What is the most recommended regimen for a patient post-ischemic stroke to reduce future stroke risk?

The most recommended regimen for a patient post-ischemic stroke to reduce future stroke risk is the daily use of aspirin at a low dose of 81 mg. Aspirin is an antiplatelet agent that works by inhibiting platelet aggregation, which is a key factor in the formation of blood clots that can lead to ischemic events such as strokes.

Clinical guidelines support the use of aspirin for secondary prevention in patients who have experienced a non-cardioembolic ischemic stroke or a transient ischemic attack (TIA). This recommendation is based on robust evidence demonstrating that aspirin significantly reduces the risk of recurrent strokes and other cardiovascular events compared to no therapy or placebo.

While other agents such as clopidogrel and combination therapy with aspirin and clopidogrel can be used in certain situations, they are not typically the first-line recommendation for most patients after an initial ischemic stroke. Clopidogrel is generally reserved for patients who cannot tolerate aspirin or for specific clinical scenarios, while dual antiplatelet therapy may increase the risk of bleeding and is not routinely recommended for long-term use after stroke.

In summary, the low-dose daily aspirin regimen has a well-established role in preventing recurrent strokes and is supported by clinical guidelines, making it