ABSTRACT
Antithrombotic agents remain the cornerstone of a therapeutic strategy for both primary and secondary stroke prevention. Currently there are four antiplatelet agents with Food and Drug Administration approval in the USA for this purpose: aspirin, ticlopidine, clopidogrel and combination aspirin and extended release dipyridamole (ASA/ER-DP). There has been a plethora of clinical trials testing the safety and efficacy of these medications in this setting, yet, opinion remains diverse regarding the best agent or agents for stroke prevention. The clinical trials can be separated arbitrarily into those primarily evaluating primary prevention and those evaluating secondary prevention. In this chapter we shall review the mechanism of action of the antiplatelet agents and the indications for their use, and make recommendations based on the evidence.
