Antithrombotic Therapy to Prevent Recurrent Strokes in Ischemic Cerebrovascular Disease JACC Scientific Expert Panel

被引：63

作者：

Del Brutto, Victor J. ^{[1
]}

Chaturvedi, Seemant ^{[2
]}

Diener, Hans-Christoph ^{[3
]}

Romano, Jose G. ^{[1
]}

Sacco, Ralph L. ^{[1
]}

机构：

[1] Univ Miami, Miller Sch Med, Dept Neurol, Miami, FL 33136 USA

[2] Univ Maryland, Dept Neurol, Baltimore, MD 21201 USA

[3] Univ Duisburg Essen, Univ Hosp Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2019年 / 74卷 / 06期

基金：

美国国家卫生研究院;

关键词：

anticoagulants; antiplatelets; antithrombotics; ischemic stroke; secondary prevention; VERTEBRAL ARTERY-STENOSIS; MOLECULAR-WEIGHT HEPARIN; PATENT FORAMEN OVALE; RANDOMIZED-TRIAL RATIONALE; DIRECT ORAL ANTICOAGULANTS; DOSE ACETYLSALICYLIC-ACID; PLACEBO-CONTROLLED TRIAL; HIGH-RISK PATIENTS; SECONDARY PREVENTION; ANTIPLATELET THERAPY;

D O I：

10.1016/j.jacc.2019.06.039

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Stroke survivors carry a high risk of recurrence. Antithrombotic medications are paramount for secondary prevention and thus crucial to reduce the overall stroke burden. Appropriate antithrombotic agent selection should be based on the best understanding of the physiopathological mechanism that led to the initial ischemic injury. Antiplatelet therapy is preferred for lesions characterized by atherosclerosis and endothelial injury, whereas anticoagulant agents are favored for cardiogenic embolism and highly thrombophilic conditions. Large randomized controlled trials have provided new data to support recommendations for the evidence-based use of antiplatelet agents and anticoagulant agents after stroke. In this review, the authors cover recent trials that have altered clinical practice, cite systematic reviews and meta-analyses, review evidence-based recommendations based on older landmark trials, and indicate where there are still evidence-gaps and new trials being conducted. (C) 2019 by the American College of Cardiology Foundation.

引用

页码：786 / 803

页数：18

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