Key result
Aspirin, clopidogrel, or dipyridamole-aspirin are cornerstone therapies for noncardioembolic stroke, while oral anticoagulation is more effective for secondary prevention in atrial fibrillation.
This review highlights that standard antiplatelet therapy is foundational for noncardioembolic stroke, while oral anticoagulation is superior for stroke prevention in atrial fibrillation, with a noted trade-off of increased bleeding with more potent antiplatelet regimens.
Supports antithrombotic distinctions by stroke subtype; leaves open prospective trials of novel agents.
This article provides the reader with an overview and an update on antithrombotic stroke-prevention strategies. Relevant journals were hand-searched by the authors to compile a broad, but not comprehensive, summary of innovative and clinically relevant studies. These findings were then summarized to provide an expert opinion on selected fields of medical stroke prevention. We conclude that aspirin, clopidogrel or dipyridamol-aspirin are the cornerstone therapies in patients with noncardioembolic stroke. More potent antiplatelet drugs or the combination of aspirin and clopidogrel prevent more ischemic events but also lead to more bleeding complications. For secondary stroke prevention in patients with atrial fibrillation, oral anticoagulation is more effective than aspirin or the combination of aspirin and clopidogrel.
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Weimar et al. (2009) conducted a review in Stroke prevention. Antithrombotic medication was evaluated. Aspirin, clopidogrel, or dipyridamole-aspirin are cornerstone therapies for noncardioembolic stroke, while oral anticoagulation is more effective for secondary prevention in atrial fibrillation.
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