Antithrombotics and thrombolytics in stroke.
Although angioplasty, stenting and thrombolysis of the cerebral circulation are being attempted with increasing frequency, antithrombotic and antiplatelet regimens have not yet been standardized in the treatment of stroke. Safety and efficacy of antithrombotic therapies during cerebrovascular interventions may depend onclinical presentation and carotid lesion characteristics. Platelet glycoprotein (GP) IIb/IIIa receptor antagonists might have potential value as a monotherapy or as an adjunctive therapy with thrombolytics or interventional procedures. However, the risk of cerebral hemorrhage may be higher in patients with acute stroke than in subjects with transient ischemic attack (TIA) or partial occlusion. For high-risk cerebrovascular lesions such as basilar artery, atherothrombosis or acute carotid artery occlusion, initial experience suggests that platelet GPIIb/IIIa receptor antagonists may have implications in reducing acute re-occlusion rates during the various interventional procedures. The aim of this paper is to review the use of antithrombotics as prophylaxis treatment in stroke, in addition, to comparing the benefits/risks of using thrombolytics as acute intervention.
Mousa
Shaker A
SA
Albany College of Pharmacy, NY 12208-3492, USA. mousas@acp.edu
Iqbal
Omar
O
Fareed
Jawed
J
D001281:Atrial Fibrillation / Q000150:complications; D002543:Cerebral Hemorrhage / Q000517:prevention & control; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex