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Updated: Aug 11, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
[Antithrombotic therapy in cerebrovascular disorders]
1Medisinsk avdeling Aker sykehus, Oslo.
Insights
Warfarin is recommended for primary and secondary prevention of thromboembolism in patients with non-valvular atrial fibrillation over 60 or with risk factors. Aspirin is an alternative for those with contraindications.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Context:
- Guideline recommendations for stroke prevention.
- Focus on non-valvular atrial fibrillation (NVAF) and thromboembolic risk.
- Management of ischemic stroke and transient ischemic attacks (TIAs).
Purpose:
- To outline prophylactic anticoagulant and antiplatelet therapy guidelines.
- To define patient populations for warfarin and aspirin use.
- To address the role of anticoagulation in progressive ischemic stroke and embolism.
Summary:
- Warfarin is indicated for primary and secondary prophylaxis in NVAF patients >60 years or with risk factors.
- Aspirin is recommended for patients with contraindications to warfarin.
- Antiplatelet therapy shows a ~25% reduction in subsequent stroke risk for TIAs and minor strokes, and is likely indicated for acute, stable ischemic stroke.
Impact:
- Informs clinical practice for stroke prevention strategies.
- Highlights the importance of tailored anticoagulant and antiplatelet therapy.
- Provides evidence-based recommendations for managing thromboembolic events in specific patient groups.
Abstract:
Warfarin is recommended as primary prophylactic therapy for patients older than 60 years with non-valvular atrial fibrillation and for patients with additional risk factors for thromboembolism. Warfarin should also be given as secondary prophylaxis. Patients with contraindications to warfarin should be given aspirin. Anticoagulant therapy is recommended against progressive ischemic stroke and in cardiogenic cerebral embolism, although conclusive evidence of the benefit is lacking. In the case of transient ischemic attacks and minor stroke, antiplatelet therapy reduces the risk of subsequent stroke by approximately 25 percent. Antiplatelet therapy is probably indicated in cases of acute, stable ischemic stroke.
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