Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease

Stroke is a common and devastating condition caused by atherothrombosis, thromboembolism, or haemorrhage. Patients with chronic coronary syndromes (CCS) or peripheral artery disease (PAD) are at increased risk of stroke because of shared pathophysiological mechanisms and risk-factor profiles. A rang...

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Autores: Parker, WAE, Gorog, DA, Geisler, T, Vilahur, G, Sibbing, D, Rocca, B, Storey, RF
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p4207
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4207
Access Level:acceso abierto
Palabra clave:Stroke
Myocardial infarction
Coronary artery disease
Peripheral arterial disease
Antiptatelet drugs
Anticoagulant drugs
Aspirin
Clopidogrel
Ticagrelor
rivaroxaban
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spelling Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial diseaseParker, WAEGorog, DAGeisler, TVilahur, GSibbing, DRocca, BStorey, RFStrokeMyocardial infarctionCoronary artery diseasePeripheral arterial diseaseAntiptatelet drugsAnticoagulant drugsAspirinClopidogrelTicagrelorrivaroxabanStroke is a common and devastating condition caused by atherothrombosis, thromboembolism, or haemorrhage. Patients with chronic coronary syndromes (CCS) or peripheral artery disease (PAD) are at increased risk of stroke because of shared pathophysiological mechanisms and risk-factor profiles. A range of pharmacological and non-pharmacological strategies can help to reduce stroke risk in these groups. Antithrombotic therapy reduces the risk of major adverse cardiovascular events, including ischaemic stroke, but increases the incidence of haemorrhagic stroke. Nevertheless, the net clinical benefits mean antithrombotic therapy is recommended in those with CCS or symptomatic PAD. Whilst single antiplatelet therapy is recommended as chronic treatment, dual antiplatelet therapy should be considered for those with CCS with prior myocardial infarction at high ischaemic but low bleeding risk. Similarly, dual antithrombotic therapy with aspirin and very-low-dose rivaroxaban is an alternative in CCS, as well as in symptomatic PAD. Full-dose anticoagulation should always be considered in those with CCS/PAD and atrial fibrillation. Unless ischaemic risk is particularly high, antiplatelet therapy should not generally be added to full-dose anticoagulation. Optimization of blood pressure, low-density lipoprotein levels, glycaemic control, and lifestyle characteristics may also reduce stroke risk. Overall, a multifaceted approach is essential to best prevent stroke in patients with CCS/PAD.OXFORD UNIV PRESS2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4207EUROPEAN HEART JOURNAL SUPPLEMENTSISSN: 1520765XISSNe: 15542815reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p42072026-06-14T12:41:47Z
dc.title.none.fl_str_mv Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
title Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
spellingShingle Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
Parker, WAE
Stroke
Myocardial infarction
Coronary artery disease
Peripheral arterial disease
Antiptatelet drugs
Anticoagulant drugs
Aspirin
Clopidogrel
Ticagrelor
rivaroxaban
title_short Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
title_full Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
title_fullStr Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
title_full_unstemmed Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
title_sort Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease
dc.creator.none.fl_str_mv Parker, WAE
Gorog, DA
Geisler, T
Vilahur, G
Sibbing, D
Rocca, B
Storey, RF
author Parker, WAE
author_facet Parker, WAE
Gorog, DA
Geisler, T
Vilahur, G
Sibbing, D
Rocca, B
Storey, RF
author_role author
author2 Gorog, DA
Geisler, T
Vilahur, G
Sibbing, D
Rocca, B
Storey, RF
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Stroke
Myocardial infarction
Coronary artery disease
Peripheral arterial disease
Antiptatelet drugs
Anticoagulant drugs
Aspirin
Clopidogrel
Ticagrelor
rivaroxaban
topic Stroke
Myocardial infarction
Coronary artery disease
Peripheral arterial disease
Antiptatelet drugs
Anticoagulant drugs
Aspirin
Clopidogrel
Ticagrelor
rivaroxaban
description Stroke is a common and devastating condition caused by atherothrombosis, thromboembolism, or haemorrhage. Patients with chronic coronary syndromes (CCS) or peripheral artery disease (PAD) are at increased risk of stroke because of shared pathophysiological mechanisms and risk-factor profiles. A range of pharmacological and non-pharmacological strategies can help to reduce stroke risk in these groups. Antithrombotic therapy reduces the risk of major adverse cardiovascular events, including ischaemic stroke, but increases the incidence of haemorrhagic stroke. Nevertheless, the net clinical benefits mean antithrombotic therapy is recommended in those with CCS or symptomatic PAD. Whilst single antiplatelet therapy is recommended as chronic treatment, dual antiplatelet therapy should be considered for those with CCS with prior myocardial infarction at high ischaemic but low bleeding risk. Similarly, dual antithrombotic therapy with aspirin and very-low-dose rivaroxaban is an alternative in CCS, as well as in symptomatic PAD. Full-dose anticoagulation should always be considered in those with CCS/PAD and atrial fibrillation. Unless ischaemic risk is particularly high, antiplatelet therapy should not generally be added to full-dose anticoagulation. Optimization of blood pressure, low-density lipoprotein levels, glycaemic control, and lifestyle characteristics may also reduce stroke risk. Overall, a multifaceted approach is essential to best prevent stroke in patients with CCS/PAD.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4207
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=4207
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS
publisher.none.fl_str_mv OXFORD UNIV PRESS
dc.source.none.fl_str_mv EUROPEAN HEART JOURNAL SUPPLEMENTS
ISSN: 1520765X
ISSNe: 15542815
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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repository.mail.fl_str_mv
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