What if a patient has a stroke while taking an antiplatelet agent?
The notion of treatment “failure” has been proposed if a patient has a stroke or TIA while on a specific agent.
Genetic variation in antiplatelet response has been convincingly established for clopidogrel and suggested for aspirin, but genetic testing is not routinely used in the selection of antiplatelet agents.
Currently, only limited retrospective data support changing to a different antiplatelet agent after stroke.
In the absence of definitive data, it may be more fruitful to address risk factor reduction strategies and medication adherence.
The role of laboratory platelet inhibition measures in choice of antiplatelet agent remains to be established.
