What is the recommended approach to dual antiplatelet therapy in selected minor ischemic strokes?

What is the recommended approach to dual antiplatelet therapy in selected minor ischemic strokes?

• A. Use only single antiplatelet therapy.
• B. Not recommended in any case.
• C. Short-term dual antiplatelet therapy as guided by clinician.
• D. Continue for months as standard practice.

Answer: (C)

Early after a minor ischemic stroke, there’s a window where the risk of another stroke is high but the bleeding risk from stronger therapy is still manageable. In selected patients, using two antiplatelet medicines for a short, planned period can markedly reduce the chance of another stroke during those first days to weeks. The evidence shows that a brief course of dual antiplatelet therapy started soon after onset lowers recurrent stroke risk compared with aspirin alone, as long as the duration is limited (about three weeks) to keep bleeding risk in check. Extending dual therapy for months increases bleeding without giving additional protection against recurrence, so long-term dual therapy isn’t standard. Therefore, the best approach is to use short-term dual antiplatelet therapy guided by the clinician, tailoring the plan to the individual’s risk factors and timing after the event.

Early after a minor ischemic stroke, there’s a window where the risk of another stroke is high but the bleeding risk from stronger therapy is still manageable. In selected patients, using two antiplatelet medicines for a short, planned period can markedly reduce the chance of another stroke during those first days to weeks. The evidence shows that a brief course of dual antiplatelet therapy started soon after onset lowers recurrent stroke risk compared with aspirin alone, as long as the duration is limited (about three weeks) to keep bleeding risk in check. Extending dual therapy for months increases bleeding without giving additional protection against recurrence, so long-term dual therapy isn’t standard. Therefore, the best approach is to use short-term dual antiplatelet therapy guided by the clinician, tailoring the plan to the individual’s risk factors and timing after the event.