Stroke, summary, Use of Antiplatelet Agents after Transient Ischemic Attack (TIA) and Stroke, Holisticonline.com

Stroke

Use of Antiplatelet Agents after Transient Ischemic Attack (TIA) and Stroke

Cerebral Ischemia	First Line Therapy	Second-Choice Therapy
Atherothrombotic, lacunar (small vessel disease), or	Acetylsalicylic acid (ASA) 50-325 mg/day	Clopidogrel 75 mg/day Extended-release dipyridamole ( ER-DP) 200 mg/day in combination with acetylsalicylic acid (ASA) 25 mg/twice per day
Recurrence on acetylsalicylic acid (ASA) therapy	Clopidogrel 75 mg/day Extended-release dipyridamole ( ER-DP) 200 mg/day in combination with acetylsalicylic acid (ASA) 25 mg/twice per day	Warfarin (INR 2-3)
Cardioembolic TIA or Stroke: Defined Source
Nonvalvular atrial fibrillation	Warfarin INR 2-3 (target 2.5),	If warfarin contraindicated, acetylsalicylic acid (ASA) 50-325 mg/day Clopidogrel 75 mg/day Extended-release dipyridamole ( ER-DP) 200 mg/day in combination with acetylsalicylic acid (ASA) 25 mg/twice per day
Left ventricular thrombus, recent myocardial infarction (MI or heart attack)	Warfarin INR 2-3 (target 2.5), 6-month therapy	If warfarin contraindicated, acetylsalicylic acid (ASA) 50-325 mg/day Clopidogrel 75 mg/day Extended-release dipyridamole ( ER-DP) 200 mg/day in combination with acetylsalicylic acid (ASA) 25 mg/twice per day
Prosthetic valvular heart disease	Warfarin INR 3-4 (target 3.5), lifelong	If warfarin contraindicated, acetylsalicylic acid (ASA) 50-325 mg/day Clopidogrel 75 mg/day Extended-release dipyridamole ( ER-DP) 200 mg/day in combination with acetylsalicylic acid (ASA) 25 mg/twice per day
Cardioembolic TIA or Stroke: Possible Source
	Antiplatelet agents
Atherosclerotic Corotid Stenosis
> 70%	Carotid endarterectomy	Antiplatelet agents
50-69%	Carotid endarterectomy,	Antiplatelet agents
< 50%	Antiplatelet agents

INR = International Normalized Ratio

Source: Eugene D. Kaplan, MD, and Ralph L. Sacco, MD, MSc:, "Use of Antiplatelet Therapy for Stroke Prevention," Clinical Geriatrics, Vol. 10, Number 2, February 2002

Caution: If you suspect a stroke, seek emergency medical treatment immediately. Time is of essence.

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