Current guidelines on antiplatelet agents for secondary prevention of noncardiogenic stroke: an evidence-based review

Postgrad Med. 2010 Mar;122(2):49-53. doi: 10.3810/pgm.2010.03.2121.


Antiplatelet therapy is a mainstay of secondary prevention of ischemic strokes. Recent studies, such as Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS), the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial, and the European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), have added much to our understanding about how best to utilize the various antiplatelet agents available. Aspirin has been shown to reduce the risk of recurrent strokes, and the combination of aspirin and dipyridamole has repeatedly been shown to outperform aspirin alone. Recently, clopidogrel was demonstrated to be "noninferior" to an aspirin/dipyridamole combination, and can be considered as a first-line agent. The American Stroke Association and American Heart Association have clear recommendations on how to utilize these agents.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • American Heart Association
  • Aspirin / therapeutic use
  • Clopidogrel
  • Dipyridamole / therapeutic use
  • Drug Therapy, Combination
  • Humans
  • Ischemic Attack, Transient / drug therapy
  • Ischemic Attack, Transient / prevention & control*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Risk Factors
  • Secondary Prevention*
  • Stroke / drug therapy
  • Stroke / prevention & control*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • United States
  • Vasodilator Agents / therapeutic use


  • Platelet Aggregation Inhibitors
  • Vasodilator Agents
  • Dipyridamole
  • Clopidogrel
  • Ticlopidine
  • Aspirin