Abstract
The aim of this mini-review is to discuss the main antiplatelet agents that have been successfully used in the secondary prevention of non-cardioembolic ischemic stroke and transient ischemic attacks (TIA). The methodology is based on a literature review of available peer-reviewed English studies listed in PubMed. The findings reveal that aspirin remains a reliable antiplatelet agent in the secondary prevention of acute non-cardioembolic ischemic stroke and TIA. Nevertheless, currently, there are also other agents, i.e., ticagrelor, clopidogrel, and cilostazol, that can be applied. In addition, the results indicate that time is significant not only in severe stroke but also in non-severe stroke and TIA, which suggests that antiplatelet therapy should be applied within 24 h after the first symptoms because early treatment can lead to an improvement in neurological outcomes and reduce the chance of an early subsequent stroke.
Highlights
Strokes are among the major causes of morbidity, mortality, and long-term disability [1]
Amarenco et al [7], within the SOCRATES project, indicated that if ticagrelor was administered within 24 h of symptom onset, it would be more effective than aspirin in preventing stroke, myocardial infarction, or death at 90 days in patients with acute ischemic stroke or a transient ischemic attack when associated with potentially symptomatic ipsilateral atherosclerotic stenosis
Their findings showed that there were no differences in the rate of life-threatening bleeding or major or minor bleeding episodes in patients with ipsilateral stenosis in the ticagrelor group compared with the aspirin group
Summary
Strokes are among the major causes of morbidity, mortality, and long-term disability [1]. In European Union countries, the number of patients with strokes is expected to grow by 27% between 2017 and 2047. The reason for this is that there has been an increase in aging population groups and better survival rates after a stroke [3]. The most frequent type of stroke, comprising on average between 80 and 90% of all strokes, is ischemic stroke [4]. This type of stroke results from the occlusion of the artery that supplies blood to the brain. The initial manifestations of ischemic stroke and TIA are often followed by recurrent vascular events, including recurrent strokes [7]
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