Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke

被引:84
作者
Lip, Gregory Y. H. [1 ,2 ,3 ,4 ,5 ]
Lane, Deirdre A. [1 ,2 ,3 ]
Lenarczyk, Radoslaw [4 ]
Boriani, Giuseppe [6 ]
Doehner, Wolfram [7 ,8 ,9 ]
Benjamin, Laura A. [10 ]
Fisher, Marc [11 ]
Lowe, Deborah [12 ]
Sacco, Ralph L. [13 ]
Schnabel, Renate [14 ]
Watkins, Caroline [15 ]
Ntaios, George [16 ]
Potpara, Tatjana [5 ,17 ]
机构
[1] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England
[2] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England
[3] Aalborg Univ, Dept Clin Med, Aalborg, Denmark
[4] Med Univ Silesia, Silesian Ctr Heart Dis, Div Med Sci Zabrze, Dept Cardiol Congenital Heart Dis & Electrotherap, Curie Sklodowska Str 9, PL-41800 Zabrze, Poland
[5] Univ Belgrade, Sch Med, Belgrade, Serbia
[6] Univ Modena & Reggio Emilia, Policlin Modena, Dept Biomed Metab & Neural Sci, Cardiol Div, Modena, Italy
[7] Charite Univ Med Berlin, BIH Ctr Regenerat Therapies BCRT, Berlin, Germany
[8] Charite Univ Med Berlin, Dept Internal Med & Cardiol, Virchow Klinikum, German Ctr Cardiovasc Res DZHK Partner Site Berli, Berlin, Germany
[9] Charite Univ Med Berlin, Ctr Stroke Res Berlin, Berlin, Germany
[10] Univ Coll London Natl Hosp Neurol & Neurosurg Que, Lab Mol & Cell Biol, London, England
[11] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA
[12] Wirral Univ Teaching Hosp NHS Fdn Trust, Wirral CH49 5PE, Merseyside, England
[13] Univ Miami, Miller Sch Med, UM Clin & Translat Sci Inst, Miami, FL 33136 USA
[14] Univ Heart & Vasc Ctr Hamburg Eppendorf, German Ctr Cardiovasc Res DZHK Partner Site Hambu, Hamburg, Germany
[15] Univ Cent Lancashire, Fac Hlth & Care, Preston PR1 2HE, Lancs, England
[16] Univ Thessaly, Fac Med, Sch Hlth Sci, Dept Internal Med, Larisa, Greece
[17] Clin Ctr Serbia, Cardiol Clin, Belgrade, Serbia
基金
英国惠康基金;
关键词
Stroke; Heart disease; Integrated care; Delivery of care; Patient pathways; ACUTE ISCHEMIC-STROKE; LEFT-VENTRICULAR THROMBUS; PATENT FORAMEN OVALE; CARDIAC MAGNETIC-RESONANCE; LIFE-STYLE INTERVENTIONS; MOBILE HEALTH TECHNOLOGY; QUALITY-OF-LIFE; ATRIAL-FIBRILLATION; RISK-FACTORS; BLOOD-PRESSURE;
D O I
10.1093/eurheartj/ehac245
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The management of patients with stroke is often multidisciplinary, involving various specialties and healthcare professionals. Given the common shared risk factors for stroke and cardiovascular disease, input may also be required from the cardiovascular teams, as well as patient caregivers and next-of-kin. Ultimately, the patient is central to all this, requiring a coordinated and uniform approach to the priorities of post-stroke management, which can be consistently implemented by different multidisciplinary healthcare professionals, as part of the patient 'journey' or 'patient pathway,' supported by appropriate education and tele-medicine approaches. All these aspects would ultimately aid delivery of care and improve patient (and caregiver) engagement and empowerment. Given the need to address the multidisciplinary approach to holistic or integrated care of patients with heart disease and stroke, the European Society of Cardiology Council on Stroke convened a Task Force, with the remit to propose a consensus on Integrated care management for optimizing the management of stroke and associated heart disease. The present position paper summarizes the available evidence and proposes consensus statements that may help to define evidence gaps and simple practical approaches to assist in everyday clinical practice. A post-stroke ABC pathway is proposed, as a more holistic approach to integrated stroke care, would include three pillars of management: center dot A: Appropriate Antithrombotic therapy. center dot B: Better functional and psychological status. center dot C: Cardiovascular risk factors and Comorbidity optimization (including lifestyle changes).
引用
收藏
页码:2442 / 2460
页数:19
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