Fast Five Quiz: Aspirin Use

Mary L. Windle, PharmD


January 03, 2020

AHA/American Stroke Association guidelines recommend administering aspirin, 325 mg orally, within 24-48 hours of ischemic stroke onset. The benefit of aspirin is modest but statistically significant and appears principally to involve the reduction of recurrent stroke. However, in patients who receive IV tPA, aspirin administration should be delayed 24 hours.

For patients with noncardioembolic TIAs, 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).

In patients who have atrial fibrillation in association with a TIA, long-term anticoagulation with warfarin to a target international normalized ratio of 2-3 is typically recommended. Aspirin 325 mg/day is recommended for patients unable to take oral anticoagulants. However, the addition of clopidogrel to aspirin therapy, compared with aspirin therapy alone, may be reasonable.

Read more about the treatment of strokes.


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