In Which Situations Is Antiplatelet Therapy Justified?

Since the end of the 1970s, though convincing studies were lacking, it has become a rule to treat any patient with cerebrovascular disease with an antiplatelet such as aspirin or dipyridamole. Subsequently, numerous studies demonstrated a moderate effect of these drugs for the secondary prevention of stroke. On average, antiplalelet therapies decrease the absolute risk of any ulterior vascular event by 2-3%, which represents a decrease of relative risk of about one quarter.

The relative risk of death (whatever the cause) decreases by 17%. Therefore, it is justified to give such a treatment to any patient with a cerebrovascular event (transient ischemic attack (TIA), regressive ischemic neurological disease (RIND) or stroke). More-over, the International Stroke Trial (1ST) and Chinese Acute Stroke Trial (CAST), demonstrated that antiplatelet therapy (specifically aspirin), when begun within the 48 h following stroke, diminishes the risk of a new stroke and death in the following 14 ... more.

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