The role of dual antiplatelet therapy combining aspirin and clopidogrel, is controversial. There are two settings in which such treatment might be considered: (a) patients presenting with a first ischemic event at high risk for a recurrence; and (b) patients who experience a second ischemic event while being treated with aspirin or clopidogrel monotherapy. In this paper we review the literature dealing with secondary prevention of ischemic stroke, with an emphasis on dual antiplatelet therapy. We examine international guidelines and present a case study which illustrates the application of this information.

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