AHA/ASA guideline recommendations for prevention of stroke in women prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]

Overview

2014 AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (DO NOT EDIT)

Class I
"1. Women with asymptomatic carotid stenosis should be screened for other treatable risk factors for stroke, and appropriate lifestyle changes and medical therapies should be instituted. (Level of Evidence: C) "
"2. In women who are to undergo CEA, aspirin is recommended unless contraindicated, because aspirin was used in every major trial that demonstrated efficacy of CEA. (Level of Evidence: C) "
"3. For women with recent TIA or IS within the past 6 months and ipsilateral severe (70%–99%) carotid artery stenosis, CEA is recommended if the perioperative morbidity and mortality risk is estimated to be <6%(Level of Evidence: A) "
"4. For women with recent TIA or IS and ipsilateral moderate (50%–69%) carotid stenosis, CEA is recommended depending on patient-specific factors, such as age and comorbidities, if the perioperative morbidity and mortality risk is estimated to be <6%. (Level of Evidence: B) "
"5. If a high-risk (ie, 10-year predicted CVD risk ≥10%) woman has an indication for aspirin but is intolerant of aspirin therapy, clopidogrel should be substituted. (Level of Evidence: B) "
Class IIa
"1. Prophylactic CEA performed with <3% morbidity/mortality can be useful in highly selected patients with an asymptomatic carotid stenosis (minimum 60% by angiography, 70% by validated Doppler ultrasound). (Level of Evidence: A) "
"2. When CEA is indicated for women with TIA or stroke, surgery within 2 weeks is reasonable rather than delaying surgery, if there are no contraindications to early revascularization. (Level of Evidence: B) "
"3. Aspirin therapy (75–325 mg/d) is reasonable in women with diabetes mellitus unless contraindicated (Level of Evidence: B) "

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