Aspirin nonresponse in patients with arterial causes of ischemic stroke: Considerations in detection and management

Patients with a history of ischemic stroke or transient ischemic attack (TIA) are at risk for recurrent ischemic events in the same or different vascular bed. Due to the central role of platelets in the spectrum of ischemic events in all vascular beds, antiplatelet therapy is a critical component of treatment. Of all antiplatelet therapies approved for the secondary prevention of stroke, aspirin is the most well-established and is recommended for all patients with a history of cerebrovascular disease. However, some patients do not respond to aspirin therapy and are termed “aspirin-resistant.” This review discusses issues of, and possible solutions to, decreased platelet response to aspirin in patients with arterial causes of ischemic stroke.