Prevention of Cerebrovascular Ischemic Events with Antiplatelet Drugs: Who Benefits Most?

Abstract

Antiplatelet agents have been studied extensively in clinical stroke prevention trials for 25 years. Only two have proven effective, aspirin and ticlopidine. Current data suggest that antiplatelets have a limited role in the primary prevention of stroke, and that ticlopidine is superior to aspirin in most settings. Ticlopidine may have special advantages in women, aspirin failure and in patients with vertebrobasilar insufficiency, hypertension and diabetes. Many unanswered questions require further study.