MacDougall Niall J J, Amarasinghe Sanjay, Muir Keith W
Division of Clinical Neurosciences, University of Glasgow, Institute of Neurological Sciences, Southern General Hospital, Glasgow, G51 4TF, UK.
Expert Rev Cardiovasc Ther. 2009 Sep;7(9):1103-15. doi: 10.1586/erc.09.77.
Stroke and transient ischemic attacks result from a range of mechanisms. Secondary prevention includes both conventional approaches to vascular risk-factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy) and more specific interventions, such as carotid endarterectomy or anticoagulation for atrial fibrillation. The relative importance of even conventional risk factors in stroke differs from coronary artery disease. Large clinical trials produce information on most aspects of stroke prevention. Stroke and transient ischemic attacks are now recognized as medical emergencies, with a high early risk of recurrence, and evidence is accumulating to support the importance of immediate institution of secondary preventative treatments. We review current literature on the secondary prevention of stroke.
中风和短暂性脑缺血发作由多种机制引起。二级预防既包括针对血管危险因素管理的传统方法（降低血压、使用他汀类药物降低胆固醇、戒烟和抗血小板治疗），也包括更具针对性的干预措施，如颈动脉内膜切除术或针对心房颤动的抗凝治疗。即使是传统危险因素在中风中的相对重要性也与冠状动脉疾病不同。大型临床试验提供了有关中风预防大多数方面的信息。中风和短暂性脑缺血发作现在被视为医疗急症，早期复发风险很高，并且越来越多的证据支持立即开展二级预防治疗的重要性。我们综述了有关中风二级预防的当前文献。
