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Despite diagnostic advances and new evidence on how to best treat patients with ischemic stroke, the risk of stroke recurrence remains unacceptably high. Therefore, there is a great need for novel therapies and markers to guide risk stratification, reveal stroke aetiology, identify patients who may benefit most from interventions, predict risk for another stroke, and recognize the risk of short-term complications or unfavorable long-term outcomes. The purpose of this chapter is to provide an update on: (i) emerging markers in atherothrombotic stroke; (ii) role of systemic inflammation in contributing to stroke occurrence; (iii) the main antiplatelet agents that have been successfully used in the secondary prevention of non-cardiogenic ischemic stroke and transient ischemic attack; (iv) screening for high-on-treatment platelet reactivity after stroke; and (v) to explore novel and effective antiplatelet strategies for the secondary prevention of ischemic stroke. Rising questions such as indications for antiplatelet therapy after a successful recanalisation following acute ischemic stroke should be answered in the future to optimize outcomes. Finally, we aim to focus on personalized antiplatelet regimens and current translational research findings in this field.
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