Monthly Archives: November 2009

Stroke. Conclusion

Despite the large number of clinical studies, there are important unanswered issues concerning the management of patients with ischemic cerebrovascular events. In the acute management of stroke, there are many ongoing clinical trials with antithrombotic drugs, as well as neuroprotective

Acute Stroke Treatments

In the acute setting, thrombolysis with TPA has been approved by the FDA for the treatment of ischemic stroke where the therapy can be instituted within 3 hours of symptoms. The NIH TPA trials demonstrated a consistent and persuasive improvement

Warfarin

Warfarin is an oral anticoagulant which has been demonstrated to be effective in the prevention of cardioembolic stroke. Recent randomized clinical trials have evaluated the relative merits of warfarin or aspirin in patients with asymptomatic nonvalvular atrial fibrillation. Warfarin is

Ticlopidine. Dipyridamole. Clopidogrel

Ticlopidine The other antiplatelet agent that has proven efficacy in stroke prevention is ticlopidine. In the Canadian American Ticlopidine Study, ticlopidine was compared to placebo after a completed non-cardioembolic stroke among 1053 patients. Ticlopidine resulted in a 23% risk reduction

Antithrombotic Agents. Aspirin

Antithrombotic agents are ultimately aimed at interfering with the process of thrombosis or formation of intravascular clot which involves platelets and fibrin. Antiplatelet agents deter the adherence of platelets to the wall of an injured vessel or to one another.

Carotid Endarterectomy

Specific Treatments for Patients with Tia or Minor Stroke Depending on the mechanism of the cerebral ischemic event, there are now options from which to chose for the prevention of first or recurrent stroke. Newer treatments such as thrombolysis and

Treatment of Hyperlipidemias

Clinical trials analyzing the relationship of lipid lowering strategies and stroke have yet to confirm a reduction in risk for patients with TIA or stroke. For TIA and stroke-free subjects, a recent meta-analysis of 16 trials of lipid lowering using

Treatments for Cardiac Conditions

Measures which are effective in reducing the incidence of cardiac disease could lead to a reduction in stroke incidence. Anti-platelet agents have proven efficacy in the reduction of nonfatal myocardial infarction in primary prevention studies. Beta-blockers have been shown to