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Antithrombotic Therapy for Primary and Secondary Prevention of Ischemic Stroke: JACC State-of-the-Art Review. 2023
Antonio Greco, and
Giovanni Occhipinti, and
Daniele Giacoppo, and
Federica Agnello, and
Claudio Laudani, and
Marco Spagnolo, and
Maria Sara Mauro, and
Carla Rochira, and
Simone Finocchiaro, and
Placido Maria Mazzone, and
Denise Cristiana Faro, and
Davide Landolina, and
Nicola Ammirabile, and
Antonino Imbesi, and
Carmelo Raffo, and
Davide Capodanno
Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-San Marco," University of Catania, Catania, Italy. Electronic address: https://twitter.com/AGrecoMD.
Stroke is a devastating condition with significant morbidity and mortality worldwide. Antithrombotic therapy plays a crucial role in both primary and secondary prevention of stroke events. Single or dual antiplatelet therapy is generally preferred in cases of large-artery atherosclerosis and small-vessel disease, whereas anticoagulation is recommended in conditions of blood stasis or hypercoagulable states that mostly result in red thrombi. However, the benefit of antithrombotic therapies must be weighed against the increased risk of bleeding, which can pose significant challenges in the pharmacological management of this condition. This review provides a comprehensive summary of the currently available evidence on antithrombotic therapy for ischemic stroke and outlines an updated therapeutic algorithm to support physicians in tailoring the strategy to the individual patient and the underlying mechanism of stroke.
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