Secondary prevention of ischaemic stroke

doi:10.5316/wjn.v3.i4.97

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Dec 28, 2013 (publication date) through May 13, 2024

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World Journal of Neurology

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2218-6212

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Neurol. Dec 28, 2013; 3(4): 97-114
Published online Dec 28, 2013. doi: 10.5316/wjn.v3.i4.97

Table 1 Antiplatelet therapy after non-cardioembolic stroke or transient ischaemic attack

	Options	Recommendation
AHA/ASA[25]	Aspirin (50-325 mg); aspirin plus dipyridamole; clopidogrel	Aspirin, aspirin plus dipyridamole or clopidogrel
ESO[24]	Aspirin; aspirin plus dipyridamole; clopidogrel; triflusal	Clopidogrel or aspirin plus dipyridamole
ACCP[52]	Aspirin (75-100 mg); clopidogrel; aspirin plus dipyridamole; cilostazol	Clopidogrel or aspirin plus dipyridamole

AHA/ASA: American Heart Association/American Stroke Association; ESO: European Stroke Organisation; ACCP: American College of Chest Physicians.

Table 2 CHADS₂, CHA₂DS₂VASC, and HAS-BLED risk stratification methods

CHADS₂
Congestive heart failure	1
Hypertension	1
Age ≥ 75 yr	1
Diabetes mellitus	1
Stroke, TIA, or thromboembolism	2
Maximum score	6
CHA₂DS₂VASc
Congestive heart failure/LV dysfunction	1
Hypertension	1
Age ≥ 75 yr	2
Diabetes mellitus	1
Stroke, TIA, or thromboembolism	2
Vascular disease (previous MI, PAD, or aortic plaque)	1
Age 65-74 yr	1
Sex category (female sex)	1
Maximum score	9
HAS-BLED
Hypertension	1
Abnormal renal/liver function	1 point each
Stroke	1
Bleeding history or predisposition	1
Labile INR	1
Elderly (age > 65 yr)	1
Drugs (e.g., concomitant antiplatelet/NSAID) or alcohol	1 point each
Maximum score	9

TIA: Transient ischaemic attack; LV: Left ventricular; MI: Myocardial infarction; PAD: Peripheral artery disease; NSAID: Nonsteroidal inflammatory drugs; INR: International normalized ratio.

Table 3 Anticoagulation therapy after stroke or transient ischaemic attack in patients with atrial fibrillation

	Recommendation	Alternatives in patients unsuitable to anticoagulation
AHA/ASA[25]	Warfarin (INR 2.0-3.0)	Aspirin
ESO[24]	Warfarin (INR 2.0-3.0)	Aspirin plus dypiridamole
ACCP[52]	Dabigatran (150 mg twice daily)	Aspirin plus clopidogrel

AHA/ASA: American Heart Association/American Stroke Association; ESO: European Stroke Organisation; ACCP: American College of Chest Physicians; INR: International normalized ratio.

Citation: Volonghi I, Padovani A, Zotto ED, Giossi A, Costa P, Morotti A, Poli L, Pezzini A. Secondary prevention of ischaemic stroke. World J Neurol 2013; 3(4): 97-114
URL: https://www.wjgnet.com/2218-6212/full/v3/i4/97.htm
DOI: https://dx.doi.org/10.5316/wjn.v3.i4.97