What is the evidence for dual antiplatelet therapy (DAPT) for stroke prevention compared to single antiplatelet therapy?
The benefit and risks of DAPT compared to single antiplatelet therapy for the prevention of recurrent stroke was evaluated in patients with an ischemic stroke or TIA. This was reviewed by the Evidence Review Committee and discussed with AHA methodologists. The writing group concluded that many of these prevention strategies were important to include in any guideline on the prevention of recurrent stroke. Numerous studies have evaluated strategies for stroke prevention in individuals without a history of stroke/TIA (ie, primary prevention studies) or included individuals with a history of stroke/TIA mixed into the pools of patients studied in smaller numbers. The writing group determined that there is often no reason to think that the mechanism of stroke prevention and benefits would be different in primary versus secondary prevention, although not studied within a purely secondary stroke prevention trial.