Published online Dec 28, 2013. doi: 10.5316/wjn.v3.i4.144
Revised: August 9, 2013
Accepted: September 14, 2013
Published online: December 28, 2013
Transient ischemic attacks and minor ischemic strokes have a high risk of an unstable clinical course in the initial 48-72 h after symptom onset. Early antiplatelet treatment is recommended to treat most patients with acute ischemic stroke because few patients can be treated with thrombolysis due to the limit of strict indications, such as a time window. Antiplatelets aim to prevent recurrence or deterioration of stroke. The guidelines recommend the use of aspirin in the acute stage based on two clinical trials. However, some patients still developed recurrence or deterioration of stroke despite timely aspirin administration. Thus, the question remains unclear whether another effective and safe antiplatelet strategy for the treatment of acute ischemic stroke exists. Growing evidence shows that combination antiplatelets may be superior to mono antiplatelets in the treatment of acute ischemic stroke.
Core tip: Patients with acute ischemic stroke have a high risk of deterioration in the 48-72 h after symptom onset. Although thrombolysis is an effective method, most patients are excluded due to the limit of strict indications. Early antiplatelets are recommended for most patients. However, the question remains unclear whether another effective and safe antiplatelet strategy for the treatment of acute ischemic stroke exists. Growing evidence shows that combination antiplatelets may be superior to mono antiplatelets in the treatment of acute ischemic stroke.