Stroke. 2014 Jul;45(7):2160-236. doi: 10.1161/STR.0000000000000024. Epub 2014 May 1.
The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.
本更新指南的目的是为缺血性卒中和短暂性脑缺血发作幸存者的未来卒中预防提供全面和及时的基于证据的建议。本指南面向所有管理这些患者二级预防的临床医生。针对危险因素控制、血管阻塞干预、心源性栓塞的抗栓治疗以及非心源性卒中的抗血小板治疗提供了基于证据的建议。还针对各种特定情况下的复发性卒中预防提供了建议,包括主动脉弓粥样硬化、动脉夹层、卵圆孔未闭、高同型半胱氨酸血症、高凝状态、抗磷脂抗体综合征、镰状细胞病、脑静脉窦血栓形成和妊娠。特别章节涉及颅内出血后抗栓和抗凝治疗的使用以及指南的实施。