It has been more than two years since the cerebral infarction occurred. Is it possible that it will recur? What medicine should be used to prevent recurrence?

A friend asked Huazi that he had suffered from cerebral infarction for more than two years and had not had a recurrence. He heard from others that if there had been no recurrence for such a long time, it was very likely that there would be no recurrence. Is this true? If I want to prevent the recurrence of cerebral infarction, what medicine should I take? Can I take it for a long time?

Huazi replied that the recurrence rate of cerebral infarction is very high. After the first cerebral infarction, the probability of recurrence within 5 years is about 40%. Therefore, we should not take it lightly just because there has been no recurrence for a period of time, but should persist in prevention. To prevent cerebral infarction, different drugs need to be used according to different risk factors, and they need to be taken for a long time.

1. Preventing the recurrence of cerebral infarction is a long-term task. There are two main causes of cerebral infarction:

One is cerebral atherosclerosis. When atherosclerotic plaques rupture, they induce platelet aggregation, which in turn activates fibrin to form thrombi, blocking arteries, or detaching and blocking distal small-caliber arteries.

The second is atrial fibrillation. The quivering atria cannot pump blood into the ventricles normally, which will cause the blood flow in the atria to slow down and easily form wall thrombi on the atrial wall. After falling off, they will become emboli, and when they run to the brain, they will block smaller arteries.

With the current medical level, these two risk factors for cerebral infarction are difficult to completely eliminate and are likely to cause recurrence of cerebral infarction. Therefore, after a cerebral infarction occurs, the most important thing is to prevent another attack.

II. Medication for the prevention of cerebral infarction 1. Atherosclerosis: Atherosclerosis refers to the cholesterol in the blood entering the arterial intima, forming hardened plaques. First of all, we need to control the causes of atherosclerosis and delay the progression of plaques. For example, smokers need to quit smoking, and people with "three highs" chronic diseases such as hypertension, diabetes, and hyperlipidemia need to take medication to keep their indicators within normal range.

There is no way to completely eliminate the atherosclerotic plaques that have already formed, but they can be "reinforced" with statins. Because only unstable plaques are prone to rupture, long-term use of statins (more than 2 to 4 years) can make the plaques more "solid" and less likely to rupture.

To be on the safe side, you should also take antiplatelet drugs while using statins. Aspirin, clopidogrel, ticagrelor, etc. are all commonly used antiplatelet drugs. Usually, one of them can be used to inhibit platelet function, so that when plaques rupture, platelet aggregation can be inhibited to form thrombi.

2. Atrial fibrillation: Atrial fibrillation is mainly caused by various heart diseases, such as congenital heart disease, rheumatic heart disease, hypertensive heart disease, etc. Therefore, these heart diseases should be treated first to try to convert atrial fibrillation to normal heart rhythm. However, if it cannot be converted to normal heart rhythm, anticoagulant treatment should be carried out.

Anticoagulant therapy and antiplatelet therapy are different and should not be confused. Patients with atrial fibrillation need to use anticoagulant drugs such as warfarin and rivaroxaban. Long-term treatment is required to inhibit coagulation in order to avoid blood clots in the atrium and prevent cerebral infarction.

3. Drugs for preventing cerebral infarction need long-term use. The effect of each drug after entering the human body is limited, while the risk factors for cerebral infarction persist. Therefore, drugs must be taken every day to continuously produce preventive effects. Especially for those who have already suffered a cerebral infarction, there is no such thing as "no recurrence for a long time". Only by taking drugs continuously can you guarantee your safety to the greatest extent.

For people who have suffered a cerebral infarction, preventing the recurrence of the disease is a long-term task. As long as the medication does not cause serious, intolerable side effects, it is basically a lifelong medication and cannot be stopped.

Although drugs may bring some side effects, they are nothing compared to the damage caused by cerebral infarction. The side effects of drugs are reversible, preventable and treatable, but once cerebral infarction occurs, it is a lifelong thing, and the disability and mortality rates are very high.

Moreover, during the medication process, the side effects of the drugs can be monitored and adjusted according to the situation, such as choosing better-tolerated drugs, adjusting the drug dosage, or using appropriate methods to combat the side effects of the drugs, without causing excessive damage to the body.

In summary, after a stroke, the use of appropriate medication can reduce the risk of recurrence, but continuous medication is required to ensure continued effectiveness of prevention. Don't relax your vigilance just because there have been no problems for a long time. It is better to be careful than to be cautious. You need a doctor's guidance when taking medication. If you find any problems during medication, please consult a doctor or pharmacist in time. I am pharmacist Huazi, welcome to follow me and let me be the pharmacist by your side.