Donate Help Contact The AHA Sign In Home
American Heart Association
Stroke
Search: search_blue_button Advanced Search
Stroke. 2006;37:577-617
doi: 10.1161/01.STR.0000199147.30016.74
Free Article
This Article
Free upon publication Free Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sacco, R. L.
Right arrow Articles by Tomsick, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sacco, R. L.
Right arrow Articles by Tomsick, T.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Stroke
*Transient Ischemic Attack
Related Collections
Right arrow Transient Ischemic Attacks
Right arrow Acute Stroke Syndromes
Right arrow Primary and Secondary Stroke Prevention
Right arrow Related Internet Resources

(Stroke. 2006;37:577.)
© 2006 American Heart Association, Inc.


AHA/ASA Guidelines

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
Abstract

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. (Stroke. 2006;37:577-617.)


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:


Home page
StrokeHome page
R. J. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, S. C. Johnston, et al.
Update to the AHA/ASA Recommendations for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
Stroke, May 1, 2008; 39(5): 1647 - 1652.
[Full Text] [PDF]


Home page
Am. J. Neuroradiol.Home page
D.C. Suh, J.K. Kim, J.W. Choi, B.S. Choi, H.W. Pyun, Y.J. Choi, M.-H. Kim, H.R. Yang, H.I. Ha, S.J. Kim, et al.
Intracranial Stenting of Severe Symptomatic Intracranial Stenosis: Results of 100 Consecutive Patients
AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 781 - 785.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
P. Verro, P. B. Gorelick, and D. Nguyen
Aspirin Plus Dipyridamole Versus Aspirin for Prevention of Vascular Events After Stroke or TIA: A Meta-Analysis
Stroke, April 1, 2008; 39(4): 1358 - 1363.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
N. K. Hills and S. C. Johnston
Trends in Usage of Alternative Antiplatelet Therapy After Stroke and Transient Ischemic Attack
Stroke, April 1, 2008; 39(4): 1228 - 1232.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
E. Doufekias, A. Z. Segal, and J. R. Kizer
Cardiogenic and aortogenic brain embolism.
J. Am. Coll. Cardiol., March 18, 2008; 51(11): 1049 - 1059.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
E. I. Levy, J. Mocco, R. M. Samuelson, R. D. Ecker, B. S. Jahromi, and L. N. Hopkins
Optimal treatment of carotid artery disease.
J. Am. Coll. Cardiol., March 11, 2008; 51(10): 979 - 985.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Neuroradiol.Home page
A. Kastrup, K. Groschel, T. Nagele, A. Riecker, F. Schmidt, S. Schnaudigel, and U. Ernemann
Effects of Age and Symptom Status on Silent Ischemic Lesions after Carotid Stenting with and without the Use of Distal Filter Devices
AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 608 - 612.
[Abstract] [Full Text] [PDF]


Home page
Arch Intern MedHome page
K. A. LaBresh, M. J. Reeves, M. R. Frankel, D. Albright, and L. H. Schwamm
Hospital Treatment of Patients With Ischemic Stroke or Transient Ischemic Attack Using the "Get With The Guidelines" Program
Arch Intern Med, February 25, 2008; 168(4): 411 - 417.
[Abstract] [Full Text] [PDF]


Home page
Vasc MedHome page
M. E Schachter, H. A Tran, and S. S Anand
Oral anticoagulants and non-cardioembolic stroke prevention
Vascular Medicine, February 1, 2008; 13(1): 55 - 62.
[Abstract] [PDF]


Home page
StrokeHome page
B. Hallstrom, A.-C. Jonsson, C. Nerbrand, B. Norrving, and A. Lindgren
Stroke Incidence and Survival in the Beginning of the 21st Century in Southern Sweden: Comparisons With the Late 20th Century and Projections Into the Future
Stroke, January 1, 2008; 39(1): 10 - 15.
[Abstract] [Full Text] [PDF]


Home page
NeurologyHome page
A. Towfighi, J. L. Saver, R. Engelhardt, and B. Ovbiagele
A midlife stroke surge among women in the United States
Neurology, November 13, 2007; 69(20): 1898 - 1904.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
R. M. Samuelson, J. Yamamoto, E. I. Levy, A. H. Siddiqui, and L. N. Hopkins
The Argument to Support Broader Application of Extracranial Carotid Artery Stent Technology
Circulation, October 2, 2007; 116(14): 1602 - 1610.
[Full Text] [PDF]


Home page
StrokeHome page
C. S. Hodgson
To FAST or Not to FAST?
Stroke, October 1, 2007; 38(10): 2631 - 2632.
[Full Text] [PDF]


Home page
CirculationHome page
L. B. Goldstein
Acute Ischemic Stroke Treatment in 2007
Circulation, September 25, 2007; 116(13): 1504 - 1514.
[Full Text] [PDF]


Home page
Am. J. Neuroradiol.Home page
D. Seidenwurm, P. Turski, J. Barr, J. Connors, M. Lev, S. Mukherji, and E. Russell
Performance Measures in Neuroradiology
AJNR Am. J. Neuroradiol., September 1, 2007; 28(8): 1435 - 1438.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
H. B. van der Worp and J. van Gijn
Acute Ischemic Stroke
N. Engl. J. Med., August 9, 2007; 357(6): 572 - 579.
[Full Text] [PDF]


Home page
CirculationHome page
T. L. P. Slottow, D. H. Steinberg, and R. Waksman
Overview of the 2007 Food and Drug Administration Circulatory System Devices Panel Meeting on Patent Foramen Ovale Closure Devices
Circulation, August 7, 2007; 116(6): 677 - 682.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
B. Norrving, P. Wester, K. S. Sunnerhagen, A. Terent, A. Sohlberg, F. Berggren, P.-O. Wester, K. Asplund, for the Stroke Guidelines Working Group,, and National Board of Health and Welfare, Stockholm, S
Beyond Conventional Stroke Guidelines: Setting Priorities
Stroke, July 1, 2007; 38(7): 2185 - 2190.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
M. S. Dhamoon, W. Tai, B. Boden-Albala, T. Rundek, M. C. Paik, R. L. Sacco, and M. S.V. Elkind
Risk of Myocardial Infarction or Vascular Death After First Ischemic Stroke: The Northern Manhattan Study
Stroke, June 1, 2007; 38(6): 1752 - 1758.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
R. L. Sacco
The 2006 William Feinberg Lecture: Shifting the Paradigm From Stroke to Global Vascular Risk Estimation
Stroke, June 1, 2007; 38(6): 1980 - 1987.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
G. Saposnik and M. K. Kapral
Poststroke Care: Chronicles of a Neglected Battle
Stroke, June 1, 2007; 38(6): 1727 - 1729.
[Full Text] [PDF]


Home page
Rheumatology (Oxford)Home page
C. Christodoulou, S. Sangle, and D. P. D'Cruz
Vasculopathy and arterial stenotic lesions in the antiphospholipid syndrome
Rheumatology, June 1, 2007; 46(6): 907 - 910.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al.
Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists.
Circulation, May 22, 2007; 115(20): e478 - e534.
[Abstract] [Full Text] [PDF]


Home page
Arch NeurolHome page
J. A. Viehman, J. L. Saver, D. S. Liebeskind, S. Starkman, L. K. Ali, B. Buck, T. Razinia, and B. Ovbiagele
Utility of Urinalysis in Discriminating Cardioembolic Stroke Mechanism
Arch Neurol, May 1, 2007; 64(5): 667 - 670.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
A. Kastrup, K. Groschel, and U. Ernemann
Response to Letter by Cohen
Stroke, May 1, 2007; 38(5): e19 - e20.
[Full Text] [PDF]


Home page
StrokeHome page
L. H. Kuller
So, What's New?
Stroke, May 1, 2007; 38(5): 1427 - 1429.
[Full Text] [PDF]


Home page
StrokeHome page
P. B. Gorelick
Combining Aspirin With Oral Anticoagulant Therapy: Is This a Safe and Effective Practice in Patients With Atrial Fibrillation?
Stroke, May 1, 2007; 38(5): 1652 - 1654.
[Full Text] [PDF]


Home page
StrokeHome page
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al.
Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists
Stroke, May 1, 2007; 38(5): 1655 - 1711.
[Abstract] [Full Text] [PDF]


Home page
Journal of Pharmacy PracticeHome page
S. C. Fagan, H. F. Elewa, and D. J. Rychly
Statin Therapy for Secondary Stroke Prevention: Evidence Catches Up to Practice
Journal of Pharmacy Practice, April 1, 2007; 20(2): 117 - 122.
[Abstract] [PDF]


Home page
StrokeHome page
M. Moussouttas
Emerging Therapies: ESPRIT
Stroke, April 1, 2007; 38(4): 1142 - 1142.
[Full Text] [PDF]


Home page
CirculationHome page
J. K. Liao
Secondary Prevention of Stroke and Transient Ischemic Attack: Is More Platelet Inhibition the Answer?
Circulation, March 27, 2007; 115(12): 1615 - 1621.
[Abstract] [Full Text] [PDF]


Home page
NeurologyHome page
K. M. Barrett and K. C. Johnston
Intracranial posterior circulation stenting: Promise but still without evidence
Neurology, March 13, 2007; 68(11): 805 - 806.
[Full Text] [PDF]


Home page
NeurologyHome page
W. J. Jiang, X. T. Xu, B. Du, K. H. Dong, M. Jin, Q. H. Wang, and N. Ma
Long-term outcome of elective stenting for symptomatic intracranial vertebrobasilar stenosis
Neurology, March 13, 2007; 68(11): 856 - 858.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
B. Ovbiagele and J. L. Saver
Intensive Statin Therapy After Stroke or Transient Ischemic Attack: A Sparcling Success?
Stroke, March 1, 2007; 38(3): 1110 - 1112.
[Full Text] [PDF]


Home page
Postgrad. Med. J.Home page
S. Ghosh, A. K. Ghosh, and S. K. Ghosh
Patent foramen ovale and atrial septal aneurysm in cryptogenic stroke
Postgrad. Med. J., March 1, 2007; 83(977): 173 - 177.
[Abstract] [Full Text] [PDF]


Home page
NeurologyHome page
E. E. Smith, A. R. Abdullah, H. Amirfarzan, and L. H. Schwamm
Serum lipid profile on admission for ischemic stroke: Failure to meet National Cholesterol Education Program Adult Treatment Panel (NCEP-ATPIII) guidelines
Neurology, February 27, 2007; 68(9): 660 - 665.
[Abstract] [Full Text] [PDF]


Home page
NeurologyHome page
R. G. Holloway, D. Tuttle, T. Baird, and W. K. Skelton
The safety of hospital stroke care
Neurology, February 20, 2007; 68(8): 550 - 555.
[Abstract] [Full Text] [PDF]


Home page
NeurologyHome page
S. Laowattana and S. M. Oppenheimer
Protective effects of beta-blockers in cerebrovascular disease
Neurology, February 13, 2007; 68(7): 509 - 514.
[Abstract] [Full Text] [PDF]


Home page
Vasc MedHome page
E. R. Bates, C. J. D. Babb, D. E. Casey, C. U. Cates, G. R. Duckwiler, T. E. Feldman, W. A. Gray, K. Ouriel, E. D. Peterson, K. Rosenfield, et al.
ACCF/SCAI/SVMB/SIR/ASITN 2007 Clinical Expert Consensus Document on Carotid Stenting: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (ACCF/SCAI/SVMB/SIR/ASITN Clinical Expert Consensus Document Committee on Carotid Stenting)
Vascular Medicine, February 1, 2007; 12(1): 35 - 83.
[PDF]


Home page
Eur Heart JHome page
R. Zahn, T. Ischinger, M. Hochadel, U. Zeymer, W. Schmalz, N. Treese, K. E. Hauptmann, H. Seggewiss, I. Janicke, H. Haase, et al.
Carotid artery stenting in octogenarians: results from the ALKK Carotid Artery Stent (CAS) Registry
Eur. Heart J., February 1, 2007; 28(3): 370 - 375.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
American Society of Interventional & Therapeutic N, Society for Cardiovascular Angiography and Interve, Society for Vascular Medicine and Biology, Society of Interventional Radiology, E. R. Bates, J. D. Babb, D. E. Casey Jr, C. U. Cates, G. R. Duckwiler, T. E. Feldman, et al.
ACCF/SCAI/SVMB/SIR/ASITN 2007 Clinical Expert Consensus Document on Carotid Stenting: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (ACCF/SCAI/SVMB/SIR/ASITN Clinical Expert Consensus Document Committee on Carotid Stenting)
J. Am. Coll. Cardiol., January 2, 2007; 49(1): 126 - 170.
[Full Text] [PDF]


Home page
NeurologyHome page
M. A. de Lecinana, J. A. Egido, C. Fernandez, E. Martinez-Vila, S. Santos, A. Morales, E. Martinez, A. Pareja, J. Alvarez-Sabin, I. Casado, et al.
Risk of ischemic stroke and lifetime estrogen exposure
Neurology, January 2, 2007; 68(1): 33 - 38.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
E. Bedard, J. Rodes-Cabau, C. Houde, A. Mackey, D. Rivest, S. Cloutier, M. Noel, A. Marrero, J.-M. Cote, P. Chetaille, et al.
Enhanced Thrombogenesis but Not Platelet Activation Is Associated With Transcatheter Closure of Patent Foramen Ovale in Patients With Cryptogenic Stroke
Stroke, January 1, 2007; 38(1): 100 - 104.
[Abstract] [Full Text] [PDF]


Home page
J CARDIOVASC PHARMACOL THERHome page
P. Gorelick, O. Sechenova, and C. H. Hennekens
Evolving Perspectives on Clopidogrel in the Treatment of Ischemic Stroke
Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2006; 11(4): 245 - 248.
[Abstract] [PDF]


Home page
StrokeHome page
E. Touze, J.-L. Mas, J. Rother, S. Goto, A. T. Hirsch, Y. Ikeda, C.-S. Liau, E. M. Ohman, A. J. Richard, P. W. F. Wilson, et al.
Impact of Carotid Endarterectomy on Medical Secondary Prevention After a Stroke or a Transient Ischemic Attack: Results from the Reduction of Atherothrombosis for Continued Health (REACH) Registry
Stroke, December 1, 2006; 37(12): 2880 - 2885.
[Abstract] [Full Text] [PDF]


Home page
StrokeHome page
J. Borja, I. Izquierdo, and J. Garcia-Rafanell
Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack
Stroke, November 1, 2006; 37(11): 2653 - 2653.
[Full Text] [PDF]


Home page
StrokeHome page
L. B. Goldstein and J. L. Saver
Thrombolysis in Stroke: a Medicolegal Quagmire
Stroke, November 1, 2006; 37(11): 2663 - 2663.
[Full Text] [PDF]


Home page
StrokeHome page
P. U. Heuschmann, M. K. Biegler, O. Busse, S. Elsner, A. Grau, U. Hasenbein, P. Hermanek, R. W.C. Janzen, P. L. Kolominsky-Rabas, K. Kraywinkel, et al.
Development and Implementation of Evidence-Based Indicators for Measuring Quality of Acute Stroke Care: The Quality Indicator Board of the German Stroke Registers Study Group (ADSR)
Stroke, October 1, 2006; 37(10): 2573 - 2551.
[Abstract] [Full Text] [PDF]


Home page
JWatch NeurologyHome page
Guidelines on Secondary Prevention of Ischemic Stroke
Journal Watch Neurology, August 29, 2006; 2006(829): 1 - 1.
[Full Text]


Home page
NEJMHome page
The Stroke Prevention by Aggressive Reduction in C
High-Dose Atorvastatin after Stroke or Transient Ischemic Attack
N. Engl. J. Med., August 10, 2006; 355(6): 549 - 559.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
D. M. Kent
Stroke -- An Equal Opportunity for the Initiation of Statin Therapy
N. Engl. J. Med., August 10, 2006; 355(6): 613 - 615.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons
J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al.
ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons
J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675.
[Full Text] [PDF]


Home page
StrokeHome page
T. Mysak and K. Tulloch
Addressing the Guidelines
Stroke, August 1, 2006; 37(8): 1967 - 1967.
[Full Text] [PDF]


Home page
StrokeHome page
J. L. Saver and L. B. Goldstein
The New Standing Guideline Committee Policy of the American Stroke Association Stroke Council
Stroke, March 1, 2006; 37(3): 753 - 753.
[Full Text] [PDF]