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Neurologists frequently lament that we are about a decade behind cardiologists: therapies initially pioneered in coronary artery disease, such as use of thrombolytics and statins, eventually filter down to the treatment of stroke. However, an opportunity presents itself by taking advantage of cardiology therapeutic advances or red flags raised in the treatment of coronary artery disease. Should neurologists be concerned about potential implications for our patients with stroke or TIAs if concerns arise in the context of cardiovascular disease?
One concern that has been raised is the potential for adverse vascular events following the discontinuation of clopidogrel1 in those receiving dual antiplatelet therapy with aspirin and clopidogrel for acute coronary syndrome. In these patients, dual antiplatelet therapy is frequently administered for 3 to 12 months and subsequently aspirin monotherapy is continued indefinitely. A few …
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