By Richard C Becker, Frederick A Spencer

Stroke is the commonest reason for grownup mortality within the usa. Antithrombotic brokers shape the mainstay of stroke prevention. Aspirin produces a modest relief within the danger of moment stroke and brief ischemic assault (TIA, mini-stroke) and is broadly urged for preliminary remedy. The thienopyridines (Ticlid) and clopodogrel (Plavix) are choices for secondary prevention in sufferers who don't reply to or can't take aspirin. they're not more potent than aspirin and feature been linked to thrombotic thrombocytopenic purpura. the mix of aspirin and extended-release dipyridamole (Aggrenox) has numerous mechanisms of motion and an additive influence on lowering stroke probability in comparison with both agent on my own. A 2-fold raise in danger relief and favorable security profile recommend that the mix can function first-line prophylaxis opposed to a moment stroke. This quantity, as a part of the Oxford American Pocket Note sequence, presents the clinician wtih up to date info at the directions, and healing strategies in recurrent stroke/TIA prevention. priceless positive aspects comprise therapy algorithms, illustrations, medicine tables, charts and figures to let either the professional and the first supplier to make sure the simplest concepts to their sufferers so that it will hinder the reocurrence of stroke/TIA.

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Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 2006;367(9523):1665–73. 45. , et al; PRoFESS Study Group. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med 2008 Sep 18;359(12):1238–51. 46. , et al; Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) study group. Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, 44 ANTITHROMBOTIC THERAPY active and placebo-controlled study.

2006, Massachusetts Medical Society. All rights reserved. 30 ANTITHROMBOTIC THERAPY this at-risk population. There were no significant differences in this outcome in the two patient groups. DIPYRIDAMOLE, EXTENDED-RELEASE DIPYRIDAMOLE/ASPIRIN COMBINATION (AGGRENOX) Aggrenox is a combination platelet antagonist that includes aspirin (25 mg) and dipyridamole (200 mg extended-release preparation). It is typically taken twice daily. Mechanism of Action Aspirin’s mechanism of action has been discussed previously.

Ticlopidine Aspirin Stroke Study Group. Ticlopidine versus aspirin for stroke prevention: on-treatment results from the ticlopidine aspirin stroke study. J Stroke Cerebrovasc Dis 1993; 3:168–76. 38. Bennett CL, Weinberg PD, Rozenberg-Ben-Dror K, et al. Thrombotic thrombocytopenic purpura associated with ticlopidine. A review of 60 cases. Ann Intern Med 1998;128:541–4. 39. Antman EM, Wiviott SD, Murphy SA, et al. Early and late benefits of prasugrel in patients with acute coronary syndromes 43 OAPN undergoing percutaneous coronary intervention: a TRITONTIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with PrasugrelThrombolysis In Myocardial Infarction) analysis.

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