Cardiovascular · UKMLA & AKT
Stroke (ischaemic)
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- First-line: clopidogrel - NICE first-line antiplatelet for secondary prevention after ischaemic stroke; inhibits ADP-mediated platelet activation
- If clopidogrel contraindicated or not tolerated: aspirin + dipyridamole combination
- If AF confirmed as cause: anticoagulation with a DOAC (e.g. apixaban) replaces antiplatelet therapy entirely - start at ~14 days to reduce risk of haemorrhagic transformation
Clopidogrel is NICE first-line for secondary prevention - not aspirin alone, not aspirin + dipyridamole. Aspirin 300 mg is used acutely (first 24 h post-thrombolysis) but is not the long-term secondary prevention agent of choice.
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