Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke: a clinical practice guideline
Date Added:
January 6, 2019
Journal/Publication:
BMJ
Publisher:
BMJ Publishing Group Ltd
Publication Date:
December 18, 2018
Type:
Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines
Format:
Article
DOI (1):
10.1136/bmj.k5130
PMID (1):
30563885
Abstract
What is the role of dual antiplatelet therapy after high risk transient ischaemic attack or minor stroke? Specifically, does dual antiplatelet therapy with a combination of aspirin and clopidogrel lead to a greater reduction in recurrent stroke and death over the use of aspirin alone when given in the first 24 hours after a high risk transient ischaemic attack or minor ischaemic stroke? An expert panel produced a strong recommendation for initiating dual antiplatelet therapy within 24 hours of the onset of symptoms, and for continuing it for 10-21 days. Current practice is typically to use a single drug.
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RPR Commentary
This expert panel has issued a strong recommendation for initiating dual antiplatelet therapy (e.g. aspirin plus clopidogrel) within 24 hours of the onset of symptoms of a high-risk TIA or minor ischemic stroke based upon evidence from a recent large meta-analysis.