Response to Letter by Naylor Regarding Article, “Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association”
The references selected for the Guidelines are peer-reviewed papers that are representative, but not all-inclusive, with priority given to references with higher levels of evidence.
We thank Dr Borja and his coauthor for alerting us to the data from trials on triflusal. These trials demonstrate the safety of triflusal, but they have not shown any superiority over aspirin for noncardioembolic stroke or transient ischemic attack. At present, triflusal is not an approved agent for stroke prevention in North America; therefore, it was not included in our recommendations. We hope that more evidence will become available on triflusal for future updated recommendations.
In response to Dr. Naylor's correspondence, we regret that the timing of publication of the International Carotid Stenting Study (ICSS) precluded its incorporation into this version of the Guidelines. Publication of 2011 Guidelines was ultimately delayed in order to include the results of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) and ensure harmonization with the ASA/ACCF/AHA/AANN/AANS/ACR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients with Extracranial Carotid and Vertebral Artery Disease; however it was not possible to review the literature again to include all new references on the eve of publication. Data from ICSS will undoubtedly be considered in future Guideline updates.
Karen L. Furie, MD, MPH
Massachusetts General Hospital
Department of Neurology
J. Philip Kistler MGH Stroke Research Center
Stroke welcomes Letters to the Editor and will publish them, if suitable, as space permits. Letters must reference a Stroke published-ahead-of-print article or an article printed within the past 3 weeks. The maximum length is 750 words including no more than 5 references and 3 authors. Please submit letters typed double-spaced. Letters may be shortened or edited. Include a completed copyright transfer agreement form (available online at http://stroke.ahajournals.org and http://submit-stroke.ahajournals.org).
- © 2011 American Heart Association, Inc.