Role of Clopidogrel in Minor Stroke and Transient Ischaemic Attack

1. Role of Clopidogrel in
Transient Ischaemic Attack / Minor
Stroke
Ade Wijaya, MD - Neurologist

4. Definition
Stroke: An episode of acute (focal/global) neurological
dysfunction presumed to be caused by ischemia or
hemorrhage of Central Nervous System (brain, retinal, spinal
cord) persisting ≥24 hours or until death, other etiologies
excluded.
Transient Ischaemic Attack: A transient episode of
neurologic dysfunction due to focal brain, spinal cord, or
retinal ischemia, without acute infarction or tissue injury

5. Pathogenesis

8. Management of Ischaemic Stroke
Acute Stroke Treatment
• Intravenous thrombolysis
• Mechanical Thrombectomy
Secondary Stroke Prevention
• Antiplatelet
• Anticoagulant

9. Acute Ischaemic Stroke Treatment
< 4.5 hours < 24 hours

10. Secondary Stroke Prevention

14. Mechanism of Action

15. Role of Dual Antiplatelet
in TIA/Minor Stroke

16. MATCH TRIAL

17. CHARISMA TRIAL

18. CHANCE TRIAL

19. POINT TRIAL

21. Recommendation (AHA/ASA)

22. Recommendation (AHA/ASA)

23. Recommendation (ESO)

24. Interaksi Clopidogrel

25. Conclusion
• Clopidogrel can be used for secondary stroke
prevention in ischaemic stroke.
• For patients with an acute high-risk transient ischemic
attack or minor ischemic stroke of non-cardioembolic
origin (NIHSS 0-3), who are not at high bleeding risk,
dual antiplatelet therapy is recommended with
clopidogrel 75 mg daily plus acetylsalicylic acid 81 mg
daily for a duration of 21 days after the event, followed
by antiplatelet monotherapy thereafter (acetylsalicylic
acid or clopidogrel alone)

26. THANK YOU