Antithrombotic therapy in the secondary prevention of stroke

Mel’nikova E.V.; Kadinskaia M.I.; Gerasimenko D.V.; Shmonin A.A.

doi:https://doi.org/

Mel’nikova E.V.

Medical Diagnostic and Prophylactic Centre, Yaroslavl’

Kadinskaia M.I.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.P. Pavlova

Gerasimenko D.V.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.P. Pavlova

Shmonin A.A.

First Saint-Petersburg Pavlov State Medical University, Saint-Petersburg;
The Northwestern Federal Medical Research Center, Saint-Petersburg;
Saint-Petersburg City Hospital №26, 196247, Saint-Petersburg, Russia

Antithrombotic therapy in the secondary prevention of stroke

Authors:

Mel’nikova E.V., Kadinskaia M.I., Gerasimenko D.V., Shmonin A.A.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2010;110(12‑2): 23‑27

Read: 3724 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Mel’nikova EV, Kadinskaia MI, Gerasimenko DV, Shmonin AA. Antithrombotic therapy in the secondary prevention of stroke. S.S. Korsakov Journal of Neurology and Psychiatry. 2010;110(12‑2):23‑27. (In Russ.)

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

Factors determining the effectiveness of various antithrombotic therapy regimens after coronary artery bypass surgery in patients with diffuse lesions and small diameter of coronary arteries: a 12-month prospective follow-up. Russian Cardiology Bulletin. 2025;(3):25-35

Antithrombotic therapy after coronary artery bypass grafting: how to improve prognosis and preserve grafts. Russian Cardiology Bulletin. 2026;(1):5-12

Abstract:

The review is devoted to the secondary prevention of ischemic events after ischemic stroke. Recommendations for antithrombotic therapy and prolonged indirect anticoagulant therapy with INR monitoring based on evidence-based medicine of the secondary prevention of ischemic stroke and TIA are presented. Patients who do not need anticoagulants should receive antiplatelet therapy. Due to the increasing number of patients resistant to antiaggregant therapy, the rapid and adequate evaluation of platelet function is needed. Current laboratory diagnostic methods have some shortcomings and do not meet criteria of evidence-based medicine. It is necessary to improve the laboratory diagnosis with the elaboration of reliable standardized methods.

Keywords:

secondary prevention of stroke

antithrombotic therapy

Authors:

Mel’nikova E.V.

Medical Diagnostic and Prophylactic Centre, Yaroslavl’

Kadinskaia M.I.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.P. Pavlova

Gerasimenko D.V.

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.P. Pavlova

Shmonin A.A.

Close metadata

References:

Tul D.F. Sosudistye zabolevaniya golovnogo mozga. Per. s angl. Pod red. E.I. Guseva, A.B. Gekht. Rukovodstvo dlya vrachei. 6-e izd. M: GEOTAR-Media 2007;608.
Rekomendatsii po vedeniyu bol'nykh s ishemicheskim insul'tom i tranzitornymi ishemicheskimi atakami. Eur Stroke Organisat 2008.
Heart and Stroke Statistical Update. Am Heart Ass (Dallas) 2007.
Kozlova T.V., Taratuta T.V. Vozmozhnosti optimizatsii antikoagulyantnoi terapii varfarinom. Rus med zhurn 2008;11:1532-1535.
Kozlova T.V., Taratuta T.V., Aksenova M.B., Khlevchuk T.V. Vzaimodeistvie al'ternativnoi terapii s varfarinom: chto neobkhodimo znat' vracham. Kardiovask ter i prof 2010;9:3:106-109.
Halkes P.H., van Gijn J., Kappelle L.J. et al. ESPRIT Study Group. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 2006;367:9523:1665-1673.
Oliveira D.C., Silva R.F., Silva D.J., Lima V.C. Aspirin resistance: fact or fiction? Arq Bras Cardiol 2010;95:3:91-94.
Paciaroni M., Agnelli G., Micheli S., Caso V. Efficacy and safety of anticoagulant treatment in acute cardioembolic stroke: a meta-analysis of randomized controlled trials. Stroke 2007;38:2:423-430.
Skvortsova V.I. Snizhenie zabolevaemosti, smertnosti i invalidnosti ot insul'tov v Rossiiskoi Federatsii. Zhurn nevrol i psikhiatr 2007;25-31 (Insul't, prilozhenie k zhurnalu, spetsvypusk).
Platelet Function Testing by Aggregometry. Approved Guideline H58-A,28:31:Replaces H58-P:27:19.
Barber M., Langhorne P., Rumley A. et al. D-dimer predicts early clinical progression in ischemic stroke: confirmation using routine clinical assays. Stroke 2006;37:4:1113-1115.
Diener H.-C., Ringelstein E.B., Von Kummer R. et al. Prophylaxis of thrombotic and embolic events in acute ischemic stroke with the low-molecular-weight heparin certoparin: Results of the PROTECT trial. Stroke 2006;37:139-144.
Ageno W., Finazzi S., Steidl L. et al. Plasma measurement of D-dimer levels for the early diagnosis of ischemic stroke subtypes. Arch Int Med 2002;162:22:2589-2593.
Sherman D.G., Albers G.W., Bladin C. et al. PREVAIL Investigators. The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison. Lancet 2007;369:9570:1347-1355.
Kamphuisen P.W., Agnelli G., Sebastianelli M. Prevention of venous thromboembolism after acute ischemic stroke. J Thromb Haemost 2005;3:6:1187-1194.
Kelly J., Rudd A., Lewis R.R. et al. Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging. Stroke 2004;35: 1215-2320.
Shorr A.F., Jackson W.L., Sherner J.H., Moores L.K. Differences Between Low-Molecular-Weight and Unfractionated Heparin for Venous Thromboembolism Prevention Following Ischemic Stroke: A Metaanalysis Chest. Stroke 2008;133:1:149-155.
Dzyak G.V., Kligunenko E.N., Snisar' V.I. Fraktsionirovannye i nefraktsionirovannye gepariny v intensivnoi terapii. M: Medpress-inform 2005.
McCarthy S.T., Turner J.J., Robertson D. et al. Low-dose heparin as a prophylaxis against deep-vein thrombosis after acute stroke. Lancet 1977;2:8042:800-801.
McCarthy S.T., Turner J. Low-dose subcutaneous heparin in the prevention of deep-vein thrombosis and pulmonary emboli following acute stroke. Age Ageing 1986;15:2:84-88.
Hidalgo M. Prophylaxis of venous thromboembolism in abdominal wall surgery. Hernia 2000;4:242-247.
Prandoni P. Prevention and treatment of venous thromboembolism with low-molecular-weight heparins: Clinical implications of the recent. Eur Guidelines J 2008,6:13.