Filling the gap between science & clinical practice: Prevention of stroke recurrence

Anna Russolillo, Matteo Nicola Dario Di Minno, Antonella Tufano, Domenico Prisco, Giovanni Di Minno

Research output: Contribution to journalArticle

Abstract

Because of its high recurrence rate, active secondary prevention is mandatory once an episode of stroke has occurred. In non-cardioembolic stroke, in addition to lifestyle changes and to targeted treatments, current guidelines recommend Aspirin, Clopidogrel or Aspirin+extended-release dipyridamole. In cardioembolic stroke (due to atrial fibrillation or flutter [AF]), Vitamin K antagonists (VKAs) are recommended in most of patients. A favorable risk/benefit ratio of these treatments has been demonstrated also in elderly patients. However, registry data emphasize that such interventions are often under-used, especially in AF patients. A poor knowledge of current guidelines may play a role in hampering their application in clinical practice. The risk of major bleeding associated with antithrombotic drugs, their inherent limitations, such as socio-demographic (age > 80 years, living alone) and clinical (previous or recent bleeding, trauma, cancer, dementia) features, may account for the gap between current guidelines for stroke/TIA prevention and clinical practice. The objective of the present report is to evaluate the gap between current recommendations/guidelines for stroke/TIA prevention and clinical practice (registry findings). In our opinion new antithrombotic drugs and detailed educational programs (especially devoted to general practitioners and to some medical specialists), concerning efficacy, safety and limitations of these strategies, are needed to better manage stroke epidemics in the third millennium.

Original languageEnglish
Pages (from-to)3-8
Number of pages6
JournalThrombosis Research
Volume129
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • Active secondary prevention
  • Clinical practice
  • Gaps
  • Recommendations
  • Stroke

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Russolillo, A., Di Minno, M. N. D., Tufano, A., Prisco, D., & Di Minno, G. (2012). Filling the gap between science & clinical practice: Prevention of stroke recurrence. Thrombosis Research, 129(1), 3-8. https://doi.org/10.1016/j.thromres.2011.08.012