Stroke Treatment 1 year later

[RNOK06]

Hey guys, I am new to this forum so please be nice. So I have a question in regards to treatment for stroke. What is the treatment for a patient with ischemic stroke one year later? Does the patient normally take aspirin alone or together with another anticoagulant such as Plavix after a year of stroke? I read somewhere that the risk of hemorrhage is higher if dual therapy is taken together more than 3 months. So can someone please explain to me. Thank you I will greatly appreciate it!

[PeakRN]

Treatment after a year is rehab, symptom management, and risk management.

Treatment with Clopidogrel and ASA together is neither a standard of treatment nor a huge contraindication. I would not be surprised to see neurologists or cardiologists who place patients on both together. There are many studies that are trying to truly determine the risk versus benefit of dual antiplatelet therapy. Medical decision making balances risk and benefit and cannot be dispensed generally but rather is based on every patient.

A big thing to remember that not all 'blood thinners' have the same mechanism of action. ASA and clopidogrel are platelet aggregation inhibitors, not really true anticoagulants (they do not prevent the formation of coagulation signaling/functioning proteins). Warfarin and the NAOCs actually prevent the clotting cascade. Warfarin and Dabigatran are the only two anticoagulants with reversal agents (technically so does heparin, but I don't think you'll see many patients taking that at home).

[RNOK06]

Thank you for taking the time to answer my question, I really appreciate it.