What are the most appropriate stroke preventive treatments?
The most appropriate preventive treatments depend on the patient’s risk factors for stroke, causes of the patient’s previous stroke, comorbid medical conditions, and treatment goals. Ideally, the treatment plan will document the presence of advanced comorbid illnesses or individual risk factors that cannot be easily modified and any choices by the patient to forego treatments intended to reduce risk factors. • Is aspirin effective for primary stroke prevention? Aspirin is not effective for primary stroke prevention. It is moderately effective at reducing the risk of recurrent thrombotic stroke. • What about aspirin plus extended-release dipyridamole to prevent stroke recurrence? The European Stroke Prevention Study-2 demonstrated that ASA/ER-DP significantly reduced the risk of recurrent stroke (ASA 50 mg/day; ER-DP 400 mg/day). The most recent ACCP guideline, citing the lack of a clear risk-benefit ratio despite a high-quality study, makes an intermediate-strength recommendation (Grad
