COR LOE Recommendations In patients with noncardioembolic ischemic stroke or TIA, antiplatelet therapy is indicated in preference to oral anticoagulation to reduce the risk of recurrent ischemic stroke and other cardiovascular events while minimizing the risk For patients with noncardioembolic ischemic stroke or TIA, aspirin 50 to 325 mg daily, clopidogrel 75 mg, or the combination of aspi- rin 25 mg and extended-release dipyridamole 200 mg twice daily is indicated for secondary prevention of ischemic stroke.*791 794 For patients with recent minor (NIHSS score 3) noncardioembolic ischemic stroke or high-risk TIA (ABCD2 score 4), DAPT (aspirin plus clopidogrel) should be initiated early (ideally within 12 24 hours of symptom onset and at least within 7 days of onset) and continued for 21 to 90 days, followed by SAPT, to reduce the risk of recurrent ischemic For patients with recent (< 24 hours) minor to moderate stroke (NIHSS score 5), high-risk score 6), or symptomatic intra- cranial or extracranial 30% stenosis of an artery that could account for the event, DAPT with ticagrelor plus aspirin for 30 days may be considered to reduce the risk of 30-day recur- rent stroke but may also increase the risk of serious bleeding events, including ICH.797 For patients already taking aspirin at the time of noncardioembolic ischemic stroke or TIA, the effectiveness of increasing the dose of aspirin or changing to another antiplatelet medication is not well established.410,798 800 3: Harm ASR For patients with noncardioembolic ischemic stroke or TIA, the continuous use of DAPT (aspirin plus clopidogrel) for >90 days or the use of triple antiplatelet therapy is associated with excess risk of hemorrhage.381,382,801 SR indicates systematic review. 