Acute ischemic stroke treatment in a nutshell

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Antithrombotic therapy: Considerations for individual patient • Side effects • Dosing, Compliance, Need for monitoring • Cost • Other indications • Contra-indications • Resistance – no guidelines yet, much ongoing research • Genetic polymorphisms • Need for gastric protection • Drug-drug interaction • Drug-food interaction
Great population benefit in view of high incidence of stroke • ESPRIT (A+D vs A) ARR 3% over 3 years – NNT to prevent vascular event/ bleeding in 3 years = 33 • In Singapore, 10000 ischemic stroke pts/ yr – Assume 2/3 can be treated with A + D = 6666 – Number of potential events prevented for one year cohort after 3 years = 202
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 and 12: • BENEFIT RCT EVIDENCE
Page 13 and 14: TIME IS BRAIN • At 3 months, OR f
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: One of many concerns Don’t forget
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

Acute ischemic stroke treatment in a nutshell

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