WSC 2025 | The need for novel secondary stroke prevention strategies
Mike Sharma, MD, MSc, FRCPC, McMaster University, Hamilton, Canada, discusses the need for novel secondary stroke prevention strategies. He highlights that aspirin is traditionally used, but stroke recurrence rates remain high, indicating a large unmet need for treatment with anti-thrombotics better than aspirin. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.
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Transcript
The basic issue we have is for most patients for long-term prevention, the only anti-thrombotic is aspirin. Aspirin by itself. So, treatment we’ve had for 50 years since the initial trials were done in stroke. Everything we’ve done to try to advance it has failed either because of increased bleeding risk or lack of efficacy. The only progress we’ve made is over the first 3 weeks or so short-term dual antiplatelet therapy is better than aspirin but after that for the lifetime of the patient we have only aspirin...
The basic issue we have is for most patients for long-term prevention, the only anti-thrombotic is aspirin. Aspirin by itself. So, treatment we’ve had for 50 years since the initial trials were done in stroke. Everything we’ve done to try to advance it has failed either because of increased bleeding risk or lack of efficacy. The only progress we’ve made is over the first 3 weeks or so short-term dual antiplatelet therapy is better than aspirin but after that for the lifetime of the patient we have only aspirin. Recurrence rates of stroke are still quite high. You know modestly it’s about 6% per year but when we look at strokes which are not cardioembolic, where the highest need is, what we see our increase risks of 10% or higher in the first year. This is in Denmark, in the UK as well as Japan and they increase subsequently after that. Double-digit absolute risk in medicine are rare and we really want to avoid them. So there’s a strong large unmet need for treatment with anti-thrombotics better than aspirin.
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