Stroke prevention: anti-platelet and anti-thrombolytic therapy.

Abstract:

:In patients with TIA or ischemic stroke of noncardiac origin antiplatelet drugs are able to decrease the risk of stroke by 11-15%, and the risk of stroke, MI, and vascular death by 15-22%, but not mortality. Low doses of aspirin (50-325 mg) are as effective as high doses and cause less gastrointestinal side effects. Severe bleeding complications are not dose-dependent. The combination of aspirin with slow release dipyridamole is superior to aspirin alone for stroke prevention. Ticlopidine is superior to aspirin but has slightly more serious adverse effects (neutropenia). It will be replaced by clopidgrel which has a better safety profile. Anticoagulation with an INR between 3.0 and 4.5 is too dangerous. Whether anticoagulation with lower INR is safe and effective is not yet known.

journal_name

Neurol Clin

journal_title

Neurologic clinics

authors

Diener HC

doi

10.1016/s0733-8619(05)70196-1

subject

Has Abstract

pub_date

2000-05-01 00:00:00

pages

343-55

issue

2

eissn

0733-8619

issn

1557-9875

pii

S0733-8619(05)70196-1

journal_volume

18

pub_type

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