Have Antiplatelet Agents a Place in the Treatment of Acute Stroke?
Within the first 3 h and in some patients within 6 h after symptom onset fibrinolytics are most effective to treat acute stroke. When there is a contraindication for fibrinolytics, aspirin (~ 300 mg/day) is the best agent to be given early after stroke (there are no studies yet with heparin or LWMH given within 3 h of stroke onset). Its beneficial effect is annihilated by an excess of intra- and extracranial hemorrhages. A beneficial effect of the association of low-dose heparin with aspirin was suggested by the 1ST, but remains controversial.
