General exceptions
There is doubt that the symptoms were of vascular origin The patient is at very low risk of vascular events (for example, a single episode of amaurosis fugax in a patient with no evidence of carotid atheroma and no evidence of coronary heart disease or peripheral vascular disease)
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Exceptions for specific drugs (apart from their usual contraindications)
Aspirin: clear history of aspirin allergy; recent gastrointestinal bleeding Statin: total cholesterol <3.5 mmol/l ACE inhibitor/diuretic/blood pressure lowering and (a) blood pressure <115/75 mm Hg; (b) severe occlusive arterial disease in the neck (for example, bilateral carotid occlusion) The patient is already on a very large number of drugs
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