Abstract
Ischemic stroke is the third most common cause of death and of long-term disability and exhibits a high recurrence rate. Therefore, appropriate primary and secondary prevention is mandatory. In non-cardioembolic stroke, in addition to lifestyle changes and to targeted treatments, current guidelines recommend antiplatelet treatment. In cardioembolic stroke, Vitamin K antagonists (VKAs) are recommended. Although a favorable risk/benefit ratio of both treatments has also been demonstrated in elderly patients, registry data emphasize that such interventions are often under-used, especially in patients with atrial fibrillation (AF). Furthermore, variability in the inter-individual response to drugs has been recognized as a leading cause of event recurrence. Thus, in addition to poor adherence, efficacy and safety issues appear to be involved in the recurrence rate of stroke. In this review, we report main Registries data on adherence to stroke prevention treatment schedule. We also discuss the major limitations of “traditional” antithrombotic drugs and report Phase III study results on safety and efficacy of new antiplatelet and anticoagulant drugs, with emphasis on stroke prevention.
Keywords: Stroke prevention, recommendations, compliance, new antithrombotic drugs, ischemic stroke, vitamin K antagonists, atrial fibrillation, myocardial infarction, coronary artery bypass grafting, cytochrome P-450
Current Vascular Pharmacology
Title: New Anti-Thrombotic Drugs for Stroke Prevention
Volume: 9 Issue: 6
Author(s): Matteo Nicola Dario Di Minno, Anna Russolillo, Marina Camera, Marta Brambilla, Angela De Gregorio, Elena Tremoli and Giovanni Di Minno
Affiliation:
Keywords: Stroke prevention, recommendations, compliance, new antithrombotic drugs, ischemic stroke, vitamin K antagonists, atrial fibrillation, myocardial infarction, coronary artery bypass grafting, cytochrome P-450
Abstract: Ischemic stroke is the third most common cause of death and of long-term disability and exhibits a high recurrence rate. Therefore, appropriate primary and secondary prevention is mandatory. In non-cardioembolic stroke, in addition to lifestyle changes and to targeted treatments, current guidelines recommend antiplatelet treatment. In cardioembolic stroke, Vitamin K antagonists (VKAs) are recommended. Although a favorable risk/benefit ratio of both treatments has also been demonstrated in elderly patients, registry data emphasize that such interventions are often under-used, especially in patients with atrial fibrillation (AF). Furthermore, variability in the inter-individual response to drugs has been recognized as a leading cause of event recurrence. Thus, in addition to poor adherence, efficacy and safety issues appear to be involved in the recurrence rate of stroke. In this review, we report main Registries data on adherence to stroke prevention treatment schedule. We also discuss the major limitations of “traditional” antithrombotic drugs and report Phase III study results on safety and efficacy of new antiplatelet and anticoagulant drugs, with emphasis on stroke prevention.
Export Options
About this article
Cite this article as:
Nicola Dario Di Minno Matteo, Russolillo Anna, Camera Marina, Brambilla Marta, De Gregorio Angela, Tremoli Elena and Di Minno Giovanni, New Anti-Thrombotic Drugs for Stroke Prevention, Current Vascular Pharmacology 2011; 9 (6) . https://dx.doi.org/10.2174/157016111797484189
DOI https://dx.doi.org/10.2174/157016111797484189 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Ultrasonographic Assessment of Cirrhosis and Portal Hypertension
Current Medical Imaging The Impetus of COVID -19 in Multiple Organ Affliction Apart from Respiratory Infection: Pathogenesis, Diagnostic Measures and Current Treatment Strategy
Infectious Disorders - Drug Targets Preface
Current Cardiology Reviews Does A Subclinical Cardiotoxic Effect of Clozapine Exist? Results from a Follow-up Pilot Study
Cardiovascular & Hematological Agents in Medicinal Chemistry A Unique Intracellular, Extracellular and Transmembrane Circulation of Potassium Ions in the Auditory Inner Ear as an Anticarcinogenic Principle? Part 1
Inflammation & Allergy - Drug Targets (Discontinued) Covid-19 Susceptibility and Severity Might be Modified by Vitamin D Status: Theoretical and Practical Considerations
Current Respiratory Medicine Reviews The TWEAK-Fn14 System: Breaking the Silence of Cytokine-Induced Skeletal Muscle Wasting
Current Molecular Medicine Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management
Current Psychiatry Reviews Pathophysiology of Airway Colonization in Critically ill COPD Patient
Current Drug Targets Combination of Therapeutic Hypothermia and Other Neuroprotective Strategies after An Ischemic Cerebral Insult
Current Neuropharmacology Editorial (Thematic Issue: Immunophilins, Protein Chemistry and Cell Biology of a Promising New Class of Drug Targets – Part II)
Current Molecular Pharmacology Granulocyte Colony-Stimulating Factor (G-CSF) for Cardio- and Cerebrovascular Regenerative Applications
Current Medicinal Chemistry Compritol<sup>®</sup>888 ATO a Lipid Excipient for Sustained Release of Highly Water Soluble Active: Formulation, Scale-up and IVIVC Study
Current Drug Delivery The Impact of the Emerging Genomics Data on the Management of Agerelated Phenotypes in the Context of Cellular Senescence
Current Drug Targets Roles of Histone Deacetylases in Angiogenic Cellular Processes
Current Angiogenesis (Discontinued) Sex Differences and Emerging New Risk Factors for Atherosclerosis and Its Thrombotic Complications
Current Pharmaceutical Design Brain Insulin Resistance and Deficiency as Therapeutic Targets in Alzheimers Disease
Current Alzheimer Research Role of Bradykinin in the Regulation of Endothelial Nitric Oxide Synthase Expression by Cardiovascular Drugs
Current Pharmaceutical Design Pharmacologic Modulators of Soluble Guanylate Cyclase/Cyclic Guanosine Monophosphate in the Vascular System - From Bench Top to Bedside
Current Vascular Pharmacology Ca2+ Signalling in Damaged Endothelium and Arterial Remodelling: Do Connexin Hemichannels Provide a Suitable Target to Prevent In-stent Restenosis?
Current Drug Therapy