascular events.
• Cardioembolic disease and large artery atherothrombosis are primary causes of ischemic stroke and TIA.

Purpose of the Study:

• To provide an updated review of oral antithrombotic agents for secondary prevention after ischemic stroke or TIA.
• To appraise current evidence on the efficacy and safety of antithrombotic therapies.
• To guide clinical decisions in balancing ischemic protection with bleeding risk.

Main Methods:

• Systematic review of recent clinical trials.
• Appraisal of evidence on oral anticoagulant and antiplatelet therapies.
• Analysis of therapeutic strategies for various ischemic stroke and TIA subtypes.

Main Results:

• Antithrombotic therapy is central to managing ischemic stroke and TIA.
• Balancing antithrombotic efficacy and bleeding risk presents a clinical challenge.
• Numerous trials have informed current indications for anticoagulant and antiplatelet use.

Conclusions:

• Oral antithrombotic agents are crucial for preventing recurrent ischemic events.
• Evidence supports specific antithrombotic strategies based on stroke/TIA subtype.
• Optimizing the benefit-risk ratio remains a key focus in clinical practice.