The potential use of transdermal drug delivery for the prophylaxis and management of stroke and coronary artery disease

In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]. Antiplatelet therapy with aspirin and/or clopidogrel is also a common practice utilized for the management of stroke, acute myocardial infarction and coronary artery disease [3]. There are two different but closely related approaches to improve therapy- to develop new disease-modifying agents or to find alternative drug administration routes for existing drugs. Transdermal drug delivery leverages the advantages of injections and tablets- painlessness, minimal invasiveness and the avoidance of presystemic metabolism and can potentially be applied to medications used for the prevention and/or management of coronary artery disease and stroke.