Medical therapy for stroke prevention in the older patient: What to do when aspirin isn't enough

Stroke is the most common life-threatening neurological disease and is the fourth leading cause of death among adult Canadians. Aspirin is the most frequently prescribed antithrombotic drug to prevent stroke but may not be a suitable choice in older patients who have already had stroke symptoms despite its use, or cannot tolerate its side effects. For these patients, clopidogrel or the combination of low-dose aspirin with extended release (ER) dipyridamole should be considered for prevention of stroke, This review will compare the relative benefits of aspirin, clopidogrel, and low-dose aspirin/ER-dipyridamole in geriatric patients at risk for stroke.