Cost-effectiveness of antiplatelet therapy for secondary stroke prevention.

Antiplatelet therapy is recommended over anticoagulants for the secondary prevention of vascular death in patients with noncardioembolic ischemic stroke or transient ischemic attack based upon the 2006 American Heart Association/American Stroke Association guidelines for the prevention of stroke and the National Stroke Association guidelines for the management of transient ischemic attack. Aspirin is commonly used as a cornerstone antiplatelet agent considering its mild but definite prevention benefit and low costs. Other antiplatelet strategies that are currently recommended include extended-release dipyridamole plus low-dose aspirin (Aggrenox((R)), Asasantin((R))) and clopidogrel. In this brief review, we evaluate the cost-effectiveness of antiplatelet agents for secondary stroke prevention to better understand the socioeconomical value of the recommended agents.