Stroke ACC/AHA guidelines
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
ACC/AHA Guidelines- Recommendations for Ischemic Stroke (DO NOT EDIT)[1]
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Class I1. Neurological consultation should be obtained in STEMI patients who have an acute ischemic stroke. (Level of Evidence: C) 2. STEMI patients who have an acute ischemic stroke should be evaluated with echocardiography, neuroimaging, and vascular imaging studies to determine the cause of the stroke. (Level of Evidence: C) 3. STEMI patients with acute ischemic stroke and persistent AF should receive lifelong moderate-intensity (INR 2 to 3) warfarin therapy. (Level of Evidence: A) 4. STEMI patients with or without acute ischemic stroke who have a cardiac source of embolism (AF, mural thrombus, or akinetic segment) should receive moderate-intensity (INR 2 to 3) warfarin therapy in addition to aspirin. The duration of warfarin therapy should be dictated by clinical circumstances (e.g., at least 3 months for patients with an LV mural thrombus or akinetic segment and indefinitely in patients with persistent AF). The patient should receive LMWH or UFH until adequately anticoagulated with warfarin. (Level of Evidence: B) Class IIa1. It is reasonable to assess the risk of ischemic stroke in patients with STEMI. (Level of Evidence: A) 2. It is reasonable that STEMI patients with nonfatal acute ischemic stroke receive supportive care to minimize complications and maximize functional outcome. (Level of Evidence: C) Class IIb1. Carotid angioplasty/stenting, 4 to 6 weeks after ischemic stroke, might be considered in STEMI patients who have an acute ischemic stroke attributable to an internal carotid artery–origin stenosis of at least 50% and who have a high surgical risk of morbidity/mortality early after STEMI. (Level of Evidence: C) |
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References
- ↑ Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK (August 2004). "ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction)". Circulation 110 (9): e82–292. PMID 15339869.
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