| Acute high-risk TIA or minor ischemic stroke (non-cardioembolic, NIHSS 0–3, low bleeding risk) |
Clopidogrel + ASA |
Clopidogrel 300–600 mg once + ASA 160–325 mg once |
Clopidogrel 75 mg daily + ASA 81 mg daily |
21 days only |
Antiplatelet monotherapy indefinitely (ASA or clopidogrel) |
A |
| Beyond 21 days after TIA/minor stroke (no special indication) |
DAPT not recommended |
— |
— |
Do NOT continue DAPT |
Continue single antiplatelet |
B |
| Alternative short-term DAPT option (selected patients, low bleed risk) |
Ticagrelor + ASA |
Ticagrelor 180 mg once + ASA 160–325 mg once |
Ticagrelor 90 mg BID + ASA 81 mg daily |
30 days |
Antiplatelet monotherapy thereafter |
B |
| Symptomatic intracranial atherosclerotic stenosis 70–99% (recent TIA/stroke, low bleed risk) |
SAMMPRIS protocol: Clopidogrel + ASA |
Standard ASA + clopidogrel loading |
Clopidogrel 75 mg daily + ASA 81–325 mg daily |
90 days (3 months) |
Antiplatelet monotherapy + high-intensity statin, aggressive BP control, lifestyle modification |
B |