Antithrombotic Therapy for Primary and Secondary Prevention of Ischemic Stroke: JACC State-of-the-Art Review

Antonio Greco, Giovanni Occhipinti, Daniele Giacoppo, Federica Agnello, Claudio Laudani, Marco Spagnolo, Maria Sara Mauro, Carla Rochira, Simone Finocchiaro, Placido Maria Mazzone, Denise Cristiana Faro, Davide Landolina, Nicola Ammirabile, Antonino Imbesi, Carmelo Raffo, Davide Capodanno

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1538-1557
Number of pages20
JournalJournal of the American College of Cardiology
Volume82
Issue number15
DOIs
StatePublished - 10 Oct 2023
Externally publishedYes

Keywords

  • anticoagulation
  • antiplatelet therapy
  • antithrombotic therapy
  • prevention
  • stroke

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