Progress in clinical neurosciences: pharmacotherapies for the secondary prevention of stroke

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
Daniel G Hackam, Moira K Kapral

Abstract

Stroke is a leading cause of mortality and long-term disability worldwide. Survivors of a previous stroke or transient ischemic attack are vulnerable to further cerebrovascular events, as well as myocardial infarction, peripheral vascular disease, congestive heart failure and vascular death. Traditional approaches to the secondary prevention of stroke have included aspirin after ischemic stroke, warfarin for stroke associated with cardioembolic sources, and carotid endarterectomy for eligible candidates with significant carotid artery stenosis. In recent years, much evidence has emerged to support a broader array of pharmacotherapies, including newer antiplatelet agents, lipid lowering drugs, and several classes of blood pressure lowering therapies. Also under study are B vitamins for patients with cerebrovascular disease and hyper-homocysteinemia, and oral direct thrombin inhibitors for high-risk patients with atrial fibrillation. We review the literature to determine the clinical significance of these therapies, and provide recommendations regarding their use in the prevention of recurrent stroke.

References

Aug 1, 1992·Archives of Neurology·J L Wilterdink, J D Easton
Jul 22, 1974·JAMA : the Journal of the American Medical Association
Mar 8, 1969·British Medical Journal·J AchesonE C Hutchinson
Nov 1, 1970·Circulation·P Leren
May 1, 1982·Stroke; a Journal of Cerebral Circulation·R L SaccoP M McNamara
Jun 23, 1997·Archives of Internal Medicine·J R CrouseC D Furberg
Jun 20, 1998·JAMA : the Journal of the American Medical Association·F H MesserliU Goldbourt
Dec 4, 1998·Stroke; a Journal of Cerebral Circulation·G J HankeyE G Stewart-Wynne
Aug 17, 1999·Archives of Internal Medicine·S D RossD Luo
Jan 13, 2000·Journal of General Internal Medicine·S WarshafskyW H Frishman
Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Feb 5, 2000·Stroke; a Journal of Cerebral Circulation·W N KernanR I Horwitz
May 24, 2000·Neurology·R G HollowayS R Rush
Jun 3, 2000·Stroke; a Journal of Cerebral Circulation·N CohenD Modai
Aug 3, 2000·The New England Journal of Medicine·H D WhiteA M Tonkin
Apr 13, 2001·JAMA : the Journal of the American Medical Association·G G SchwartzUNKNOWN Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators
May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Nov 28, 2001·American Journal of Hypertension·S JuliusP Palatini
Dec 12, 2001·Stroke; a Journal of Cerebral Circulation·W LalouschekUNKNOWN Vienna Stroke Study Group
Jan 11, 2002·Lancet·P SleightUNKNOWN Heart Outcomes Prevention Evaluation (HOPE) Study

❮ Previous
Next ❯

Citations

Feb 6, 2017·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Ruth E HallMark T Bayley

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Related Papers

Herz
Jörg Ederle, Martin M Brown
Annali italiani di medicina interna : organo ufficiale della Società italiana di medicina interna
G G Nenci, S Goracci
© 2021 Meta ULC. All rights reserved