Recurrent Stroke while on Antiplatelet Therapy

Seby John; Irene Katzan

doi:10.1016/j.ncl.2014.12.007

Recurrent Stroke while on Antiplatelet Therapy

Neurol Clin. 2015 May;33(2):475-89. doi: 10.1016/j.ncl.2014.12.007. Epub 2015 Feb 2.

Authors

Seby John¹, Irene Katzan²

Affiliations

¹ Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, S80, Cleveland, OH 44195, USA.
² Neurological Institute Center for Outcomes Research & Evaluation, Cleveland Clinic, 9500 Euclid Avenue, S80, Cleveland, OH 44195, USA. Electronic address: katzani@ccf.org.

PMID: 25907917
DOI: 10.1016/j.ncl.2014.12.007

Abstract

Of the ≈795,000 strokes in the United States annually, 185,000 are recurrent. A third to half of them occur while on antiplatelet therapy. Multiple reasons could explain breakthrough stroke while on antiplatelet therapy. Management of recurrent stroke requires a meticulous search for the cause and mechanism of stroke. At present, there is no indication for antiplatelet resistance testing in ischemic stroke, or adjusting medications based on its results. Recent trials have shown the effectiveness of dual antiplatelet therapy in the acute period after an ischemic event, but no benefit has been found with this regimen for long-term secondary prevention.

Keywords: Antiplatelets; Ischemic stroke; Recurrence; Resistance; Treatment failure.

Publication types

Review

MeSH terms

Humans
Platelet Aggregation Inhibitors / therapeutic use*
Recurrence
Stroke / drug therapy*
Stroke / epidemiology
Stroke / prevention & control*

Substances

Platelet Aggregation Inhibitors