What is the best antithrombotic regimen for a patient with a history of TIAs who has difficulty affording medications?

In the management of patients with a history of Transient Ischemic Attacks (TIAs), the choice of antithrombotic therapy is crucial in reducing the risk of recurrent events. Aspirin, at a low dose of 81 mg daily, is often recommended as first-line therapy for secondary stroke prevention due to its efficacy and safety profile.

Aspirin works by inhibiting platelet aggregation, thus reducing the likelihood of clot formation that can lead to another stroke or TIA. It is well-established in clinical guidelines and has been thoroughly studied, demonstrating a significant reduction in the risk of subsequent vascular events in patients with a history of TIAs.

Moreover, cost may be a significant consideration for patients when selecting a medication regimen. Aspirin is generally much more affordable and widely available compared to other options, such as warfarin or newer antiplatelet agents like prasugrel and clopidogrel. This affordability factor is critical for ensuring adherence to therapy, which is essential for effective secondary prevention.

While other medications like warfarin, prasugrel, and clopidogrel may have their roles in specific patient populations (for example, patients with atrial fibrillation may benefit from anticoagulation with warfarin), they