This Article Free upon publication Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sacco, R. L. Articles by Tomsick, T. Search for Related Content PubMed PubMed Citation Articles by Sacco, R. L. Articles by Tomsick, T. Pubmed/NCBI databases Medline Plus Health Information Stroke Transient Ischemic Attack Related Collections Transient Ischemic Attacks Acute Stroke Syndromes Primary and Secondary Stroke Prevention Related Internet Resources

(Circulation. 2006;113:e409-e449.)
© 2006 American Heart Association, Inc.

AHA/ASA Guideline

Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack

A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline.

Ralph L. Sacco, MD, MS, FAHA, FAAN, Chair; Robert Adams, MD, FAHA, Vice Chair; Greg Albers, MD; Mark J. Alberts, MD, FAHA; Oscar Benavente, MD; Karen Furie, MD, MPH, FAHA; Larry B. Goldstein, MD, FAHA, FAAN; Philip Gorelick, MD, MPH, FAHA, FAAN; Jonathan Halperin, MD, FAHA; Robert Harbaugh, MD, FACS, FAHA; S. Claiborne Johnston, MD, PhD; Irene Katzan, MD, FAHA; Margaret Kelly-Hayes, RN, EdD, FAHA; Edgar J. Kenton, MD, FAHA, FAAN; Michael Marks, MD; Lee H. Schwamm, MD, FAHA; Thomas Tomsick, MD, FAHA

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches for the implementation of guidelines and their use in high-risk populations.

Key Words: AHA Scientific Statements • ischemia • ischemia attack, transient • stroke

Related Internet Resources:

Slide Set by the Stroke Council Professional Education Committee

This article has been cited by other articles:

				C L Shovlin, J E Jackson, K B Bamford, I H Jenkins, A R Benjamin, H Ramadan, and E Kulinskaya Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia Thorax, March 1, 2008; 63(3): 259 - 266. [Abstract] [Full Text] [PDF]

				C. M. Wu, K. McLaughlin, D. L. Lorenzetti, M. D. Hill, B. J. Manns, and W. A. Ghali Early Risk of Stroke After Transient Ischemic Attack: A Systematic Review and Meta-analysis Arch Intern Med, December 10, 2007; 167(22): 2417 - 2422. [Abstract] [Full Text] [PDF]

				N. A. Nickman, J. Biskupiak, F. Creekmore, H. Shah, and D. I . Brixner Antiplatelet medication management in patients hospitalized with ischemic stroke Am. J. Health Syst. Pharm., November 1, 2007; 64(21): 2250 - 2256. [Abstract] [Full Text] [PDF]

				E. R Mohler III Carotid stenting for atherothrombosis Heart, September 1, 2007; 93(9): 1147 - 1151. [Full Text] [PDF]

				R. Zahn, M. Hochadel, U. Zeymer, J. Senges, and H. Mudra Concerns on carotid stenting in octogenarians: reply Eur. Heart J., August 2, 2007; 28(16): 2045 - 2045. [Full Text] [PDF]

				J. Hirsh, M. O'Donnell, and J. W. Eikelboom Beyond Unfractionated Heparin and Warfarin: Current and Future Advances Circulation, July 31, 2007; 116(5): 552 - 560. [Full Text] [PDF]

				O. I.I. Soliman, M. L. Geleijnse, F. J. Meijboom, A. Nemes, O. Kamp, P. Nihoyannopoulos, N. Masani, S. B. Feinstein, and F. J. Ten Cate The use of contrast echocardiography for the detection of cardiac shunts Eur J Echocardiogr, June 1, 2007; 8(3): s2 - s12. [Abstract] [Full Text] [PDF]

				A. I. Qureshi Carotid Angioplasty and Stent Placement after EVA-3S Trial Stroke, June 1, 2007; 38(6): 1993 - 1996. [Full Text] [PDF]

				I. Inglessis and M. J. Landzberg Interventional Catheterization in Adult Congenital Heart Disease Circulation, March 27, 2007; 115(12): 1622 - 1633. [Full Text] [PDF]

				Ph. G. Steg, D. L. Bhatt, P. W. F. Wilson, R. D'Agostino Sr, E. M. Ohman, J. Rother, C.-S. Liau, A. T. Hirsch, J.-L. Mas, Y. Ikeda, et al. One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis JAMA, March 21, 2007; 297(11): 1197 - 1206. [Abstract] [Full Text] [PDF]

				V. J. Howard, L. A. McClure, J. F. Meschia, L. Pulley, S. C. Orr, and G. H. Friday High Prevalence of Stroke Symptoms Among Persons Without a Diagnosis of Stroke or Transient Ischemic Attack in a General Population: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study. Arch Intern Med, October 9, 2006; 166(18): 1952 - 1958. [Abstract] [Full Text] [PDF]

				August 22 Highlight and Commentary: Predictors of recurrent stroke in African Americans Neurology, August 22, 2006; 67(4): 553 - 553. [Full Text] [PDF]