Utilization of Antiplatelet in Ischemic Stroke

Author(s): Carlo Joe

Objective: A review of the literature on antiplatelet medications for the prevention of primary and secondary strokes, including their mechanism of action, price, and reasons for their lack of benefit. Sources of data: The databases MEDLINE, Cochrane Reviews, and PubMed were used to gather the articles (1980-2021). We looked at abstracts from scientific meetings. Ischemic stroke, aspirin, clopidogrel, dipyridamole, ticagrelor, cilostazol, prasugrel, and glycoprotein IIb/IIIa inhibitors were among the search terms.

Selection of a study and data collection: Both original and review articles written in English were evaluated. Multiple nations’ guidelines were looked at. Two authors independently evaluated the articles. Synthesis of data: There is a lot of evidence that aspirin and clopidogrel can be used to prevent secondary strokes. These medications work better together to prevent future strokes in the acute phase (the first 21 days after the initial stroke), but long-term combination therapy is linked to higher rates of bleeding. Failure of antiplatelet therapy is influenced by genetic polymorphisms and poor adherence. In some racial groups, antiplatelet agents like cilostazol may be better than clopidogrel and aspirin, but more research is needed on more diverse ethnic groups. Relevance to clinical practice and patient care: The available data on the use of various antiplatelet medications after stroke are presented in this review. Topics for future research include dual therapy, recurrence following the start of secondary preventative therapy, and these topics.

Conclusions: Even though there is a lot of evidence to support the use of certain antiplatelet medications after a stroke, personalized therapies still have a lot of room for improvement. Screening patients for platelet polymorphisms that cause antiplatelet resistance and incorporating more racially diverse populations into randomized trials are two examples of these.