Antiplatelet agents for prevention of recurrent ischemic stroke

Abstract

Prevention of secondary stroke is an important objective in the management of patients with ischemic stroke or TIA. Commonly used antiplatelet regimens for this indication include aspirin, clopidogrel and ASA-ERDP. Based on current evidence, ASA-ERDP appears to be more effective than aspirin monotherapy, and one study has shown that clopidogrel may be more effective than aspirin. Furthermore, results from the recent PROFESS trial suggest that ASA-ERDP and clopidogrel are equally effective in reducing the risk of recurrent stroke, though further studies are needed to compare the efficacy and safety of these two agents. Recently updated guidelines have attempted to define the appropriate use of antiplatelet therapy for the prevention of recurrent stroke. However, individual patient characteristics need to be considered when selecting therapy. Specifically, factors such as cost, tolerability, adherence and other comorbidities may guide treatment choices.