Which type of medication is prescribed for secondary prevention of stroke following a major ischemic stroke?

For secondary prevention of stroke following a major ischemic stroke, monotherapy with aspirin is often prescribed because it significantly reduces the risk of subsequent strokes in patients who have already experienced one. Aspirin works as an antiplatelet agent, inhibiting platelet aggregation and thus preventing thrombus formation.

In many clinical guidelines, aspirin is recommended as a first-line therapy for patients who have had a non-cardioembolic ischemic stroke. The established benefit of aspirin is based on substantial evidence showing its effectiveness in preventing further vascular events in this population.

Although dual antiplatelet therapy might be suitable in some specific scenarios or for certain patients (like those with a high risk of recurring events), it is generally not the standard approach for all patients post-ischemic stroke due to increased bleeding risk and cost considerations. Anticoagulants are primarily used in patients with cardioembolic ischemic stroke, such as those with atrial fibrillation, rather than in those with non-cardioembolic sources. Long-acting nitrates are not used in the context of stroke prevention; they are more associated with angina and heart failure management.

In summary, monotherapy with aspirin is the most widely accepted and recommended practice for secondary prevention of stroke in