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Updated: Oct 22, 2025
Ferric Chloride-induced Murine Thrombosis Models
Published on: September 5, 2016
[Anti-Platelet and Anti-Coagulant Drugs]
1Department of Neurology, Tokyo Women's Medical University.
Insights
Antithrombotic therapy, including anticoagulants and antiplatelet drugs, is crucial for preventing secondary strokes. Guidelines specify different treatments based on stroke type and patient factors like kidney function and heart conditions.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Antithrombotic therapy is vital for secondary stroke prevention.
- Current guidelines recommend anticoagulants for cardioembolic stroke and antiplatelets for non-cardioembolic infarction.
Purpose of the Study:
- To outline current clinical practice guidelines for antithrombotic therapy in secondary stroke prevention.
- To detail the selection of anticoagulants and antiplatelet agents based on stroke etiology and patient-specific factors.
Main Methods:
- Review of clinical practice guidelines for stroke prevention.
- Analysis of drug recommendations for different stroke subtypes and patient populations.
Main Results:
- Direct oral anticoagulants are preferred for non-valvular atrial fibrillation due to lower bleeding risk.
- Warfarin is recommended for patients with kidney dysfunction, artificial valves, or specific heart conditions.
- Dual antiplatelet therapy (aspirin and clopidogrel) is advised in the acute phase of non-cardioembolic infarction, while single antiplatelet therapy is preferred for chronic management.
Conclusions:
- Therapeutic choices for antithrombotic management in secondary stroke prevention are guided by stroke type and individual patient characteristics.
- Balancing efficacy and safety, particularly bleeding risk, is paramount in selecting antithrombotic agents for stroke survivors.
Abstract:
Antithrombotic therapy is essential for secondary stroke prevention. Clinical practice guidelines recommend anticoagulant and antiplatelet drug administration as first-line therapy for cardioembolic stroke and non-cardioembolic infarction, respectively. Direct oral anticoagulants represent first-choice treatment for cardioembolism secondary to non-valvular atrial fibrillation owing to few hemorrhagic complications associated with this therapy. However, warfarin with optimal control of the international normalized ratio for standardization of prothrombin time is preferred in patients with kidney dysfunction, artificial valve implantation, valvular heart disease, and cardiomyopathy. Antiplatelet drugs, including aspirin, clopidogrel, and cilostazol are used in patients with non-cardioembolic infarction. Dual antiplatelet agents, including aspirin and clopidogrel, are recommended during the acute stage because of the high risk of recurrent ischemic stroke. In contrast, a single antiplatelet drug is recommended during the chronic stage to avoid the risk of intracranial hemorrhage.
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