ASA remains a key antithrombotic for stroke prevention, though its use requires careful balancing of benefits against the risk of intracranial hemorrhage, especially in primary prevention.
May warrant caution with ASA in primary stroke prevention; leaves open optimal risk-benefit strategies.
Prevention of stroke remains one of the most pressing healthcare issues. Acetylsalicylic acid (ASA) is the only antithrombotic drug used for primary and secondary prevention of atherothrombotic stroke. A serious and challenging limitation to extensive antithrombotic therapy in ischemic stroke is the risk of hemorrhagic complications, primarily intracranial hemorrhages. In primary prevention of stroke in individuals without clinical manifestations of atherosclerosis, it is especially important to correlate the perceived benefit and the possible risk posed from the administration of ASA. The combination of ASA with other antiplatelet drugs (dipyridamole, clopidogrel) could additionally benefit some patients after stroke or transient ischemic attack.
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P. S. Laguta (2017) studied this question.
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