Secondary Prevention of Atherothrombotic Events After Ischemic Stroke

Adams, Harold P.

doi:10.4065/84.1.43

Cited by 33 publications

(17 citation statements)

References 89 publications

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“…279,281 The awareness that different forms of cardiac disease may place an individual patient at increased risk of stroke mandates a comprehensive diagnostic evaluation. 279,282 Cardiac conditions associated with a high risk for stroke include atrial arrhythmias (eg, atrial fibrillation/flutter, sick sinus syndrome), left atrial thrombus, primary cardiac tumors, vegetations, and prosthetic cardiac valves. 279 Other cardiac conditions that increase the risk of stroke include dilated cardiomyopathy, coronary artery disease, valvular heart disease, and endocarditis.…”

Section: Other Cardiac Conditionsmentioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,300

577

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Background and Purpose-This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council Scientific Statement Oversight Committee and the AHA Manuscript Oversight Committee. The writing group used systematic literature reviews (covering the time since the last review was published in 2006 up to April 2009), reference to previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate recommendations using standard AHA criteria (Tables 1 and 2). All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. The guideline underwent extensive peer review by the Stroke Council leadership and the AHA scientific statements oversight committees before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Schemes for assessing a person's risk of a first stroke were evaluated. Risk factors or risk markers for a first stroke were classified according to potential for modification (nonmodifiable, modifiable, or potentially modifiable) and strength of evidence (well documented or less well documented). Nonmodifiable risk factors include age, sex, low birth weight, race/ethnicity, and genetic predisposition. Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia, carotid artery stenosis, sickle cell disease, postmenopausal hormone therapy, poor diet, physical inactivity, and obesity and body fat

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Section: Other Cardiac Conditionsmentioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,300

577

View full text Add to dashboard Cite

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“…Hypertension was a significant negative determinant of embolic infarction in our cancer patients. Hypertension is an important risk factor for large artery disease and lacunar infarction [25]. Therefore, patients with hypertension are less likely to develop cerebral infarct caused by an embolism.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Acute Cerebral Infarcts in Patients with Active Malignancy Using Diffusion-Weighted Imaging

2009

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Background and Purpose: It is still controversial whether the nature of cerebral infarcts differs between cancer patients and the general population. The aim of this study is to delineate the characteristics of acute cerebral infarction in patients with active malignancy using diffusion-weighted imaging (DWI). Materials and Methods: Seventy consecutive patients with both active malignancy and acute cerebral infarction (confirmed by DWI) were retrospectively included. These 70 were divided into 3 groups on the basis of infarct pattern: embolic infarction, large artery disease, and lacunar infarction. Medical records were reviewed in detail for demographic data, cancer information, vascular risk factors, and prognosis. Results: Two thirds of cancer patients had multiple infarcts, and 30% of infarcts were located infratentorially. Embolic infarction, large artery disease, and lacunar infarction occurred in 60, 31, and 9% of cancer patients, respectively. Gastrointestinal (GI) cancer was significantly related to embolic infarction (odds ratio 4.64, p = 0.04). The 3-month mortality rates were higher in patients with rather than without cancer metastasis (68 vs. 8%; p < 0.001). Conclusions: Cerebral infarcts in cancer patients tended to be embolic and multiple. Patients with GI cancer were particularly susceptible to embolic infarction.

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“…Taken together, this study focused on patients with CADD, PAD, CeVAD, or a recent history of ACS, which represent a group of high-risk patients with ASCVD [10][11][12] . Prevention of ischemic events in patients with ASCVD involves controlling factors that promote the course of atherosclerosis, including hypertension, hyperlipidemia, diabetes, and smoking, as well as local interventions such as carotid endarterectomy and endovascular treatment 13) . Patients who have had an initial atherothrombotic event are at a high risk for both a subsequent ischemic event in the same arterial bed and ischemic events at other arterial sites 14,15) .…”

mentioning

confidence: 99%