ANTIPLATELET THERAPY IN HIGH-RISK STROKE PATIENTS: REAL-WORLD EVIDENCE

Stroke is a major global health burden and one of the leading causes of disability and mortality worldwide. According to the World Health Organization (WHO), stroke accounts for approximately 5.5 million deaths annually, with a significant proportion of survivors experiencing long-term disability. In India, stroke incidence has been rising due to aging populations, increased prevalence of hypertension and diabetes, and lifestyle changes. Among the different types of strokes, ischemic stroke is the most common, constituting about 75% of all stroke cases, followed by hemorrhagic stroke and transient ischemic attack (TIA). Antiplatelet therapy is a cornerstone of secondary prevention of ischemic stroke. Patients with a history of stroke or TIA have a high risk of recurrent events, which can be debilitating or fatal. Antiplatelet drugs such as aspirin, clopidogrel, and ticagrelor reduce platelet aggregation, thereby preventing clot formation in the arteries supplying blood to the brain. Dual antiplatelet therapy (DAPT)—a combination of two antiplatelet agents—is sometimes prescribed for high-risk patients to provide greater protection against recurrent strokes. However, balancing the benefits of stroke prevention with the risk of bleeding complications remains a clinical challenge.