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Aysha Aslam (talk | contribs) (/* Secondary prevention for specific causes of ischemic stroke{{cite journal| author=Donnan GA, Fisher M, Macleod M, Davis SM| title=Stroke. | journal=Lancet | year= 2008 | volume= 371 | issue= 9624 | pages= 1612-23 | pmid=18468545 | doi=10.1016/S0140-...) |
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*If intolerant to anticoagulation, aspirin 325 mg or clopidogrel 75 mg (if aspirin intolerant) | *If intolerant to anticoagulation, aspirin 325 mg or clopidogrel 75 mg (if aspirin intolerant) | ||
===Secondary prevention for specific causes of ischemic stroke<ref name="pmid18468545">{{cite journal| author=Donnan GA, Fisher M, Macleod M, Davis SM| title=Stroke. | journal=Lancet | year= 2008 | volume= 371 | issue= 9624 | pages= 1612-23 | pmid=18468545 | doi=10.1016/S0140-6736(08)60694-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18468545 }} </ref>=== | ===Secondary prevention for specific causes of transient ischemic stroke<ref name="pmid18468545">{{cite journal| author=Donnan GA, Fisher M, Macleod M, Davis SM| title=Stroke. | journal=Lancet | year= 2008 | volume= 371 | issue= 9624 | pages= 1612-23 | pmid=18468545 | doi=10.1016/S0140-6736(08)60694-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18468545 }} </ref>=== | ||
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Revision as of 20:04, 8 December 2016
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Transient ischemic attack Microchapters |
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Differentiating Transient Ischemic Attack from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Transient ischemic attack secondary prevention On the Web |
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American Roentgen Ray Society Images of Transient ischemic attack secondary prevention |
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Risk calculators and risk factors for Transient ischemic attack secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Secondary prevention
Life style modification for secondary prevention
Life style modification measures which may help reduce the risk of recurrent stroke and prevent complications may include:
- Increased physical activity->10 min of exercise such as walking, running, bicycling or swimming >3 times/wk
- Eating healthy balanced diet
- Smoking cessation
- Decreased alcohal intake
Treatment of modifiable risk factors
Blood pressure
- BP control to less than 140/90mmHg or 130/90mm Hg with an angiotensin inhibitor alone or in combination with a diuretic or angiotensin receptor blocker
Diabetes mellitus
- Diabetes control with fasting blood glucose level <126mg/dl.
Hyperlipidemia
- Initiation of statin for hyperlipidemia with goal LDL level<100mg/dl
Antithrombotic stroke
- Long term antiplatelet therapy with aspirin, dipyrimadole plus aspirin, clopidogrel or aspirin alone
- Anticoagulation not required
Cardioembolic stroke
- Anticoagualtion for atrial fibrillation with Vit K antagonist or NOACs.
- If intolerant to anticoagulation, aspirin 325 mg or clopidogrel 75 mg (if aspirin intolerant)
Secondary prevention for specific causes of transient ischemic stroke[1]
| Cause of ischemic stroke | Revascularization | Multifactorial risk reduction | ||||||
|---|---|---|---|---|---|---|---|---|
| Carotid endartectomy | Carotid stenting | Other Surgical options | Antiplatelet therapy | Statins | Antihypertensives | Anticoagulants | ||
| Large artery disease | Carotid Artery Stenosis | ✔ | ✔ | |||||
| Carotid occlusion | ✔ | ✔ | ||||||
| Vertebral artery stenosis | Angioplasty | ✔ | ✔ | ✔ | ||||
| Large vessel atherosclerosis | ✔ | Percutaneous transluminal angioplasty | ✔✔ | ✔✔ | ✔✔ | ✔✔ | ||
| Arterial dissection | Endovascular surgical repair | ✔ | ✔ | |||||
| Cardiac embolism | Atrial fibrillation | ✔ | ✔ | |||||
| Valvular heart disease | ✔ | |||||||
| Mitral valve disease | ✔ | |||||||
| Recent MI/ left ventricular thrombus | ✔ | |||||||
| Heart failure | ✔ | ✔ | ||||||
| Dilated cardiomyopathy | ✔ | ✔ | ||||||
| Hematological disorders | Protein C/S deficiency | ✔ | ||||||
| Sickle cell disease | Repeated blood transfusions and
Hydroxurea |
✔ | ||||||
| Antithrombin III deficiency | ✔ | |||||||
| Antiphospholipid antibody syndrome | ✔ | ✔ | ||||||