Cardiovascular Diseases

2021 Guideline for the Secondary Prevention of Stroke

The 2021 secondary stroke prevention guideline from the American Heart Association/American Stroke Association: 1. Recommendations for the diagnostic workup to define ischemic stroke etiology. 2. Management of vascular risk factors remains extremely important, including (but not limited to) diabetes, smoking cessation, lipids, and especially hypertension. 3. Lifestyle factors: Low-salt and Mediterranean diets are recommended. Physical activity in a supervised and safe manner should be encouraged. 4. Programs that use theoretical models of behavior change, proven techniques, and multidisciplinary support are needed. 5. Antithrombotic therapy, including antiplatelet or anticoagulant agents, is recommended for nearly all patients without contraindications. With very few exceptions, the combination of antiplatelets and anticoagulation is typically not indicated for secondary stroke prevention. Dual antiplatelet therapy is not recommended long term, and short term, dual antiplatelet therapy is recommended only in very specific patients, including those with early arriving minor stroke and high-risk transient ischemic attack or severe symptomatic intracranial stenosis. 6. Anticoagulation is usually recommended for atrial fibrillation patient if no contraindications. Heart rhythm monitoring for occult atrial fibrillation is usually recommended if no other cause of stroke is discovered. 7. Patients with severe extracranial carotid artery stenosis ipsilateral to a nondisabling stroke or transient ischemic attack who are candidates for intervention should have the stenosis fixed, likely relatively early after their ischemic stroke. 8. Aggressive medical management of risk factors and short-term dual antiplatelet therapy are preferred for patients with severe intracranial stenosis in the vascular territory of ischemic stroke or transient ischemic attack, but not angioplasty and stenting. 9. It is considered reasonable to close patent foramen ovale percutaneously in patients with younger age with nonlacunar stroke or no other cause at any age. 10. Patients with embolic stroke of uncertain source should not be treated empirically with anticoagulants or ticagrelor. Source: https://www.ahajournals.org/

hyangiu

Recent Posts

Dose Response of Physical Activity in CVD and Mortality

Two recent studies highlight the importance of physical activity volume and intensity in reducing cardiovascular…

1 day ago

Faster Walking Pace May Reduce Risk of Cardiac Arrhythmias

A prospective UK cohort study found that both self-reported average or brisk walking pace and…

1 day ago

4:3 Intermittent Fasting Outperforms Daily Caloric Restriction for Weight Loss

A U.S. randomized clinical trial found that 4:3 intermittent fasting (IMF) led to slightly greater…

4 weeks ago

Comparative CVD Efficacy of Newer Glucose-Lowering Drugs in Elderly T2D Patients

A Danish nationwide cohort study provided real world evidence that both glucagon-like peptide 1 receptor…

1 month ago

Efficacy of Non-Surgical and Non-Interventional Treatments in Low Back Pain

A systematic review and meta-analysis of placebo-controlled randomized trials showed that there is moderate certainty…

1 month ago

Statin Use Linked to Lower Risks of HCC and Liver Disease Progression

A US cohort study indicated that statin use may reduce the risks of hepatocellular carcinoma…

1 month ago

This website uses cookies.