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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Post-Ischemic Stroke Cardiovascular Risk Prevention and Management
Yilei Guo1, Danping Pan1, Haitong Wan2,3,4
1College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China.
Insights
Cardiac death is a major concern after acute ischemic stroke (IS). Comprehensive management, including lifestyle changes and medications, can reduce recurrent stroke and cardiovascular events.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Cardiac death is the second leading cause of mortality in acute ischemic stroke (IS) patients.
- Adverse cardiovascular events pose a significant risk post-stroke.
- Shared risk factors between IS and cardiovascular diseases necessitate integrated management strategies.
Purpose of the Study:
- To outline strategies for managing cardiovascular risks in acute ischemic stroke survivors.
- To emphasize the importance of comprehensive risk factor management and early intervention.
Main Methods:
- Review of existing literature on cardiovascular risk prediction and management post-stroke.
- Analysis of therapeutic approaches including monitoring, anticoagulation, lifestyle modifications, and pharmacotherapy.
- Emphasis on integrated care pathways from acute treatment to rehabilitation.
Main Results:
- Electrocardiograms and risk prediction models aid in assessing cardiovascular event risk.
- Prolonged heart rate monitoring and early anticoagulation benefit high-risk patients, particularly those with atrial fibrillation.
- Optimal management of shared risk factors (lipids, glucose, blood pressure) reduces recurrent events.
Conclusions:
- Comprehensive risk management, including lifestyle and pharmacotherapy, is crucial for improving outcomes in IS patients.
- Balancing antithrombotic therapy to prevent recurrent stroke while minimizing bleeding risk is essential.
- Optimized early rehabilitation and continuous care enhance prognosis for stroke survivors.
Abstract:
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.
