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Contemporary Antiplatelet and Anticoagulant Therapies for Secondary Stroke Prevention: A Narrative Review of Current Literature and Guidelines
AbstractPurpose of ReviewStroke is a leading cause of death and disability worldwide. The annual incidence of new or recurrent stroke is approximately 795,000 cases per year in the United States, of which 87% are ischemic in nature. In addition to the management of modifiable high-risk factors to reduce the risk of recurrent stroke, antithrombotic agents (antiplatelets and anticoagulants) play an important role in secondary stroke prevention. This review will discuss the published literature on the use of antiplatelets and anticoagulants in secondary prevention of acute ischemic stroke and transient ischemic attack (TIA), ...
Source: Current Neurology and Neuroscience Reports - April 11, 2023 Category: Neuroscience Source Type: research

Intravenous thrombolysis versus antiplatelet therapy in minor stroke patients with large vessel occlusion
CONCLUSION: In patients with minor stroke harboring LVO within 4.5-h time window, intravenous t-PA was associated with higher odds for the excellent functional outcome, as compared with the aspirin alone. Further randomized controlled trials are warranted.PMID:36880290 | DOI:10.1111/cns.14124
Source: CNS Neuroscience and Therapeutics - March 7, 2023 Category: Neuroscience Authors: Chunmiao Duan Yunyun Xiong Hongqiu Gu Shang Wang Kai-Xuan Yang Manjun Hao Xueyan Feng Xingquan Zhao Xia Meng Yongjun Wang Source Type: research

Navigating Antiplatelet Treatment Options for Stroke: Evidence-Based and Pragmatic Strategies
AbstractPurpose of ReviewThe benefit of using antiplatelet monotherapy in acute ischemic stroke and secondary stroke prevention is well established. In the last few years, several large randomized trials showed that the use of short-term dual antiplatelet therapy in particular stroke subtypes may reduce the risk of recurrent ischemic events. The aim of this article is to provide a critical analysis of the current evidence and recommendations for the use of antiplatelet agents for stroke prevention.Recent FindingsLong-term therapy with aspirin, clopidogrel, or aspirin plus extended-release dipyridamole is recommended for se...
Source: Current Neurology and Neuroscience Reports - October 13, 2022 Category: Neuroscience Source Type: research

Association between aspirin-induced hemoglobin decline and outcome after acute ischemic stroke in G6PD-deficient patients
CONCLUSION: Hemoglobin decrease with bilirubin increase after aspirin treatment in patients with G6PD deficiency suggests hemolysis, which may influence stroke prognosis. The risk of hemoglobin decline should be carefully monitored in G6PD-deficient patients with ischemic stroke taking aspirin.PMID:34369077 | DOI:10.1111/cns.13711
Source: CNS Neuroscience and Therapeutics - August 9, 2021 Category: Neuroscience Authors: Yicong Chen Jianle Li Zilin Ou Yusheng Zhang Zhijian Liang Weisheng Deng Weixian Huang Fubing Ouyang Jian Yu Shihui Xing Jinsheng Zeng Source Type: research

Effect of alteplase versus aspirin plus clopidogrel in acute minor stroke
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Source: International Journal of Neuroscience - January 13, 2020 Category: Neuroscience Authors: Lihuan Lan Xiaoming Rong Qingyu Shen Hanxian Gong Xiangpen Li Hongxuan Wang Mei Li Jingrui Pan Xiaoni Zhang Ying Peng Source Type: research

Early Secondary Prevention in Transient Ischemic Attack (TIA) and Minor Stroke
AbstractPurpose of ReviewThe purpose of this study was to review recent literature on the early secondary prevention in transient ischemic attack (TIA) and minor stroke.Recent FindingsThe result of Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events and the secondary analysis of Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) have shown that treatment with clopidogrel and aspirin for 21  days reduced the risk of recurrent stroke with no significant increase in bleeding risk. Triple antiplatelet therapy with aspirin, clopidogrel, and dipyridamole resulted in a signific...
Source: Current Neurology and Neuroscience Reports - May 13, 2019 Category: Neuroscience Source Type: research

Medical and endovascular treatments of symptomatic intracranial stenosis. A Bayesian network meta-analysis
Publication date: Available online 8 February 2019Source: Journal of Clinical NeuroscienceAuthor(s): S. Vidale, E. Agostoni, G. Grampa, A. Consoli, D. ConsoliAbstractIntracranial stenosis is a well-established stroke risk factor with an increase of stroke recurrence or TIA up to 12.6% at 1 year. Treatments are different: medical and endovascular. We performed a multiple treatment comparison analysis to detect the best treatment in reducing the risk of stroke recurrence. We searched in Medline, Embase, Cochrane Central Register of Controlled Trials databases between 1979 and October 2017. Inclusion criteria were prospecti...
Source: Journal of Clinical Neuroscience - February 9, 2019 Category: Neuroscience Source Type: research

Stroke-Related Disease Comorbidity and Secondary Stroke Prevention Practices Among Young Stroke Survivors
Conclusions: Many young stroke survivors exhibit comorbid disease conditions that are similar to older stroke survivors. A large percentage are engaged in general chronic disease and secondary stroke prevention practices, yet less than two-thirds had seen a general doctor in the past 12 months. Primary care doctors and other health professionals are critical to the implementation of disease management strategies that consider their age, secondary stroke risk, expected life spans, and other issues that differ from older adult stroke survivors.
Source: Journal of Neuroscience Nursing - September 8, 2017 Category: Neuroscience Tags: Article Source Type: research

Secondary Stroke Prevention in Cryptogenic Stroke and Embolic Stroke of Undetermined Source (ESUS)
AbstractPurpose of the ReviewThe purpose of the study was to review the literature on cryptogenic stroke and embolic stroke of undetermined stroke (ESUS). Cryptogenic stroke according to TOAST criteria is a stroke which is not due to cardiogenic embolism, small vessel disease with lacunes or large vessel disease of brain supplying arteries. In the context of secondary stroke prevention studies, cryptogenic stroke is not operationally defined.Recent FindingsThe new concept of “embolic stroke of undetermined source” (ESUS) provides an operational definition. ESUS is diagnosed as a non-lacunar stroke on cerebral imaging a...
Source: Current Neurology and Neuroscience Reports - July 13, 2017 Category: Neuroscience Source Type: research

Dissection of Cervical and Cerebral Arteries
AbstractPurpose of ReviewWe aimed to summarize recent findings in cervical (CeAD) and intracranial artery dissection (IAD) research.Recent FindingsConsidered a disease of the young- and middle-aged, an analysis on the largest CeAD-population to date (n = 2391) revealed that about 1 of 14 CeAD-patients was aged ≥60 years. Distinct genetic variants were associated with CeAD. However, in clinical practice, genetic investigations are not helpful due to the small effect size. Despite the paucity of data from randomized-controlled trials in CeAD-s troke patients, both intravenous thrombolysis and endovascular treatment shou...
Source: Current Neurology and Neuroscience Reports - June 30, 2017 Category: Neuroscience Source Type: research

Antithrombotic Therapy.
Authors: Kwon SU, Kim JS Abstract Symptomatic cerebral atherosclerosis including intracranial atherosclerosis (ICAS) is associated with a high risk of recurrent stroke. Antithrombotic agents are the mainstay of therapy in these patients. Several studies have found anticoagulation (warfarin) to increase the risk of bleeding events and have an efficacy no better than that of aspirin. Therefore, anticoagulants are not widely used unless patients develop recurrent ischemic symptoms despite receiving antiplatelet therapy. Because ICAS progression is not uncommon and the risk of stroke recurrence is high when aspirin mon...
Source: Frontiers of Neurology and Neuroscience - December 15, 2016 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Vertebral artery pseudoaneurysms secondary to blunt trauma: Endovascular management by means of neurostents and flow diverters
Publication date: Available online 15 July 2016 Source:Journal of Clinical Neuroscience Author(s): José E. Cohen, John M. Gomori, Gustavo Rajz, Guy Rosenthal, Hosni Abu El Hassan, Samuel Moscovici, Eyal Itshayek Extracranial vertebral pseudoaneurysms that develop following blunt trauma to the cervical area may have a benign course; however, embolic or ischemic stroke and progressive pseudoaneurysm enlargement may occur. We review the presentation and endovascular management of pseudoaneurysms of the cervical vertebral artery (VA) due to blunt trauma in nine patients (eight male, mean age 27years). Pseudoaneurysms...
Source: Journal of Clinical Neuroscience - July 16, 2016 Category: Neuroscience Source Type: research

Sodium Sulfide, a Hydrogen Sulfide-Releasing Molecule, Attenuates Acute Cerebral Ischemia in Rats.
CONCLUSION: Sodium sulfide, a H2 S donor, presents protective effect on acute cerebral ischemia, and might be a promising therapeutic drug. PMID: 27160344 [PubMed - as supplied by publisher]
Source: CNS Neuroscience and Therapeutics - May 8, 2016 Category: Neuroscience Authors: Shi HQ, Zhang Y, Cheng MH, Fan BS, Tian JS, Yu JG, Chen B Tags: CNS Neurosci Ther Source Type: research

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