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Antiplatelet Therapy in Cerebrovascular Disorders

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Platelets in Thrombotic and Non-Thrombotic Disorders

Abstract

Stroke is a preventable public health problem, with widespread effects. Antithrombotic medications are the mainstay of both primary and secondary stroke prevention. This chapter discusses the role of antiplatelet medications such as aspirin, clopidogrel, and dipyridamole in the acute treatment, primary prevention, and secondary prevention of stroke. For acute treatment, the current recommendations are early treatment with aspirin alone for acute ischemic stroke patients who are not receiving thrombolysis. For primary prevention, the recommendations do not generally recommend any antiplatelet unless the patient has atrial fibrillation, in which case anticoagulation is favored. For secondary prevention, the current data favors the use of an antiplatelet agent, either aspirin, clopidogrel, or the combination aspirin-dipyridamole. There is ongoing research into the role of combination aspirin plus clopidogrel, as this may be beneficial in certain subgroups of non-cardioembolic stroke patients. There is also ongoing research on novel antiplatelet agents, with the aim of decreasing recurrent stroke rates as well as bleeding events. This chapter provides a summary of current evidence and recommendations and addresses future possibilities for antiplatelet treatment for ischemic stroke.

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Author information

Authors and Affiliations

  1. Stanford University, 300 Pasteur Drive, MC 5778, Stanford, CA, 94305-5778, USA

    Ilana Spokoyny MD & Gregory Albers MD

Authors
  1. Ilana Spokoyny MD
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  2. Gregory Albers MD
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Correspondence to Gregory Albers MD .

Editor information

Editors and Affiliations

  1. Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia , Perugia, Italy

    Paolo Gresele

  2. Houston Methodist Hospital , Houston, Texas, USA

    Neal S. Kleiman

  3. Bloodworks Northwest, University of Washington , Seattle, Washington, USA

    José A. Lopez

  4. Sackler Inst of Pulmonary Pharmacol, King’s College London, London, United Kingdom

    Clive P. Page

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Spokoyny, I., Albers, G. (2017). Antiplatelet Therapy in Cerebrovascular Disorders. In: Gresele, P., Kleiman, N., Lopez, J., Page, C. (eds) Platelets in Thrombotic and Non-Thrombotic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-47462-5_92

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