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Major Stroke Prevention: A New Use for a Well-Known Medication

Major Stroke Prevention: A New Use for a Well-Known Medication

Strokes can have a devastating impact on the long-term survival and function of our patients. Therapies to treat them have been well established, and there has been a reduction in morbidity and mortality as a result. A recent study examined the impact of daily aspirin along with ticagrelor versus aspirin alone on preventing the escalation of transient ischemic attacks (TIA) and stroke into major cardiovascular accidents.

The Acute Stroke or Transient Ischemic Attack Treated With Ticagrelor and Aspirin for Prevention of Stroke and Death (THALES) study examined the use of an initial dose of ticagrelor 180 mg followed by 90 mg twice daily for days 2 to 30, compared with placebo, in conjunction with a loading dose of 300 mg to 325 mg of aspirin daily, followed by 75 mg to 100 mg for days 2 to 30. The main measure was time to occurrence for a disabling stroke or death, measured out to 30 days.

The results of this study revealed that the combination of ticagrelor and aspirin was superior in reducing the number of strokes following an initial TIA or stroke compared with aspirin alone.

Some patients within your practice who have other coronary artery diseases may already be taking ticagrelor. Practitioners may consider using ticagrelor plus aspirin to prevent strokes in vulnerable patients. The reduction of stroke incidence and disability can positively impact whether a patient must dramatically change their daily lives, living situation, and support structure—also creating a significant financial impact. To optimize the quality of life and health of patients with previous TIA and stroke, PAs and NPs would benefit from familiarizing themselves with ticagrelor and the THALES study.

  • Amarenco P, et al. Ticagrelor added to aspirin in acute ischemic stroke or transient ischemic attack in prevention of disabling stroke. JAMA Neurol. 2021;78:177-185.

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Filed under: Cardiometabolic

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