When should aspirin–clopidogrel start and stop after minor stroke or high-risk TIA? скачать в хорошем качестве

When should aspirin–clopidogrel start and stop after minor stroke or high-risk TIA?

In patients with minor ischemic stroke or high-risk TIA due to large-artery atherosclerosis, when should dual antiplatelet therapy with aspirin and clopidogrel be initiated and discontinued to maximize early stroke prevention while minimizing hemorrhagic risk? This discussion examines the use of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack, focusing on aspirin plus clopidogrel. While early recurrent stroke risk is highest in the first days after presentation, intensified platelet inhibition carries a parallel and cumulative bleeding risk. The central challenge is determining which patients benefit, when therapy should be initiated, and—critically—when it should be stopped. The conversation reviews trial-defined patient selection, timing of initiation, strict exclusion criteria, and the evidence supporting a short, time-limited course rather than prolonged treatment. Emphasis is placed on balancing front-loaded ischemic risk against ongoing hemorrhagic exposure, and on operational strategies to ensure appropriate discontinuation. The core framework is evidence-based timing, not therapeutic escalation. #Neurology #Stroke #TIA #AntiplateletTherapy #VascularNeurology