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The American Heart Association and the American Stroke Association (AHA/ASA) released the clinical guidelines for secondary prevention of ischemic stroke in Stroke on May 24.
This is the second update after a lapse of 7 years after 2014.
It will become an important reference for global ischemic stroke diagnosis and treatment
.
Dr.
Dawn O.
Kleindorfer, chairman of the guideline writing group and professor and director of the Department of Neurology at the University of Michigan School of Medicine, interpreted the guideline.
This article is organized as follows
.
Yimaitong compiles and organizes, please do not reprint without authorization
.
Wonderful content, review ↓↓↓Heavy! The 2021 AHA/ASA Stroke and Transient Ischemic Attack Guidelines for Stroke Prevention in Patients with Transient Ischemic Attack (Full Chinese Version) is here to update.
Key Points The Chairman of the Guidelines Writing Group and Professor and Director of the Department of Neurology, University of Michigan School of Medicine, Dr.
Dawn O.
Kleindorfer, said that this latest The American Heart Association and American Stroke Association (AHA/ASA) clinical guidelines for secondary prevention of ischemic stroke emphasize that healthcare workers should perform diagnostic screening within 48 hours of the onset of symptoms to determine the cause of the first stroke
.
The guideline also provides treatment recommendations based on the cause of the first stroke or transient ischemic attack (TIA)
.
Potential causes may include, but are not limited to, blockage of the large arteries in the neck or brain, damage to the small arteries of the brain by hypertension or diabetes, or arrhythmia
.
The updated guidelines are more focused on preventing stroke recurrence.
Treatment recommendations include: ➤Multidisciplinary care teams provide personalized care to patients and make joint decisions with patients to ensure that the care plan formulated includes the patient's wishes, goals, and concerns
.
➤Screen and diagnose atrial fibrillation and start medication to reduce recurrence
.
➤Most patients without contraindications should be treated with antithrombotic therapy
.
However, it is worth noting that antiplatelet combined anticoagulation therapy is usually not recommended for the prevention of stroke recurrence; dual antiplatelet therapy is only recommended for short-term treatment of patients with early small strokes and high-risk TIA or severe symptomatic stenosis
.
➤For patients with carotid artery stenosis, carotid endarterectomy should be considered, or in some cases, a stent can be placed in the carotid artery
.
➤For patients with severe intracranial stenosis that can lead to stroke, active medical management of risk factors and short-term dual antiplatelet therapy are ideal
.
➤In addition, the guidelines also point out that it is reasonable to consider percutaneous patent foramen ovale occlusion
.
The update also includes secondary prevention guidelines for patients with stroke or TIA: ➤Manage patients’ vascular risk factors such as high blood pressure, type 2 diabetes, cholesterol, triglyceride levels and smoking cessation; ➤Limit salt intake and/or Follow the Mediterranean diet; ➤For those with physical activity, participate in moderate-intensity aerobic exercise for 10 minutes 4 times a week or high-intensity aerobic exercise for 20 minutes 2 times a week
.
Summary Dr.
Dawn O.
Kleindorfer said that once someone has a stroke or TIA, it is important to understand the best way to prevent the recurrence of the stroke
.
If we can find the cause of the first stroke or TIA, we can develop strategies to prevent the recurrence of the stroke .
He also stated that the secondary stroke prevention guidelines are one of the "flagship" guidelines of the American Stroke Association, and that they were last updated in 2014
.
There are also some changes in the writing and format of this guide, which will make it easier for medical professionals to understand and locate information faster, and ultimately achieve the goal of improving patient care and preventing more strokes
.
References: [1] American Heart Association Newsroom.
Risk of second stroke can be reduced with prevention efforts based on cause of first stroke.
Available at: https://newsroom.
heart.
org/news/risk-of-second-stroke -can-be-reduced-with-prevention-efforts-based-on-cause-of-first-stroke.
Accessed June 3, 2021.
[2] Kleindorfer DO, et al.
Stroke.
2021;doi:10.
1161/STR0000000000000375.
[3] Jennifer Southall.
Updated society guidelines address prevention of second stroke.
Healio.
This is the second update after a lapse of 7 years after 2014.
It will become an important reference for global ischemic stroke diagnosis and treatment
.
Dr.
Dawn O.
Kleindorfer, chairman of the guideline writing group and professor and director of the Department of Neurology at the University of Michigan School of Medicine, interpreted the guideline.
This article is organized as follows
.
Yimaitong compiles and organizes, please do not reprint without authorization
.
Wonderful content, review ↓↓↓Heavy! The 2021 AHA/ASA Stroke and Transient Ischemic Attack Guidelines for Stroke Prevention in Patients with Transient Ischemic Attack (Full Chinese Version) is here to update.
Key Points The Chairman of the Guidelines Writing Group and Professor and Director of the Department of Neurology, University of Michigan School of Medicine, Dr.
Dawn O.
Kleindorfer, said that this latest The American Heart Association and American Stroke Association (AHA/ASA) clinical guidelines for secondary prevention of ischemic stroke emphasize that healthcare workers should perform diagnostic screening within 48 hours of the onset of symptoms to determine the cause of the first stroke
.
The guideline also provides treatment recommendations based on the cause of the first stroke or transient ischemic attack (TIA)
.
Potential causes may include, but are not limited to, blockage of the large arteries in the neck or brain, damage to the small arteries of the brain by hypertension or diabetes, or arrhythmia
.
The updated guidelines are more focused on preventing stroke recurrence.
Treatment recommendations include: ➤Multidisciplinary care teams provide personalized care to patients and make joint decisions with patients to ensure that the care plan formulated includes the patient's wishes, goals, and concerns
.
➤Screen and diagnose atrial fibrillation and start medication to reduce recurrence
.
➤Most patients without contraindications should be treated with antithrombotic therapy
.
However, it is worth noting that antiplatelet combined anticoagulation therapy is usually not recommended for the prevention of stroke recurrence; dual antiplatelet therapy is only recommended for short-term treatment of patients with early small strokes and high-risk TIA or severe symptomatic stenosis
.
➤For patients with carotid artery stenosis, carotid endarterectomy should be considered, or in some cases, a stent can be placed in the carotid artery
.
➤For patients with severe intracranial stenosis that can lead to stroke, active medical management of risk factors and short-term dual antiplatelet therapy are ideal
.
➤In addition, the guidelines also point out that it is reasonable to consider percutaneous patent foramen ovale occlusion
.
The update also includes secondary prevention guidelines for patients with stroke or TIA: ➤Manage patients’ vascular risk factors such as high blood pressure, type 2 diabetes, cholesterol, triglyceride levels and smoking cessation; ➤Limit salt intake and/or Follow the Mediterranean diet; ➤For those with physical activity, participate in moderate-intensity aerobic exercise for 10 minutes 4 times a week or high-intensity aerobic exercise for 20 minutes 2 times a week
.
Summary Dr.
Dawn O.
Kleindorfer said that once someone has a stroke or TIA, it is important to understand the best way to prevent the recurrence of the stroke
.
If we can find the cause of the first stroke or TIA, we can develop strategies to prevent the recurrence of the stroke .
He also stated that the secondary stroke prevention guidelines are one of the "flagship" guidelines of the American Stroke Association, and that they were last updated in 2014
.
There are also some changes in the writing and format of this guide, which will make it easier for medical professionals to understand and locate information faster, and ultimately achieve the goal of improving patient care and preventing more strokes
.
References: [1] American Heart Association Newsroom.
Risk of second stroke can be reduced with prevention efforts based on cause of first stroke.
Available at: https://newsroom.
heart.
org/news/risk-of-second-stroke -can-be-reduced-with-prevention-efforts-based-on-cause-of-first-stroke.
Accessed June 3, 2021.
[2] Kleindorfer DO, et al.
Stroke.
2021;doi:10.
1161/STR0000000000000375.
[3] Jennifer Southall.
Updated society guidelines address prevention of second stroke.
Healio.
