Dual antiplatelet therapy with clopidogrel and aspirin may benefit specific high-risk patients with ischemic stroke or TIA, requiring individualized strategies weighing ischemia and hemorrhage risks.
Does dual antiplatelet therapy of clopidogrel and aspirin improve secondary prevention in patients with ischemic stroke and related high-risk conditions?
Dual antiplatelet therapy with clopidogrel and aspirin may provide significant benefit for secondary prevention in specific high-risk ischemic stroke populations, requiring individualized strategies to balance ischemic and hemorrhagic risks.
Nowadays the dual antiplatelet therapy (DAPT) becomes more widely used in patients with ischemic stroke. Nevertheless, controversies exist for indications of DAPT. In view of evidence-based medicine analysis, patients with high-risk transient ischemic attack and minor stroke, severe symptomatic intracranial artery stenosis, symptomatic intracranial and extracranial artery stenosis causing artery-to-artery embolism, ischemic stroke attributed to aortic arch plaques, high-risk atrial fibrillation not suitable for oral anticoagulants, intracranial and extracranial stent implantation, and ischemic stroke with acute coronary syndrome may gain great benefit from DAPT of clopidogrel and aspirin. In clinical practice, individualized antiplatelet therapy strategies should be taken by weighing risks of ischemia and hemorrhage.
Su et al. (Tue,) conducted a review in Ischemic stroke. Dual antiplatelet therapy (clopidogrel and aspirin) was evaluated. Dual antiplatelet therapy with clopidogrel and aspirin may benefit specific high-risk patients with ischemic stroke or TIA, requiring individualized strategies weighing ischemia and hemorrhage risks.