The Importance of Platelets Response during Antiplatelet Treatment after Ischemic Stroke-Between Benefit and Risk: A Systematic Review

Int J Mol Sci. 2022 Jan 18;23(3):1043. doi: 10.3390/ijms23031043.

Abstract

Ischemic stroke is a disease related to abnormal blood flow that leads to brain dysfunction. The early and late phases of the disease are distinguished. A distinction is made between the early and late stages of the disease, and the best effect in treating an ischemic stroke is usually achieved within the first hours after the onset of symptoms. This review looked at studies platelet activity monitoring studies to determine the risks and benefits of various approaches including antiplatelet therapy. A study was conducted on recently published literature based on PRISMA. This review includes 32 research articles directly addressing the importance of monitoring platelet function during antiplatelet therapy (dual or monotherapy) after ischemic stroke. In patients with transient ischemic attack or ischemic stroke, antiplatelet therapy can reduce the risk of stroke by 11-15%, assuming that patients respond well. Secondary prevention results are dependent on platelet reactivity, meaning that patients do not respond equally to antiplatelet therapy. It is very important that aspirin-resistant patients can benefit from the use of dual antiplatelet therapy. The individualized approach to secondary stroke prevention is to administer the most appropriate drug at the correct dose and apply the optimal therapeutic procedure to the individual patient.

Keywords: antiplatelet drugs; ischemic stroke; monitoring of platelet function; personalized treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aspirin / pharmacology
  • Aspirin / therapeutic use
  • Blood Platelets / drug effects*
  • Drug Resistance
  • Drug Therapy, Combination
  • Humans
  • Ischemic Stroke / blood
  • Ischemic Stroke / drug therapy*
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin