What is the recommendation for antithrombotic therapy for patients with noncardioembolic ischemic stroke or TIA?
For patients with noncardioembolic ischemic stroke or TIA, the recommendation is to use DAPT (aspirin plus clopidogrel), for 21 to 90 days, followed by SAPT, to reduce the risk of recurrent ischemic events. For patients with recent (< 24 hours) minor to moderate stroke (NIHSS score 5), high-risk score 6), or symptomatic intra- cranial or extracranial 30% stenosis of an artery that could account for the event, DAPT with ticagrelor plus aspirin for 30 days may be considered to reduce the risk of 30-day recurrent stroke but may also increase the risk of serious bleeding events, including ICH. Continuous use of DAPT for >90 days or the use of triple antiplatelet therapy is associated with excess risk of hemorrhage.