Medicus, Vol. 24 No. 2 ASK niske doze, 2015.
Review article
Antiplatelet Therapy in Secondary Prevention of Stroke
Zlatko Trkanjec
Abstract
Secondary prevention includes treatment and rehabilitation of patients who have had a stroke or transient ischemic attack (TIA), and the identification and treatment of people at a very high risk for stroke. Secondary prevention may prolong the overall survival, improve the quality of life, and reduce the need for surgery and the incidence of recurrent stroke and TIA. In the secondary prevention of ischemic stroke, the most commonly prescribed antiplatelet drug is acetylsalicylic acid (ASA). ASA inhibits cyclooxygenase, thus preventing the synthesis of thromboxane A2 (TXA2) in platelets and that of prostacyclin (PGI2) in endothelial cells, and consequently lowers platelet aggregation and reduces the incidence of cardiovascular and cerebrovascular diseases. Therefore ASA reduces the average relative risk for vascular events by approximately 25%. ASA, administered in any dose greater than 50 mg/day, reduces the risk of stroke, while higher doses are associated with an increased incidence of ASA side-effects (gastrointestinal bleeding, indigestion, heartburn, nausea, vomiting). Out of all antiplatelet drugs available on the market, ASA is the least expensive and therefore the most cost effective drug in secondary prevention of stroke. However, antiplatelet therapy should be individualized for each patient.
Keywords
stroke; transient ischemic attack; antiplatelet therapy; acetylsalicylic acid
Hrčak ID:
148028
URI
Publication date:
4.11.2015.
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