• J Fam Pract · Jul 2006

    Review

    Clinical inquiries. What is the best management for patients who have a TIA while on aspirin therapy?

    • Nabila Ahmed, John B Coffey, and Robert Oh.
    • Ferris State University/Michigan State University, East Lansing, MI, USA.
    • J Fam Pract. 2006 Jul 1; 55 (7): 627-8.

    AbstractAlternative antiplatelet therapy for stroke prevention is indicated for patients who experience transient ischemic attacks (TIAs) while on aspirin therapy (strength of recommendation [SOR]: A, based on 1 meta-analysis and 1 randomized controlled trial). The combination of aspirin and extended-release dipyridamole reduces the risk of stroke following a TIA (SOR: A). Thieno-pyridines (eg, clopidogrel and ticlopidine) are an alternative for patients at high risk for a cardioembolic event. Ticlopidine reduces the risk of stroke following TIA, specifically showing benefit for patients previously on aspirin (SOR: A). Clopidogrel has not shown significant reduction in reoccurrence of stroke and has not been studied for patients with a previous TIA. Aspirin and a thieno-pyridine do not provide significant additional reduction in secondary strokes (SOR: A).

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