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.
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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 |
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