06 February 2023

Anti-platelet therapy may be under-prescribed for women who have experienced a mini-stroke or a transient ischemic attack, an international conference will hear.

Dr Jonathan Solomonow of Maryland Medical Center in Baltimore, USA, and colleagues looked at prescriptions made between 2018 and 2021 to 2,953 male and female survivors of a minor stroke or a transient ischemic attack (TIA).

Analysis showed that only 40% of patients were prescribed dual anti-platelet therapy (DAPT), with women being significantly less likely to be given these drugs than men.

This is despite the evidence that supports taking two anti-platelet blood thinning medications, such as aspirin or clopidogrel, to reduce the short-term risk of recurrent stroke for these patients, the researchers say.

This preliminary research will be presented at the American Stroke Association’s International Stroke Conference 2023, held in Dallas, USA, and online from 8th to 10th February.

It showed that DAPT was under-prescribed at all hospitals reviewed, but that men were more likely to receive the prescription than women (43% versus 37%). The likelihood of receiving DAPT did not vary by race, age, or whether they received treatment at a specialised stroke centre. The study covered nine stroke centres in a network overseen by the University of Maryland.

Dr Solomonow said: “All stroke survivors, regardless of sex, should receive optimal proven medications for stroke prevention including DAPT when medically appropriate.

“Patients and their family members should inquire about the use of DAPT after a stroke or TIA to consider if DAPT may be beneficial.”

He concluded: “The gender gap was not entirely surprising because there is extensive literature indicating that women with cardiovascular disease tend to be undertreated.

“Further research is needed to examine whether women are less likely to receive other proven therapies, such as statins for stroke prevention and anti-coagulation for atrial fibrillation.”


Solomonow J, Marks JR, Yarbrough KL, Mehndiratta P, Chaturvedi S (2023) “Abstract 43: Is Dual Antiplatelet Therapy Underutilized Following TIA And Minor Stroke?” Presented at the American Stroke Association International Stroke Conference 2023

Link: https://newsroom.heart.org/news/dual-blood-thinners-under-prescribed-after-minor-or-warning-stroke-especially-in-women

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