부산대학교 도서관

Stroke is a devastating condition with significant morbidity and mortality worldwide. Antithrombotic therapy plays a crucial role in both primary and secondary prevention of stroke events. Single or dual antiplatelet therapy is generally preferred in cases of large-artery atherosclerosis and small-vessel disease, whereas anticoagulation is recommended in conditions of blood stasis or hypercoagulable states that mostly result in red thrombi. However, the benefit of antithrombotic therapies must be weighed against the increased risk of bleeding, which can pose significant challenges in the pharmacological management of this condition. This review provides a comprehensive summary of the currently available evidence on antithrombotic therapy for ischemic stroke and outlines an updated therapeutic algorithm to support physicians in tailoring the strategy to the individual patient and the underlying mechanism of stroke. [Display omitted] • For primary or secondary prevention of stroke due to large-artery extracranial atherosclerosis or intracranial small-vessel disease, single or dual antiplatelet therapy is generally preferred, whereas anticoagulation is recommended in cases of cardiogenic embolism associated with atrial fibrillation, mural thrombus, mechanical prosthetic heart valves, or hypercoagulable states. • In patients with acute ischemic stroke due to arterial disease or in those with carotid artery stents, the incremental benefit of dual antiplatelet therapy is greatest in the first few weeks or months, following which antiplatelet monotherapy is generally recommended. • More research is needed to define optimum antithrombotic regimens for patients with embolic stroke of undetermined source, arterial dissection, and specific forms of nonatherosclerotic vascular disease. [ABSTRACT FROM AUTHOR]