Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack

TLDR

The aim of this new statement is to provide comprehensive and timely evidence‑based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. The statement offers evidence‑based guidance on risk‑factor control, interventional and antithrombotic strategies for atherosclerotic disease, cardioembolic and non‑cardioembolic stroke, and tailored prevention for conditions such as arterial dissections, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, sickle cell disease, cerebral venous sinus thrombosis, pregnancy, post‑menopausal hormone use, post‑hemorrhagic anticoagulation, and high‑risk populations. Stroke.

Abstract

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches for the implementation of guidelines and their use in high-risk populations. (Stroke. 2006;37:577-617.)