title: Antithrombotic management for transient ischemic attack and ischemic stroke (other than atrial fibrillation).
abstract: The new definition and risk stratification for transient ischemic attack (TIA) have clear implications for the urgency of evaluation and treatment. The optimal antithrombotic treatment for TIA is being intensively studied. New guidelines for prevention of non-cardioembolic stroke in patients with stroke or TIA recommend the use of antiplatelet agents rather than oral anticoagulation. New antiplatelet drugs are being used in cardiovascular patients, and their role in cerebrovascular patients is being studied. The impact of genetic CYP2C19 polymorphisms is becoming clarified in cardiovascular patients and it is likely these polymorphisms will affect the management of cerebrovascular patients. The results of trials of clopidogrel plus aspirin in patients with lacunar strokes and acute TIAs are forthcoming. The results of CLOSURE I, a study of a patent foramen ovale device closure trial for cryptogenic stroke or TIA, showed no differences in stroke or TIA at 2 years.
authors.affiliation: Department of Neurology, University of California, San Francisco, USA. EastonJD@neurology.ucsf.edu
authors.forename: J Donald
authors.initials: JD
authors.lastname: Easton
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D002545:Brain Ischemia / Q000188:drug therapy*; D000077407:Cilostazol; D002986:Clinical Trials as Topic; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D054092:Foramen Ovale, Patent / Q000628:therapy; D005838:Genotype; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D000068799:Prasugrel Hydrochloride; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy*; D013777:Tetrazoles / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D013876:Thiophenes; D003577:Cytochrome P-450 Enzyme System; D000077144:Clopidogrel; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D000077407:Cilostazol; D013988:Ticlopidine