Why antiplatelet therapy for stroke due to carotid atherosclerosis

[mjmdjd1]

why do we use antiplatelet therapy to treat tia/stroke that is caused by carotid atherosclerosis? Aren't coagulation and hypercholesterolemia two different things. So why use the treatment of hypercoagulation (aka antiplatelet therapy) to treat a completely different condition(carotid "ATHEROSCLEROSIS")? One involves blood clotting and the other involves cholesterol..

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[MrGrrrMonster]

This could be thought of as another way if you assume the same with CAD and MI. Essentially cholesterol plaques, when ruptured are extremely thrombotic in nature, precipitating platelet aggregation. Also, the majority of strokes are due to ischemia in small vessels, which when stenosed due to atherosclerosis are again more susceptible to thrombosis. thus aggressive anti platelet medications are indicated in the acute/ subacute setting (not quite sure about in the setting of tpa, maybe someone else can comment), and this is also why aggressive lipid control has shown improved outcomes in CAD, CVA, PVD etc. Hope this makes some sense.

 

[Mad Jack]

This could be thought of as another way if you assume the same with CAD and MI. Essentially cholesterol plaques, when ruptured are extremely thrombotic in nature, precipitating platelet aggregation. Also, the majority of strokes are due to ischemia in small vessels, which when stenosed due to atherosclerosis are again more susceptible to thrombosis. thus aggressive anti platelet medications are indicated in the acute/ subacute setting (not quite sure about in the setting of tpa, maybe someone else can comment), and this is also why aggressive lipid control has shown improved outcomes in CAD, CVA, PVD etc. Hope this makes some sense.

The biggest factor by far is pretty much this.

 

[Phloston]

why do we use antiplatelet therapy to treat tia/stroke that is caused by carotid atherosclerosis? Aren't coagulation and hypercholesterolemia two different things. So why use the treatment of hypercoagulation (aka antiplatelet therapy) to treat a completely different condition(carotid "ATHEROSCLEROSIS")? One involves blood clotting and the other involves cholesterol..

Platelets adhere to irregular surfaces (e.g., exposed collagen). When plaques with unstable caps rupture, the exposed core attracts platelets.

 

[mjmdjd1]

Thanks guys! or gals