Interní Med. 2006; 8(12): 534-538

Antiaggregation treatment for ischaemic stroke

MUDr. Ondřej Škoda

Neurologické oddělení nemocnice Pelhřimov

Antiaggregation treatment is safe and evidently efficient already during the acute phase of ischaemic stroke. Nevertheless, it is dominantly used in patients after stroke or transitory ischaemic event, for the secondary prevention of stroke recurrence. Antiaggregation is indicated in all stroke patients, except the subgroup, selected for long-term anticoagulation. Antiaggregation drugs with proved safety and efficacy are following: Acetylsalicylic acid (ASA), thienopyridines and dipyridamole. ASA is a basic antiaggregation drug. Its efficacy is not directly dose-dependent, with recommended dosage of 50–325 mg daily. In case of the clinical treatment failure, resulting in a new ischaemic event, it should be replaced for the combination of ASA with dipyridamole or for a thienopyridine. Combination of ASA (25 mg) and dipyridamole (200 mg), twice daily, is more efficient in the secondary stroke prevention than ASA alone. That´s why it can be also used as the first selection treatment, especially for patients with the increased risk of stroke recurrence. Patients, who presented ASA intolerance or allergy, should be treated with thienopyridines – clopidogrel 75 mg daily is the preferred drug. Antiaggregation treatment is a part of the complex secondary stroke prevention, based on all adequate lifestyle, pharmacological and interventional methods.

Keywords: Key words: ischaemic stroke, transitory ischaemic event, secondary prevention, antiaggregation.

Published: March 1, 2007  Show citation