Drugs for Prevention of Stroke

Researchers at the Stanford Stroke Center are evaluating a number of medications that help prevent stroke in high-risk patients, particularly those who have had a previous transient ischemic attach (TIA) or minor stroke.

These drugs fall into two major categories: anticoagulants (such as heparin and warfarin) and antiplatelet agents (such as aspirin and ticlopidine).

• Anticoagulants may be given orally or intravenously. These drugs work by thinning the blood and preventing clotting. They are also used for deep vein thromboses and pulmonary emboli.
• Antiplatelet agents work by preventing or reducing the occurrence in the bloodstream of a phenomenon known as platelet aggregation. When there is damage or injury to a blood vessel, platelets (one type of blood particle) migrate to the scene to initiate a healing process. Large numbers of platelets clump together (aggregate) and form what is essentially a plug.

This aggregation can sometimes result in formation of a thrombus (blood clot) that may block the artery or break loose and block a smaller artery. By preventing this, antiplatelet agents can reduce the risk of stroke in patients who have had TIAs or prior ischemic strokes. Antiplatelet studies are underway at Stanford to determine the most effective ways to administer these agents.

A number of other drug therapies are also under investigation at Stanford. The development of effective preventive medications will continue to be a major goal of the Stanford Stroke Center.