International Journal of Tropical Medicine
ISSN: Online 1818-779XISSN: Print 1816-3319
Abstract
Recurrent ischemic stroke prevention remains a critical challenge, with antiplatelet therapy being a key strategy. Aspirin and clopidogrel are widely used for this purpose, but the optimal duration and combination of therapy require further study due to concerns about hemorrhagic complications. This study evaluates the effectiveness of aspirin monotherapy versus dual antiplatelet therapy in preventing recurrent ischemic strokes, focusing on secondary outcomes such as major adverse cardiovascular events (MACE), hemorrhagic complications and mortality. This prospective, observational study included 60 patients with ischemic stroke from the Department of Neurosurgery. Patients were divided into two groups: Group A (n = 30, aspirin 100mg daily) and Group B (n = 30, aspirin 100 mg + clopidogrel 75 mg daily). Follow‐up assessments were conducted at 3, 6 and 12 months, measuring the occurrence of MACE (myocardial infarction, vascular death), hemorrhagic complications (intra cranial and gastrointestinal bleeding) and mortality. Mean and standard deviation were calculated and p‐values were used to assess statistical significance. The incidence of myocardial infarction was 1.97±1.30 in Group A and 2.27±1.38 in Group B, with vascular death at 1.10±0.84 and 0.80±0.90, respectively. Gastrointestinal bleeding was slightly higher in Group B (1.67±0.95) compared to Group A (1.57±1.15). Intra cranial bleeding rates were similar in both groups (1.07±0.86 in Group A and 1.03±0.89 in Group B). Mortality rates were 2.03±1.33 in Group A and 1.9±1.34 in Group B. No statistically significant difference was found between the groups for mortality or MACE outcomes (p>0.05). Both aspirin monotherapy and dual antiplatelet therapy are effective in preventing recurrent ischemic strokes. However, dual therapy slightly increased gastrointestinal bleeding without significantly reducing MACE or mortality. Clinicians should carefully weigh the benefits of dual therapy against the bleeding risk, particularly beyond 6 months of use. Personalized therapy and regular monitoring are recommended for high‐risk patients.
How to cite this article:
Mathakala Aparna, Harshal Rathod and Nandikolla Y.S. Rahul. The Role of Antiplatelet Therapy in the Prevention of Recurrent Ischemic Stroke: An Institutional Experience.
DOI: https://doi.org/10.36478/10.36478/makijtm.2024.4.45.49
URL: https://www.makhillpublications.co/view-article/1816-3319/10.36478/makijtm.2024.4.45.49