TY  -  JOUR
AU  -  Mosconi, Maria Giulia
AU  -  Paciaroni, Maurizio
T1  -  Dual antiplatelet therapy for secondary prevention in non-minor ischemic stroke
PY  -  2024
Y1  -  2024-07-01
DO  -  10.1727/4355.43440
JO  -  Rivista di Neurologia
JA  -  Riv Neurol
VL  -  1
IS  -  3
SP  -  141
EP  -  148
PB  -  Il Pensiero Scientifico Editore
SN  -  3035-3599
Y2  -  2026/04/17
UR  -  http://dx.doi.org/10.1727/4355.43440
N2  -  Summary. Introduction and aims. Dual antiplatelet therapy (DAPT) is widely recognized for its effectiveness in significantly reducing stroke recurrence in both minor ischemic stroke (IS) and high-risk transient ischemic attack (TIA) patients. This narrative review examines current literature dealing with the efficacy and safety of DAPT in patients with non-minor, non-cardioembolic IS, focusing on those patients with more severe stroke presentations (NIHSS ≥5). Methods. We conducted a comprehensive literature review of studies published between 1990 and 2024, examining the outcomes associated with the administration of DAPT compared to patients receiving single antiplatelet therapies (SAPT) for non-minor IS. Results. Our findings indicate that while DAPT seemed to have reduced the recurrence risk in minor IS and high-risk TIA patients, any associated benefits for non-minor IS patients were less convincing. In fact, the administration of DAPT in severe strokes did not consistently translate into lower recurrence without an increased risk of major bleeding. However, patients with atherosclerosis had the most remarkable improvement. Discussion. DAPT has been associated with potential benefits for specific non-minor IS populations, especially non-minor stroke patients with atherosclerosis. In this latter setting, DAPT should be initiated within 24-48 hours of symptom onset and not extend beyond 90 days after index stroke in order to minimize any bleeding risks.
ER  -