急性腦梗塞與暫時性腦缺血之抗血小板藥物選擇：及早掌握機會、快速勝利得分

In the era of reperfusion therapy, timely and proper antithrombotic agents can still protect acute ischemic stroke patients from early recurrent events, especially in those who are initially ＂too good＂ for thrombolysis or thrombectomy. Aspirin monotherapy, although commonly used, can only provide limited benefit for secondary prevention. More intensive antiplatelet regimens, such as short-term dual antiplatelet therapy, has been proved to be effective in selective patient group. The results of FASTER, CHANCE and POINT trials demonstrated that early administration (within 24 hours) of short-term clopidogrel and aspirin can prevent at least 30% recurrent stroke in patients with minor ischemic stroke (NIHSS≤3) or high risk transient ischemic attack, while that prolonged combination use of antiplatelet therapy beyond 21 days may bring up unwanted risk of hemorrhage. Other antiplatelet agents, such as dipyridamole and ticagrelor need to prove their clear benefits in early secondary stroke prevention. Clinicians should be aware of these possible therapeutic choices and tailor their management according to individual's condition to achieve maximum benefit over risk.

並列關鍵字

acute ischemic stroke ； transient ischemic attack ； antithrombotic ； antiplatelet

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