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J Korean Med Assoc > Volume 52(4); 2009 > Article
Journal of the Korean Medical Association 2009;52(4):356-364.
DOI: https://doi.org/10.5124/jkma.2009.52.4.356   
Antithrombotic and Neuroprotective Therapy in Acute Ischemic Stroke
Sung Hyuk Heo, Dae Il Chang
Department of Neurology, Kyung Hee University College of Medicine, Korea. dichang@khmc.or.kr
As, until now, many studies have failed to establish the clinical effect of numerous neuroprotectives, antithrombotic therapy must be emphasized as one of critical options among limited treatment strategies in acute ischemic stroke. Based on the accumulating evidences that platelets and coagulating proteins play an important role in the thrombus formation, antiplatelets and anticoagulants are served as antithrombotics. Recently, major advances have been made in understanding the effects of antiplatelets and anticoagulants. Large randomized clinical trials have highlighted the effectiveness and safety of early and continuous antiplatelet therapy in reducing atherothrombotic stroke recurrence. Urgent anticoagulation has been used often to prevent early recurrent stroke and to improve neurological outcomes, however, its formal use in acute stroke has been the subject of debate even in cardioembolic stroke. That's because anticoagulants also increase the risk of fatal or disabling intracranial hemorrhage and it is difficult to monitor proper anticoagulation. Although early administration of anticoagulants should be considered to prevent the secondary injury and the propagation of thrombosis in patients with atherothrombotic stroke, more evidences are needed especially in patients with infractions secondary to large artery thrombosis or cardioembolism. This review discusses recent advances related to antithrombotic strategies and putative neuroprotectives.
Key Words: Acute stroke, Antithrombotic therapy, Antiplatelet, Anticoagulant, Neuroprotective


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