Antiplatelet Agents and Aspirin: Summary and Gaps Previous guideline statements endorse the use of aspirin for cardiac but not stroke prophylaxis among asymptomatic men whose risk is sufficiently high for the benefits to outweigh the risks associated with treatment.876 These recommenda- tions were based on a reduction of coronary events in men and reduction of stroke in women. There remains little evidence (aside from cilostazol in those with peripheral artery disease) supporting the use of antiplate- let therapy other than aspirin and cilostazol for primary stroke prevention because of the lack of relevant trials. Antiplatelet Agents and Aspirin: Recommendations: 1. The use of aspirin for cardiovascular (including but not specific to stroke) prophylaxis is reasonable for people whose risk is sufficiently high (10-year risk >10%) for the benefits to outweigh the risks associ- ated with treatment. A cardiovascular risk calcula- tor to assist in estimating 10-year risk can be found online at http://my.americanheart.org/cvriskcalcula- tor (Class IIa; Level of Evidence A). 2. Aspirin (81 mg daily or 100 mg every other day) can be useful for the prevention of a first stroke among women, including those with diabetes mellitus, whose risk is sufficiently high for the benefits to outweigh the risks associated with treatment (Class IIa; Level of Evidence B). stroke in people with chronic kidney disease (ie, esti- ) (Class IIb; Level of Evidence C). This recommenda- tion does not apply to severe kidney disease (stage 4 or 5; estimated glomerular filtration rate <30 mL/ ). 4. Cilostazol may be reasonable for the prevention of a first stroke in people with peripheral arterial disease (Class IIb; Level of Evidence B). 5. Aspirin is not useful for preventing a first stroke in low-risk individuals (Class III; Level of Evidence A). 6. 