New Questions About Acute Treatment for Patients with TIA or Minor Ischemic Stroke

With emergency rooms packed with patients who could have COVID-19, patients experiencing minor symptoms of stroke may be more likely than ever to visit an urgent care center instead of the ED. As such, it would behoove you to be aware of newly published research comparing ticagrelor plus aspirin or clopidogrel plus aspirin vs aspirin alone in patients with minor ischemic stroke and transient ischemic attack. The article, published online by JAMA Network, drew data from five randomized clinical trials in which a total of 22,098 such patients received just aspirin, aspirin and ticagrelor, or aspirin and clopidogrel. While the two latter regimens were not compared head-to-head, both were found to be superior to aspirin alone. The findings “suggest that short-term dual antiplatelet therapy with aspirin and either ticagrelor or clopidogrel is effective after minor ischemic stroke or transient ischemic attack” in preventing recurrent strokes or death. To get an even better take on urgent care presentation of patients in crisis due to excessively high blood pressure, read Managing Hypertensive Emergencies in the Urgent Care Setting in the JUCM archive.