What are the AHA/ASA guidelines for antithrombotic therapy in noncardioembolic transient ischemic attack (TIA)?

Updated: Dec 03, 2018
  • Author: Ashish Nanda, MD; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Antiplatelet agents, rather than oral anticoagulants, are recommended as initial therapy. Aspirin 50-325 mg/day, a combination of aspirin and extended-release dipyridamole, and clopidogrel are all reasonable first-line options (class I recommendation). [46]

The AHA/ASA guidelines state that the combination of aspirin and clopidogrel might be considered for initiation within 24 hours of a minor ischemic stroke or TIA and for continuation for 21 days. However, the combination of aspirin and clopidogrel, when initiated days to years after a minor stroke or TIA and continued 2 to 3 years, increases the risk of hemorrhage relative to either agent alone and is not recommended for routine long-term secondary prevention after ischemic stroke or TIA. [46]


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