Prakt. Lékáren. 2015; 11(5e): e3-e9

Secondary prevention in patients surviving an ischemic stroke

Renata Cífková^1,2,3, Peter Wohlfahrt^1,3, Alena Krajčoviechová¹

¹ Centrum kardiovaskulární prevence, 1. lékařská fakulta, Univerzita Karlova v Praze a Thomayerova nemocnice, Praha

^{2ní klinika – klinika kardiologie a angiologie, 1. lékařská fakulta, Univerzita Karlova v Praze a VFN, Praha} II. inter

³ Mezinárodní centrum klinického výzkumu, Brno

Etiologic classification of ischemic stroke helps to establish correct diagnosis and initiate optimal therapy. The European guidelinesfor cardiovascular disease prevention and European Stroke Organization guidelines recommend, in patients with non-cardioembolicischemic stroke, either a combination of aspirin and dipyridamole or clopidogrel alone as first-line therapy. Recent US guidelines alsorecommend aspirin alone as the drug of first choice. Patients with recent ischemic stroke and atrial fibrillation are at high risk of recurrentischemic stroke, and are indicated for anticoagulation therapy to be usually initiated within 14 days of symptom onset. Anticoagulationtherapy ≥ 3 months is also recommended in patients after ischemic stroke, in sinus rhythm, and with thrombus formationin the left ventricle or atrium. Antihypertensive medication is recommended in patients with ischemic stroke or TIA who, after the firstseveral days, have an established BP ≥ 140 mmHg systolic or BP ≥ 90 mmHg diastolic; all drugs can be used provided BP is effectivelylowered. Current guidelines agree in that statin therapy is recommended in patients with ischemic stroke.

Keywords: TOAST classification, acetylsalicylic acid (ASA), dipyridamole, clopidogrel, antihypertensive medication, statins

Published: August 1, 2015  Show citation