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KMID : 0858420100120030088
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Korean Journal of Stroke
2010 Volume.12 No. 3 p.88 ~ p.95
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Combination Antiplatelet Therapy for Treatment and Prevention of Ischemic Stroke
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Koo Ja-Seong
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Abstract
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Antiplatelet drugs are widely used for prevention and treatment of ischemic stroke and transient ischemic attack. Considering the limited efficacy of antiplatelet drugs, combination of antiplatelet drugs can be used to potentiate antiplatelet effect. Compared to aspirin or clopidogrel alone, the combination of aspirin and clopidogrel increased the risk of bleeding complication without any additional benefit. In patients who had nonvalvular atrial fibrillation and were ineligible for oral anticoagulant, the combination aspirin and clopidogrel was better than aspirin alone though the risk of bleeding increased significantly. In two large clinical studies, the combination of aspirin and extended-release dipyridamole was more effective than aspirin alone without increasing bleeding complication. However the result of comparison to clopidogrel alone was disappointing. The combination of aspirin and cilostazol might be better than aspirin alone in preventing the progression of symptomatic stenosis of intracranial artery. Further studies are needed to investigate the risk and benefit of the combination of antiplatelet drugs in selected group of patients with acute ischemic stroke or large artery atherosclerotic stroke.
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KEYWORD
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Antiplatelet, Combination, Stroke
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