Secondary stroke prevention: review of clinical trials

Mitchell S V Elkind1

  • 1Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. mse13@columbia.edu

Clinical Cardiology
|June 11, 2004
PubMed

Insights

Patients who have had a stroke or TIA face high risks for future vascular events. This review covers clinical trials on secondary stroke prevention methods, including surgical, medical, and pharmacological therapies.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Stroke and transient ischemic attack (TIA) survivors are at elevated risk for recurrent vascular events, particularly stroke.
  • Secondary prevention strategies are crucial for mitigating these risks.

Purpose of the Study:

  • To review clinical trials focused on secondary stroke prevention.
  • To provide an overview of established stroke prevention modalities.

Main Methods:

  • Literature review of clinical trials on secondary stroke prevention.
  • Categorization of prevention methods into surgical, antihypertensive, lipid-lowering, anticoagulant, and antiplatelet therapies.

Main Results:

  • The article synthesizes findings from various clinical trials across different prevention strategies.
  • It highlights the range of interventions available for post-stroke patients.

Conclusions:

  • Effective secondary stroke prevention involves a multi-faceted approach.
  • Understanding the evidence base for different therapies is key to patient management.

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Clinical Trials: Overview01:11

Clinical Trials: Overview

Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
Regulation of Stroke Volume01:27

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...