Current issues in antiplatelet therapy for stroke prevention: the importance of stroke subtypes and differences between stroke and MI patients

Ischaemic stroke, the most common type of stroke, is classified into three main subtypes: large-vessel disease, lacunar or small-vessel disease, and cardioembolic; two further subtypes include a determined aetiology of “other” and cryptogenic. Although a substantial amount of literature exists concerning current guidelines for the secondary prevention of ischaemic stroke, treatment strategies for stroke subtypes as well as the reasons why these subtypes are significant have yet to be clearly defined. Furthermore, treatment strategies for secondary prevention of ischaemic stroke differ between patients who have suffered a previous stroke and those who have suffered a myocardial infarction. Antiplatelet therapies offer treatment that is as efficacious as warfarin, but with less severe bleeding. This review examines the importance of the different subtypes of stroke as well as differentiating between treating a heart patient and a stroke patient for secondary stroke prevention, including the advantages of using antiplatelet therapy over anticoagulants.