Table 2 . Recommendations for DAPT for acute MIS and high-risk TIA in international stroke guidelines 10 - 15 , 17 .
a ESO guideline recommends a single loading dose of 300 mg of clopidogrel in patients not already taking the relevant medication.
bAustralian guideline recommends a loading dose of 300 mg of aspirin and 300–600 mg of clopidogrel followed by 100–150 mg of aspirin and 75 mg of clopidogrel daily for 21 days.
c Canadian guideline recommends a loading dose of 300–600 mg of clopidogrel and 160 mg of aspirin at the start of treatment.
COR: class of recommendation; DAPT: dual antiplatelet therapy; LOE: level of evidence; MIS: minor ischemic stroke; SAPT: single antiplatelet therapy; TIA: transient ischemic attack.
|
Guideline |
Initiation window |
Recommendation and treatment duration |
Dosing regimen |
|
American Heart Association/American Stroke Association (2021) |
24 hours |
Recommendation of COR I, LOE A: DAPT (clopidogrel and aspirin) for 21 to 90 days followed by SAPT |
Initiation: DAPT with clopidogrel and aspirin Maintenance: SAPT |
|
Recommendation of COR IIb, LOE B-R: DAPT (ticagrelor and aspirin) for 30 days |
Initiation: DAPT with ticagrelor and aspirin |
||
|
European Stroke Organisation (2021) |
24 hours |
Strong recommendation: DAPT (clopidogrel and aspirin) for 21 days followed by SAPT |
Initiation: DAPT with clopidogrel and aspirin a Maintenance: SAPT |
|
Weak recommendation: DAPT (ticagrelor and aspirin) for 30 days |
Initiation: DAPT with ticagrelor and aspirin |
||
|
Australian Stroke Foundation (2021) |
24 hours |
Strong recommendation: DAPT (clopidogrel and aspirin) for 21 days followed by SAPT |
Initiation: DAPT with clopidogrel and aspirin b Maintenance: SAPT |
|
Weak recommendation: DAPT (ticagrelor and aspirin) for 30 days |
Initiation: DAPT with ticagrelor and aspirin |
||
|
Taiwan Stroke Society (2022) |
24 hours |
Recommendation of COR I, LOE A: DAPT (clopidogrel and aspirin) for 21 days followed by SAPT |
Initiation: DAPT with clopidogrel and aspirin Maintenance: SAPT |
|
Recommendation of Class IIb, LOE BR: DAPT (ticagrelor and aspirin) for 30 days |
Initiation: DAPT with ticagrelor and aspirin |
||
|
Canadian Stroke Best Practices (2018) |
24 hours |
Recommendation of LOE A DAPT (clopidogrel and aspirin) for 21 to 30 days followed by SAPT |
Initiation: DAPT with clopidogrel and aspirin c Maintenance: SAPT |