Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of the management of high-risk population

Abstract

AimCerebrovascular disease is the leading cause of death and disability in China, causing a huge burden among patients and their families. Hence, stroke prevention is critical, especially in the high-risk population. Here, we present the evidence-based guideline suitable for the Chinese population.MethodsLiterature search of PubMed and Cochrane library (from January 1964 to June 2019) was done. After thorough discussion among the writing group members, recommendations were listed and summarised. This guideline was reviewed and discussed by the fellow writing committees of the Chinese Stroke Association’s Stroke.ResultsThis evidence-based guideline was written in three parts: controlling the risk factors of stroke, utilisation of antiplatelet agents and assessing the risks of first-ever stroke. All recommendations were listed along with the recommending classes and levels of evidence.ConclusionsThis guideline provides recommendations for primary prevention of cerebrovascular disease among high-risk population in China. Controlling related risk factors, appropriately using antiplatelet agents, assessing the risk of developing first-ever stroke should help reduce the rate of cerebrovascular disease in China.

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

“…Cerebrovascular disease is a major cause of death and disability worldwide 1 . Acute ischaemic stroke (AIS) is the most common type of cerebrovascular disease.…”

“…Cerebrovascular disease is a major cause of death and disability worldwide. 1 Acute ischaemic stroke (AIS) is the most common type of cerebrovascular disease. Despite the availability of antithrombotic drugs and endovascular treatment in most cases, AIS remains a major public health issue that poses a significant health burden.…”

In-hospital prognosis of first-ever noncardiogenic ischemic stroke in patients with and without indication for prestroke antiplatelet therapy: Chinese Stroke Center Alliance

“…Therefore, our study emphasizes the need for better identification of patients at risk, perhaps using emerging novel risk factors (19,20). Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders highlighted that asymptomatic carotid stenosis over 50% and asymptomatic intracranial artery stenosis were considered as high-risk factors and that antiplatelets was recommended as primary prevention (Class Iia, level of evidence C) (21).…”

“…Second, the definition of indications for prestroke antiplatelet use might be imperfect. We were unable to gather information about severe stenosis (over 50-70%) of the peripheral artery, carotid artery, and intracranial artery, which were indications as well (21,25). Third, to make a compromise, we regarded AF as an indication.…”

Effects of Integrative Medicine on The Post-Stroke Cognitive Impairment (PSCI) Patients: A Study Protocol for A Randomized Multicentric Controlled Trial

“…Currently, the rehabilitation of PSCI includes drug therapy and non-drug therapy [4]. There is no speci c effective drug for the treatment of PSCI, but considering that the vascular dementia and dementia have certain overlaps in neuropathology and neurochemistry mechanism, cholinesterase inhibitors and noncompetitive N-methyl -D-aspartic acid receptor antagonist have been approved for improving cognitive function after stroke [4]. In addition, new drugs have been developed but not commonly used, such as neurotrophic enhancers like Bryostatin [5].…”