Key result
This review summarizes current evidence on using oral anticoagulant and antiplatelet therapies to balance efficacy and bleeding risk for preventing recurrent events after ischaemic stroke or TIA.
Why the study?
Antithrombotic therapy reduces ischemic risk at the expense of bleeding, making the balance between efficacy and safety a clinical challenge across various stroke and TIA subtypes.
Does oral antithrombotic therapy prevent recurrent events in patients with ischaemic stroke or TIA?
Does oral antithrombotic therapy prevent recurrent events in patients with ischaemic stroke or TIA?
This review summarizes current evidence on balancing ischemic protection and bleeding risk with oral antithrombotic therapy for secondary prevention in patients with prior ischemic stroke or TIA.
Answers are grounded in this paper and cite their sources.
May inform antithrombotic selection after ischaemic stroke or TIA; leaves open optimal regimens pending higher-level evidence.
Stroke is frequently a disabling and even life-threatening condition that has an ischaemic cause in most cases. Transient ischaemic attack (TIA) is a lower risk condition that still exposes to the risk of future major cardiovascular events. The causes of stroke can be classified as cardioembolic disease, large vessel disease, small vessel disease, undetermined, or others. Cardioembolic disease and atherothrombosis of large arteries are the most common underlying processes of ischaemic stroke and TIA. Therefore, antithrombotic therapy is a central strategy in the pharmacological management of these patients. However, because antithrombotic therapy provides ischaemic protection at the price of increased bleeding, defining the fine balance between efficacy and safety is a clinical challenge. Numerous trials have recently defined the current indications to the use of anticoagulant and antiplatelet therapy in patients with various subtypes of ischaemic stroke or TIA. In this review, we provide an updated appraisal of the currently available evidence on the use of various oral antithrombotic agents for prevention of recurrent events after an ischaemic stroke or TIA.
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Capodanno et al. (2021) conducted a review in Ischaemic stroke or transient ischaemic attack (TIA). Oral antithrombotic agents (anticoagulant and antiplatelet therapy) was evaluated. This review summarizes current evidence on using oral anticoagulant and antiplatelet therapies to balance efficacy and bleeding risk for preventing recurrent events after ischaemic stroke or TIA.
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