Acute ischemic stroke treatment in a nutshell

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RCT 3 to 4.5 hours • ECASS III • BENEFIT At 3 months, mRS 0-1 – 52.4% tPA, 45.2% Placebo – OR 1.34 (1.02- 1.76), ARR 7.2%, NNT 14 • RISKS – sICH 7.9% vs 3.5%, p=0.006 Hacke, NEJM, 2008
TIME IS BRAIN • At 3 months, OR for good outcome – 0-90 2.2 (1.8 to 4.5) – 91-180 1.6 (1.1 to 2.2) – 181-270 1.4 (1.1 to 1.9) – 271-360 1.2 (0.9 to 1.5) Hacke, Lancet 2004
Page 1 and 2: Acute ischemic stroke treatment in
Page 3 and 4: REPERFUSION TIME IS BRAIN An estima
Page 5 and 6: Reperfusion of salvageable tissue
Page 7 and 8: Improved neurological & functional
Page 9 and 10: Acute intravenous alteplase
Page 11: • BENEFIT RCT EVIDENCE
Page 15 and 16: Antithrombotic therapy: Antiplatele
Page 17 and 18: Stroke Unit Management • What is
Page 19 and 20: Acute ischaemic stroke treatment st
Page 21 and 22: Antithrombotic agents • Antiplate
Page 23 and 24: Antiplatelets in long-term secondar
Page 25 and 26: Which antiplatelet Acceptable optio
Page 27 and 28: Which antiplatelet better-Combinati
Page 29 and 30: Cilostazol (CSPS II) • Randomised
Page 31 and 32: Anticoagulation in long-term second
Page 33 and 34: Anticoagulants Dosing Monitoring SE
Page 35 and 36: WARFARIN Secondary prevention: Prio
Page 37 and 38: DABIGATRAN AF + high risk for embol
Page 39 and 40: RIVAROXABAN AF + high risk for embo
Page 41 and 42: APIXABAN AF patients could not tole
Page 43 and 44: Other indications for anticoagulati
Page 45 and 46: Good Side: Beneficial Effects • R
Page 47 and 48: One of many concerns Don’t forget
Page 49 and 50: Great population benefit in view of
Page 51 and 52: Management of Hypertension, Diabete
Page 53 and 54: Should all post-stroke patients be
Page 55 and 56: Should all post-stroke patients be
Page 57 and 58: Which antihypertensives to use Law,
Page 59 and 60: Which antihypertensive to use - Com
Page 61 and 62: Which antihypertensive to use - Com
Page 63 and 64:
What is the target BP - Upper limit
Page 65 and 66:
What is the target BP - Lower limit
Page 67 and 68:
Diabetes • Diabetes is a risk fac
Page 69 and 70:
Why DM control in stroke patients 4
Page 71 and 72:
How tight should glycemic control b
Page 73 and 74:
How tight should glycemic control b
Page 75 and 76:
Dyslipidemia • Modest relationshi
Page 77 and 78:
Statins and ischemic stroke - Meta-
Page 79 and 80:
Should all stroke patients be on st
Page 81 and 82:
BP control in secondary stroke prev
Page 83 and 84:
Lipid control in secondary stroke p
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Acute ischemic stroke treatment in a nutshell

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