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Antiplatelet treatment for acute secondary prevention of non-cardioembolic minor stroke/transient ischaemic attack: an update for the acute physician

Version 2 2023-11-16, 16:20
Version 1 2022-08-05, 09:28
journal contribution
posted on 2023-11-16, 16:20 authored by Kailash Krishnan, Zhe Kang Law, Jatinder Minhas, Philip Bath, Thompson Robinson, Nikola Sprigg, Akash Mavilakandy, Timothy England, David Eveson, Amit Mistri, Jesse Dawson, Jason Appleton

Acute stroke is the leading cause of disability in the UK and a leading cause of mortality worldwide. The majority of patients with ischaemic stroke present with minor deficits or transient ischaemic attack (TIA), and are often first seen by patient-facing clinicians. Urgent evaluation and treatment are important as many patients are at high risk of major vascular events and death within hours to days after the index event. This narrative review summarises the evidence on four antiplatelet treatments for non-cardioembolic stroke prevention: aspirin, clopidogrel, dipyridamole and ticagrelor. Each of these drugs has a unique mechanism and has been tested as a single agent or in combination. Aspirin, when given early is beneficial and short-term treatment with aspirin and clopidogrel has been shown to be more effective in high-risk TIA / minor stroke. This review concludes by highlighting gaps in evidence, including scope for future trials that could potentially change clinical practice.

History

Author affiliation

Department of Cardiovascular Sciences, University of Leicester

Version

  • AM (Accepted Manuscript)

Published in

Clinical Medicine Journal

Volume

22

Issue

5

Pagination

449-454

Publisher

Royal College of Physicians

issn

1470-2118

Acceptance date

2022-07-25

Copyright date

2022

Language

en

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