Dominic Tse1,2, Michael D Hill1,2, Shelagh B Coutts3,4. 1. Calgary Stroke Program, Department of Clinical Neuroscience, Foothills Medical Centre, 1403 29th St NW, C1242, Calgary, AB, T2N 2T9, Canada. 2. Cummings School of Medicine, University of Calgary, Calgary, AB, Canada. 3. Calgary Stroke Program, Department of Clinical Neuroscience, Foothills Medical Centre, 1403 29th St NW, C1242, Calgary, AB, T2N 2T9, Canada. scoutts@ucalgary.ca. 4. Cummings School of Medicine, University of Calgary, Calgary, AB, Canada. scoutts@ucalgary.ca.
Abstract
PURPOSE OF REVIEW: The purpose of this study was to review recent literature on the early secondary prevention in transient ischemic attack (TIA) and minor stroke. RECENT FINDINGS: The result of Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events and the secondary analysis of Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) have shown that treatment with clopidogrel and aspirin for 21 days reduced the risk of recurrent stroke with no significant increase in bleeding risk. Triple antiplatelet therapy with aspirin, clopidogrel, and dipyridamole resulted in a significant increase in major (including fatal) bleeding with no significant reduction in the recurrent stroke or TIA. The early treatment of patients with TIA or minor stroke with clopidogrel and aspirin for 21 days was effective in reducing the risk of recurrent stroke with no significant increase in bleeding risk. Most stroke guidelines have been updated to reflect this recommendation.
PURPOSE OF REVIEW: The purpose of this study was to review recent literature on the early secondary prevention in transient ischemic attack (TIA) and minor stroke. RECENT FINDINGS: The result of Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events and the secondary analysis of Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) have shown that treatment with clopidogrel and aspirin for 21 days reduced the risk of recurrent stroke with no significant increase in bleeding risk. Triple antiplatelet therapy with aspirin, clopidogrel, and dipyridamole resulted in a significant increase in major (including fatal) bleeding with no significant reduction in the recurrent stroke or TIA. The early treatment of patients with TIA or minor stroke with clopidogrel and aspirin for 21 days was effective in reducing the risk of recurrent stroke with no significant increase in bleeding risk. Most stroke guidelines have been updated to reflect this recommendation.
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