Pharmacological Management of Stroke Antiplatelet-Acute and Secondary Prevention

Antiplatelet therapy is fundamental in stroke management, with aspirin being the most widely studied agent that irreversibly inhibits thromboxane A2 production to prevent platelet aggregation; clopidogrel serves as an alternative for patients with aspirin allergy by blocking P2Y12 receptors; while dual antiplatelet therapy (aspirin plus clopidogrel) is not recommended for routine long-term secondary prevention due to increased bleeding risk, it may be beneficial for short-term use in patients with acute minor stroke (NIHSS ≤3) or high-risk TIA with ABCD2 score ≥4, or those with severe intracranial artery stenosis, where it can reduce recurrent stroke risk without significantly increasing hemorrhage risk.