Secondary Prevention of Stroke: The Role of Antiplatelet and Anticoagulant Agents

D'Arcy L. Little, MD, CCFP
York Community Services, Toronto, ON

Introduction
Every year there are approximately 50,000 strokes in Canada. Currently, close to 300,000 Canadians are stroke survivors. As stroke is an age-related condition, the number of strokes is predicted to increase as the Canadian population ages. The resultant national cost, which is estimated at 2.7 billion annually, will also increase unless improvements are made to prevention and treatment.¹ Approximately 1 in 6 survivors of a first stroke experiences a recurrent stroke over the next 5 years, of which 25% are fatal within 28 days.² The above statistics suggest that attention to secondary stroke prevention would be important in reducing the morbidity, mortality and cost to society of stroke. The purpose of this article is to review the role of anti-platelet and anticoagulant agents in the secondary prevention of stroke.

Goals of Therapy
Therapeutic measures in secondary stroke prevention aim to prevent recurrent stroke or transient ischemic attacks, with the aim of preventing morbidity and mortality from incremental neurological deficits, as well as preventing associated cardiac ischemic events.