In @entity1 with @entity63 ( @entity63 ) or @entity385 of noncardiac origin, antiplatelet drugs are able to decrease the risk of @entity64 by 11% to 15%, and decrease the risk of @entity64 , @entity583 ( @entity583 ), and @entity204 by 15% to 22%. @entity117 leads to a moderate but significant reduction of @entity64 , @entity583 , and @entity204 in @entity1 with @entity63 and @entity385 . Low doses are as effective as high doses, but are better tolerated in term of gastrointestinal side effects. The recommended @entity117 dose, therefore, is between 50 and 325 mg. Bleeding complications are not dose-dependent, and also occur with the lowest doses. The combination of @entity117 (25 mg twice daily) with slow release @entity4341 (200 mg twice daily) is superior compared with @entity117 alone for @entity64 prevention. @entity1396 is effective in secondary @entity64 prevention in @entity1 with @entity63 and @entity64 . For some endpoints, it is superior to @entity117 . Due to its side effect profile ( @entity1398 , @entity2106 ), @entity1396 should be given to @entity1 who are intolerant of @entity117 . Prospective trials have not indicated whether @entity1396 is suggested for @entity1 who have recurrent cerebrovascular events while on @entity117 . @entity1397 has a better safety profile than @entity1396 . Although not investigated in @entity1 with @entity63 , @entity1397 should also be effective in these @entity1 assuming the same pathophysiology than in @entity1 with @entity64 . @entity1397 is second-line treatment in @entity1 intolerant for @entity117 , and first-line treatment for @entity1 with @entity64 and peripheral @entity455 or @entity583 . A frequent clinical problem is @entity1 who are already on @entity117 because of @entity301 or a prior cerebral @entity63 event, and then suffer a first or recurrent @entity63 or @entity64 . No single clinical trial has investigated this problem. Therefore, recommendations are not evidence-based. Possible strategies include the following: continue @entity117 , add @entity4341 , add @entity1397 , switch to @entity1396 or @entity1397 , or switch to anticoagulation with an International Normalized Ratio (INR) of 2.0 to 3.0. The combination of low-dose @entity1229 and @entity117 was never studied in the secondary prevention of @entity64 . In @entity1 with a cardiac source of @entity887 , anticoagulation is recommended with an INR of 2.0 to 3.0. At the present time, anticoagulation with an INR between 3.0 and 4.5 can not be recommended for @entity1 with noncardiac @entity63 or @entity64 . Anticoagulation with an INR between 3.0 and 4.5 carries a high bleeding risk. Whether anticoagulation with lower INR is safe and effective is not yet known. Treatment of vascular risk factors should also be performed in secondary @entity64 prevention.

Antithrombotic Secondary Prevention After XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity455 :: ('MESH:D014652', 'Disease') :: ['arterial disease'] @entity1396 :: ('MESH:D013988', 'Chemical') :: ['ticlopidine', 'Ticlopidine'] @entity63 :: ('MESH:D007511', 'Disease') :: ['TIA', 'transient ischemic attack', 'ischemic'] @entity301 :: ('MESH:D003327', 'Disease') :: ['coronary heart disease'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel', 'Clopidogrel'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['Aspirin', 'aspirin'] @entity4341 :: ('MESH:D004176', 'Chemical') :: ['dipyridamole'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia'] @entity887 :: ('MESH:D004617', 'Disease') :: ['embolism'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI'] @entity204 :: ('MESH:D003643', 'Disease') :: ['vascular death'] @entity2106 :: ('MESH:D011697', 'Disease') :: ['thrombotic thrombocytopenic purpura'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke']
