Future antiplatelet strategies for secondary stroke prevention must address aspirin resistance while balancing ischaemic efficacy and haemorrhagic safety.
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Highlights limitations of current regimens; leaves open identification of balanced antiplatelet options in prospective trials.
Antiplatelet therapy is indicated for secondary prevention of ischaemic stroke. The first-line antiplatelet agent is aspirin. The effect of aspirin is, however, very limited, and this limited effect of aspirin is argued with termed 'aspirin resistance'. Strategies against aspirin resistance may include alternative use of other antiplatelet agents, combination of aspirin with other antiplatelet agents and investigation into molecular targets to develop novel antiplatelet agents. Progress in antiplatelet therapy should be directed at further reducing the risk of ischaemic events including ischaemic stroke without increasing the risk of haemorrhagic events including haemorrhagic stroke.
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Uchiyama et al. (2006) studied this question.
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