Antithrombotiques oraux en prévention secondaire neuro-vasculaire : une revue

Titre original : 
Oral antithrombotic therapy for the prevention of recurrent cerebrovascular events.
Titre en français : 
Antithrombotiques oraux en prévention secondaire neuro-vasculaire.
Auteurs : 
Capodanno D, Angiolillo DJ.
Revue : 
Eur Heart J Cardiovasc Pharmacother. 2021 Aug 10

Résumé : 

Stroke is frequently a disabling and even life-threatening condition that has an ischemic cause in most cases. Transient ischemic attack (TIA) is a lower-risk condition that still exposes to the risk of future major cardiovascular events. The causes of stroke can be classified as cardioembolic disease, large vessel disease, small vessel disease, undetermined, or others. Cardioembolic disease and atherothrombosis of large arteries are the most common underlying processes of ischemic stroke and TIA. Therefore, antithrombotic therapy is a central strategy in the pharmacological management of these patients. However, because antithrombotic therapy provides ischemic protection at the price of increased bleeding, defining the fine balance between efficacy and safety is a clinical challenge. Numerous trials have recently defined the current indications to the use of anticoagulant and antiplatelet therapy in patients with various subtypes of ischemic stroke or TIA. In this review, we provide an updated appraisal of the currently available evidence on the use of various oral antithrombotic agents for prevention of recurrent events after an ischemic stroke or TIA.