title: Aspirin and clopidogrel for prevention of ischemic stroke.
abstract: This review examines the role of platelets in ischemic stroke, platelet activation mechanisms, aspirin's rise as an antithrombotic agent, clopidogrel's appearance on the stage, a possible role for combination therapy, antiplatelet resistance, practical considerations, and future directions. Reviewed in this chapter are issues central to optimal antiplatelet therapy: efficacy, safety, resistance, and biochemical/laboratory testing. Current guidelines do not recommend combination aspirin and clopidogrel use, however recent research indicates dual antiplatelet therapy with combined aspirin and clopidogrel may have specific roles in secondary prevention of ischemic stroke. A cautious and analytical interpretation of the literature is advised before application of this knowledge to clinical practice. The best recommendation at this time is to follow the published guidelines for secondary prevention of ischemic stroke.
authors.affiliation: Department of Neurology, University of Minnesota, 420 Delaware St. SE, MMC 295, Minneapolis, MN 55455, USA. Thom1824@umn.edu
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Thomson
authors.forename: David C
authors.initials: DC
authors.lastname: Anderson
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy / Q000517:prevention & control*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy / Q000517:prevention & control*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin