Aspirin is not useful for preventing a first stroke in low-risk individuals (Class III; Level of Evidence A). 6. Aspirin is not useful for preventing a first stroke in people with diabetes mellitus in the absence of other high-risk conditions (Class III; Level of Evidence A). 7. Aspirin is not useful for preventing a first stroke in people with diabetes mellitus and asymptomatic peripheral artery disease (defined as asymptomatic in the presence of an ankle brachial index 0.99) (Class III; Level of Evidence B). 8. The use of aspirin for other specific situations (eg, AF, carotid artery stenosis) is discussed in the relevant sections of this statement. 9. As a result of a lack of relevant clinical trials, anti- platelet regimens other than aspirin and cilostazol are not recommended for the prevention of a first stroke (Class III; Level of Evidence C). Primary Prevention in the Emergency Department Emergency departments (EDs) in the United States are the default safety net for millions of Americans,894 yet at a time when more and moreAmericans use EDs for emergency and primary care, the By definition, EDs provide immediate access to healthcare providers trained in emergency care and allow access to advanced tech- nologies and medical specialists for patients with diverse medi- cal conditions. EDs are equipped to evaluate and manage acute life-threatening illness yet are increasingly called on to provide services typically associated with primary care. For many patients who use the ED for the majority of their healthcare services, the ED may serve as an important location to provide health promo- tion and disease prevention services, including stroke. 