Pharmacological Treatment of Acute Ischaemic Stroke: Certainties and Doubts

Ischaemic stroke represents the second cause of death worldwide and the third in Western Countries, furthermore, it is the leading cause of adult disability [1]. The incidence of first episode of ischaemic stroke in Italy is 180/230 new cases /100.000 /year. 20% of these cases were dead after the first month, while 35-40% showed relevant disability and morbidity. Nearly 80% of all ischaemic strokes are found in first episodes, while nearly 20% are represented by ischaemic stroke’s recurrences. However, the risk of ischaemic stroke in the general population shows a relevant increase after the age of 55 years, while the risk of recurrences of an ischaemic stroke raises 10% after 7 days and 18% after 3 months of an acute ischaemic stroke/ minor stroke [2]. Furthermore, after a first episode of ischaemic stroke, the risk to develop another atherothrombotic disease, as stroke’s recurrence or acute coronary syndrome, raises 20% for stroke’s recurrence and 17% for acute coronary syndrome, respectively [3].