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AHA/ASA Early Management of Acute Ischemic Stroke 2026

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47 ABCD2 indicates Age, Blood Pressure, Clinical Features, Duration, and Diabetes (TIA risk score); AIS, acute ischemic stroke; Asa, aspirin; Athero, atherosclerosis; CHANCE, Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events; CHANCE 2, Clopidogrel versus Ticagrelor in High-risk Patients with Acute Nondisabling Cerebrovascular Events; DAPT, Dual Antiplatelet erapy; INSPIRES, Innovative Stroke Prevention and Intervention Research Study; LKN, last known normal; MT, mechanical thrombectomy; NIHSS, National Institutes of Health Stroke Scale; POINT, Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke; SAPT, Single Antiplatelet erapy; THALES, Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and ASA for Prevention of Stroke and Death; and TIA, transient ischemic attack. YES DAPT DAPT SAPT SAPT SAPT Thrombolysis and MT section 2a Clopidogrel + Asa × 21 days YES YES NO NO 1 Athero (>50%) 1 LKN 24–72 hr + NIHSS ≤5 or ABCD ≥4 INSPIRES INSPIRES (patients with presumed athero) THALES 2b Ticagrelor + Asa × 30 days 2a Clopidogrel + Asa × 21 days OR

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