What are the AHA/ASA class I recommendations for stroke anticoagulation and secondary prevention?

Updated: Dec 18, 2018
  • Author: Salvador Cruz-Flores, MD, MPH, FAHA, FCCM, FAAN, FACP, FANA; Chief Editor: Helmi L Lutsep, MD  more...
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Class I recommendations from the American Heart Association/American Stroke Association (AHA/ASA) for prevention of stroke in patients who have experienced noncardioembolic ischemic stroke or TIA are as follows [5] :

  • Antiplatelet agents rather than oral anticoagulation are recommended to reduce the risk of recurrent stroke and other cardiovascular events (IA); aspirin monotherapy, the combination of aspirin and extended-release dipyridamole, and clopidogrel monotherapy are all acceptable options for initial therapy (IA)

  • For patients who have an ischemic cerebrovascular event while taking aspirin, increasing the dose of aspirin provides no additional benefit; the combination of aspirin and extended-release dipyridamole is recommended over aspirin alone (IB)

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