Stroke on antiplatelet therapy: management
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Stroke on antiplatelet therapy: management. Higher doses of Aspirin increase bleeding risk. Fully referenced neurology checklist.
Use higher loading doses
- Higher doses of Aspirin increase bleeding risk
- The safety of higher doses of Clopidogrel is not confirmed
- The effectiveness of this strategy is not confirmed
Switching between Aspirin and Clopidogrel
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Switching to alternative drugs
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Combination treatments
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Benefits and risks of switching and combination therapies
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Synonym
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References
- Michos ED, Ardehali R, Blumenthal RS, Lange RA, Ardehali H. Aspirin and clopidogrel resistance. Mayo Clin Proc 2006; 81:518-526.
- Uchiyama S. Clopidogrel resistance: identifying and overcoming a barrier to effective antiplatelet treatment. Cardiovasc Ther 2011; 29:e100-e111.
- Topçuoglu MA, Arsava EM, Ay H. Antiplatelet resistance in stroke. Expert Rev Neurother 2011; 11:251-263.
- Rothstein A, Khazaal O, Messe SR, et al. Switching from aspirin monotherapy after noncardioembolic stroke: a systematic review and network meta-analysis. Stroke 2026; 57:650-661.
- Niu PP, Guo ZN, Jin H, Xing YQ, Yang Y. Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis. BMJ Open 2016; 6:e009013.
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