Guo Yilei, Pan Danping, Wan Haitong, Yang Jiehong
College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China.
The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou 310003, China.
Healthcare (Basel). 2024 Jul 16;12(14):1415. doi: 10.3390/healthcare12141415.
Cardiac death is the second most common cause of death among patients with acute ischemic stroke (IS), following neurological death resulting directly from acute IS. Risk prediction models and screening tools including electrocardiograms can assess the risk of adverse cardiovascular events after IS. Prolonged heart rate monitoring and early anticoagulation therapy benefit patients with a higher risk of adverse events, especially stroke patients with atrial fibrillation. IS and cardiovascular diseases have similar risk factors which, if optimally managed, may reduce the incidence of recurrent stroke and other major cardiovascular adverse events. Comprehensive risk management emphasizes a healthy lifestyle and medication therapy, especially lipid-lowering, glucose-lowering, and blood pressure-lowering drugs. Although antiplatelet and anticoagulation therapy are preferred to prevent cardiovascular events after IS, a balance between preventing recurrent stroke and secondary bleeding should be maintained. Optimization of early rehabilitation care comprises continuous care across environments thus improving the prognosis of stroke survivors.
心脏性死亡是急性缺血性卒中（IS）患者中第二常见的死亡原因，仅次于由急性IS直接导致的神经源性死亡。包括心电图在内的风险预测模型和筛查工具可以评估IS后发生不良心血管事件的风险。延长心率监测时间和早期抗凝治疗对发生不良事件风险较高的患者有益，尤其是合并房颤的卒中患者。IS和心血管疾病有相似的危险因素，如果得到最佳管理，可能会降低复发性卒中及其他主要心血管不良事件的发生率。综合风险管理强调健康的生活方式和药物治疗，尤其是降脂、降糖和降压药物。虽然在IS后预防心血管事件时首选抗血小板和抗凝治疗，但应在预防复发性卒中和继发性出血之间保持平衡。优化早期康复护理包括跨环境的持续护理，从而改善卒中幸存者的预后。
