title: [Secondary prevention with clopidogrel after TIA or stroke].
abstract: In patients with TIA or stroke of arterial origin various antiplatelet agents, or combinations of these, have been found to be effective to reduce the risk of new vascular complications. International guidelines currently recommend three treatment strategies with antiplatelet agents after TIA or stroke: acetylsalicylic acid in combination with dipyridamole, clopidogrel monotherapy, or alternatively acetylsalicylic acid monotherapy. In the Netherlands, current standard antiplatelet therapy after a TIA or stroke is a combination of acetylsalicylic acid and dipyridamole. Clopidogrel monotherapy is probably equally as effective as the combination of acetylsalicylic acid and dipyridamole. Clopidogrel monotherapy is easier to use, has fewer side effects and has recently become cheaper than the combination of acetylsalicylic acid and dipyridamole. For secondary prevention in the Netherlands we advise following the international guidelines on thromboprophylaxis after TIA or stroke. Clopidogrel could be considered as an alternative treatment to the combination of acetylsalicylic acid and dipyridamole.
authors.affiliation: Academisch Medisch Centrum, afd. Neurologie, Amsterdam, the Netherlands.
authors.forename: S M Yvonne
authors.initials: SM
authors.lastname: Zuurbier
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Vermeer
authors.forename: Pieter H E
authors.initials: PH
authors.lastname: Hilkens
authors.forename: Ale
authors.initials: A
authors.lastname: Algra
authors.forename: Yvo B W E M
authors.initials: YB
authors.lastname: Roos
mesh_terms: D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D000077144:Clopidogrel; D004176:Dipyridamole / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000517:prevention & control*; D009426:Netherlands; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy / Q000517:prevention & control*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin