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Matteo Foschi: 10 Clinical Pearls for Antithrombotic Therapy in Secondary Stroke Prevention
Matteo Foschi/LinkedIn
Sep 29, 2026, 22:27

Matteo Foschi: 10 Clinical Pearls for Antithrombotic Therapy in Secondary Stroke Prevention

Matteo Foschi, Senior Consultant Neurologist at Romagna Local Health Authority (AUSL Romagna), Fellow of the European Stroke Organisation (FESO), Guidelines Production Board at European Stroke Organisation, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Stroke, adding:

“New commentary out in Stroke!

I am very happy to share our new contribution to InterSECT — The International Stroke Early Career and Training Section.

In ‘Antithrombotic Therapy in Secondary Stroke Prevention: 10 Clinical Pearls Every Clinician Should Know‘, we tried to distill an increasingly complex evidence base into 10 practical take-home messages for everyday clinical decision-making:

  1. Know your enemy – match antithrombotic therapy to the stroke mechanism.
  2. Know your antiplatelet arsenal – tailor intensity and DAPT duration to ischemic risk.
  3. Stroke on antiplatelets? Don’t just switch – first reassess adherence, interactions and competing mechanisms.
  4. When the heart is the culprit, anticoagulation is the answer.
  5. Timing matters – after AF-related stroke, think imaging rather than rigid timelines.
  6. Stroke despite anticoagulation? Re-think before changing – look for underdosing, non-adherence, interactions and competing etiologies.
  7. After intracranial bleeding, restarting anticoagulation is a decision – not a reflex.
  8. One size does not fit all – renal function, frailty, neuroimaging, genetics and comorbidities matter.
  9. Prevention is a marathon – treatment needs continuous reassessment over time.
  10. No access, no effect – even the best treatment cannot work without access, adherence and continuity of care.

A special thanks to InterSECT Section Editor Ahmed Nasreldein for inviting us to develop this proposal.

A pleasure to work on this with Lucio D’Anna, Federico De Santis, Raffaele Ornello, and Simona Sacco.”

Title: Antithrombotic Therapy in Secondary Stroke Prevention: 10 Clinical Pearls Every Clinician Should Know

Authors: Matteo Foschi, Lucio D’Anna, Federico De Santis, Raffaele Ornello, Simona Sacco

Matteo Foschi

Other posts featuring Matteo Foschi on Hemostasis Today.

AF Ahmed Nasreldein antithrombotic therapy Blood Cardiology DAPT Federico De Santis Health Hematology Hemostasis Hemostasis News Hemostasis Today InterSECT Lucio D’Anna Matteo Foschi Medicine Raffaele Ornello secondary stroke prevention Simona Sacco stroke
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