Skip to main content
Erschienen in: Herz 3/2013

01.05.2013 | Schwerpunkt

Sekundärprophylaxe des Schlaganfalls aus neurologischer Perspektive

verfasst von: Prof. Dr. G. Seidel

Erschienen in: Herz | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Zusammenfassung

Patienten nach Hirninfarkt oder transitorisch ischämischer Attacke (TIA) haben ein hohes Risiko für einen erneuten Schlaganfall, einen Myokardinfarkt oder einen vaskulären Tod. Die frühzeitige pathophysiologische Ursachenklärung und die hierauf aufbauende Sekundärprävention sind entscheidend zur Risikoreduktion. Neben der Optimierung der Lifestyle-Faktoren werden die Behandlung der arteriellen Hypertonie, die Cholesterinsenkung mit einem Statin und die Thrombozytenaggregationshemmer bei nichtkardiogener bzw. die Antikoagulation bei kardiogener Ischämie durchgeführt. Ist eine über 50%ige Abgangsstenose der A. carotis interna ursächlich, reduziert eine Revaskularisierung das Rezidivrisiko.
Literatur
1.
Zurück zum Zitat Johnston SC, Rothwell PM, Nguyen-Huynh MN et al (2007) Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 369:283–292PubMedCrossRef Johnston SC, Rothwell PM, Nguyen-Huynh MN et al (2007) Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet 369:283–292PubMedCrossRef
2.
Zurück zum Zitat Rothwell PM, Giles MF, Chandratheva A et al; Early use of Existing Preventive Strategies for Stroke (EXPRESS) study (2007) Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS) study: a prospective population-based sequential comparison. Lancet 370:1432–1442PubMedCrossRef Rothwell PM, Giles MF, Chandratheva A et al; Early use of Existing Preventive Strategies for Stroke (EXPRESS) study (2007) Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS) study: a prospective population-based sequential comparison. Lancet 370:1432–1442PubMedCrossRef
3.
Zurück zum Zitat Giles MF, Rothwell PM (2007) Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol 6:1063–1072PubMedCrossRef Giles MF, Rothwell PM (2007) Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol 6:1063–1072PubMedCrossRef
4.
Zurück zum Zitat Hackam DG, Spence JD (2007) Combining multiple approaches for the secondary prevention of vascular events after stroke: a quantitative modeling study. Stroke 38:1881–1885PubMedCrossRef Hackam DG, Spence JD (2007) Combining multiple approaches for the secondary prevention of vascular events after stroke: a quantitative modeling study. Stroke 38:1881–1885PubMedCrossRef
5.
Zurück zum Zitat Walter A, Seidel G, Thie A, Raspe H (2009) Semi-intensive stroke unit versus conventional care in acute ischemic stroke or TIA – a prospective study in Germany. J Neurol Sci 287:131–137PubMedCrossRef Walter A, Seidel G, Thie A, Raspe H (2009) Semi-intensive stroke unit versus conventional care in acute ischemic stroke or TIA – a prospective study in Germany. J Neurol Sci 287:131–137PubMedCrossRef
6.
Zurück zum Zitat Al-Khaled M, Matthis C, Seidel G (2012) The prognostic impact of the stroke unit concept after transient ischemic attack. Clin Neurol Neurosurg [Epub ahead of print] Al-Khaled M, Matthis C, Seidel G (2012) The prognostic impact of the stroke unit concept after transient ischemic attack. Clin Neurol Neurosurg [Epub ahead of print]
7.
Zurück zum Zitat Goldstein LB, Jones MR, Matchar DB et al (2001) Improving the reliability of stroke subgroup classification using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Stroke 32:1091–1098PubMedCrossRef Goldstein LB, Jones MR, Matchar DB et al (2001) Improving the reliability of stroke subgroup classification using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Stroke 32:1091–1098PubMedCrossRef
8.
Zurück zum Zitat Furie KL, Kasner SE, Adams RJ et al (2011) Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42:227–276PubMedCrossRef Furie KL, Kasner SE, Adams RJ et al (2011) Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42:227–276PubMedCrossRef
9.
Zurück zum Zitat Towfighi A, Markovic D, Ovbiagele B (2012) Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA. J Neurol Neurosurg Psychiatry 83:146–151PubMedCrossRef Towfighi A, Markovic D, Ovbiagele B (2012) Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA. J Neurol Neurosurg Psychiatry 83:146–151PubMedCrossRef
10.
Zurück zum Zitat Castillo J, Leira R, Garcia MM et al (2004) Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke 35:520–526PubMedCrossRef Castillo J, Leira R, Garcia MM et al (2004) Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke 35:520–526PubMedCrossRef
11.
Zurück zum Zitat Sandset EC, Murray GD, Bath PMW et al (2012) Relation between change in blood pressure in acute stroke and risk of early adverse events and poor outcome. Stroke 43:2108–2114PubMedCrossRef Sandset EC, Murray GD, Bath PMW et al (2012) Relation between change in blood pressure in acute stroke and risk of early adverse events and poor outcome. Stroke 43:2108–2114PubMedCrossRef
12.
Zurück zum Zitat Adams HP, Zoppo G del, Alberts MJ et al (2007) Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups, the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38:1655–1711PubMedCrossRef Adams HP, Zoppo G del, Alberts MJ et al (2007) Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups, the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38:1655–1711PubMedCrossRef
13.
Zurück zum Zitat Lakhan SE, Sapko MT (2009) Blood pressure lowering treatment for preventing stroke recurrence: a systematic review and meta-analysis. Int Arch Med 2:30PubMedCrossRef Lakhan SE, Sapko MT (2009) Blood pressure lowering treatment for preventing stroke recurrence: a systematic review and meta-analysis. Int Arch Med 2:30PubMedCrossRef
14.
Zurück zum Zitat Lawes CMM, Bennett DA, Feigin VL, Rodgers A (2004) Blood pressure and stroke: an overview of published reviews. Stroke 35:1024–1033PubMedCrossRef Lawes CMM, Bennett DA, Feigin VL, Rodgers A (2004) Blood pressure and stroke: an overview of published reviews. Stroke 35:1024–1033PubMedCrossRef
15.
Zurück zum Zitat Rothwell PM (2010) Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet 375:938–948PubMedCrossRef Rothwell PM (2010) Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet 375:938–948PubMedCrossRef
16.
Zurück zum Zitat Rashid P, Leonardi-Bee J, Bath P (2003) Blood pressure reduction and secondary prevention of stroke and other vascular events: a systematic review. Stroke 34:2741–2748PubMedCrossRef Rashid P, Leonardi-Bee J, Bath P (2003) Blood pressure reduction and secondary prevention of stroke and other vascular events: a systematic review. Stroke 34:2741–2748PubMedCrossRef
17.
Zurück zum Zitat Yusuf S, Diener HC, Sacco RL et al (2008) Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 359:1225–1237PubMedCrossRef Yusuf S, Diener HC, Sacco RL et al (2008) Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 359:1225–1237PubMedCrossRef
18.
Zurück zum Zitat Endres M (2012) Sekundärprophylaxe des ischämischen Insults. In: Diener HC, Weimar C (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie, 5. Aufl. Thieme, Stuttgart. S 324–347 Endres M (2012) Sekundärprophylaxe des ischämischen Insults. In: Diener HC, Weimar C (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie, 5. Aufl. Thieme, Stuttgart. S 324–347
19.
Zurück zum Zitat Blanco M, Nombela F, Castellanos M et al (2007) Statin treatment withdrawal in ischemic stroke: a controlled randomized study. Neurology 69:904–910PubMedCrossRef Blanco M, Nombela F, Castellanos M et al (2007) Statin treatment withdrawal in ischemic stroke: a controlled randomized study. Neurology 69:904–910PubMedCrossRef
20.
Zurück zum Zitat McCormick MT, Muir KW, Gray CS, Walters MR (2008) Management of hyperglycemia in acute stroke: how, when, and for whom? Stroke 39:2177–2185PubMedCrossRef McCormick MT, Muir KW, Gray CS, Walters MR (2008) Management of hyperglycemia in acute stroke: how, when, and for whom? Stroke 39:2177–2185PubMedCrossRef
21.
Zurück zum Zitat Ribo M, Molina C, Montaner J et al (2005) Acute hyperglycemia state is associated with lower tPA-induced recanalization rates in stroke patients. Stroke 36:1705–1709PubMedCrossRef Ribo M, Molina C, Montaner J et al (2005) Acute hyperglycemia state is associated with lower tPA-induced recanalization rates in stroke patients. Stroke 36:1705–1709PubMedCrossRef
22.
Zurück zum Zitat Els T, Klisch J, Orszagh M et al (2002) Hyperglycemia in patients with focal cerebral ischemia after intravenous thrombolysis: influence on clinical outcome and infarct size. Cerebrovasc Dis 13:89–94PubMedCrossRef Els T, Klisch J, Orszagh M et al (2002) Hyperglycemia in patients with focal cerebral ischemia after intravenous thrombolysis: influence on clinical outcome and infarct size. Cerebrovasc Dis 13:89–94PubMedCrossRef
23.
Zurück zum Zitat Ribo M, Molina CA, Delgado P et al (2007) Hyperglycemia during ischemia rapidly accelerates brain damage in stroke patients treated with tPA. J Cereb Blood Flow Metab 27:1616–1622PubMedCrossRef Ribo M, Molina CA, Delgado P et al (2007) Hyperglycemia during ischemia rapidly accelerates brain damage in stroke patients treated with tPA. J Cereb Blood Flow Metab 27:1616–1622PubMedCrossRef
24.
Zurück zum Zitat Bruno A, Levine SR, Frankel MR et al (2002) Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology 59:67–71PubMedCrossRef Bruno A, Levine SR, Frankel MR et al (2002) Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology 59:67–71PubMedCrossRef
25.
Zurück zum Zitat Schlenk F, Graetz D, Nagel A et al (2008) Insulin-related decrease in cerebral glucose despite normoglycemia in aneurysmal subarachnoid hemorrhage. Crit Care 12(1):R9PubMedCrossRef Schlenk F, Graetz D, Nagel A et al (2008) Insulin-related decrease in cerebral glucose despite normoglycemia in aneurysmal subarachnoid hemorrhage. Crit Care 12(1):R9PubMedCrossRef
26.
Zurück zum Zitat Gray CS, Hildreth AJ, Sandercock PA et al (2007) Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 6:397–406PubMedCrossRef Gray CS, Hildreth AJ, Sandercock PA et al (2007) Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 6:397–406PubMedCrossRef
27.
Zurück zum Zitat Veltkamp R (2012) Akuttherapie des ischämischen Schlaganfalls. In: Diener HC, Weimar C (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie, 5. Aufl. Thieme, Stuttgart. S 307–323 Veltkamp R (2012) Akuttherapie des ischämischen Schlaganfalls. In: Diener HC, Weimar C (Hrsg) Leitlinien für Diagnostik und Therapie in der Neurologie, 5. Aufl. Thieme, Stuttgart. S 307–323
28.
Zurück zum Zitat Schmidt NK, Martin S, Hamann GF (2010) Diabetes und Schlaganfall – eine schwierige Beziehung, akut, wie im Langzeitbereich. Akt Neurol 37:136–147CrossRef Schmidt NK, Martin S, Hamann GF (2010) Diabetes und Schlaganfall – eine schwierige Beziehung, akut, wie im Langzeitbereich. Akt Neurol 37:136–147CrossRef
29.
Zurück zum Zitat Action to Control Cardiovascular Risk in Diabetes Study Group; Gerstein HC, Miller ME, Byington RP et al (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358:2545–2559CrossRef Action to Control Cardiovascular Risk in Diabetes Study Group; Gerstein HC, Miller ME, Byington RP et al (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358:2545–2559CrossRef
30.
Zurück zum Zitat ACCORD Study Group; Gerstein HC, Miller ME, Genuth S et al (2011) Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med 364:818–828CrossRef ACCORD Study Group; Gerstein HC, Miller ME, Genuth S et al (2011) Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med 364:818–828CrossRef
31.
Zurück zum Zitat ADVANCE Collaborative Group; Patel A, MacMahon S, Chalmers J et al (2008) Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 358:2560–2572CrossRef ADVANCE Collaborative Group; Patel A, MacMahon S, Chalmers J et al (2008) Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 358:2560–2572CrossRef
32.
Zurück zum Zitat Duckworth W, Abraira C, Moritz T et al; VADT Investigators (2009) Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 360:129–139PubMedCrossRef Duckworth W, Abraira C, Moritz T et al; VADT Investigators (2009) Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 360:129–139PubMedCrossRef
33.
Zurück zum Zitat Sandercock PA, Counsell C, Gubitz GJ, Tseng MC (2008) Antiplatelet therapy for acute ischaemic stroke. Cochrane Database Syst Rev (3):CD000029 Sandercock PA, Counsell C, Gubitz GJ, Tseng MC (2008) Antiplatelet therapy for acute ischaemic stroke. Cochrane Database Syst Rev (3):CD000029
34.
Zurück zum Zitat Dengler R, Diener HC, Schwartz A et al (2010) Early treatment with aspirin plus extended-release dipyridamole for transient ischaemic attack or ischaemic stroke within 24 h of symptom onset (EARLY trial): a randomised, open-label, blinded-endpoint trial. Lancet Neurol 9:159–166PubMedCrossRef Dengler R, Diener HC, Schwartz A et al (2010) Early treatment with aspirin plus extended-release dipyridamole for transient ischaemic attack or ischaemic stroke within 24 h of symptom onset (EARLY trial): a randomised, open-label, blinded-endpoint trial. Lancet Neurol 9:159–166PubMedCrossRef
35.
Zurück zum Zitat Geeganage CM, Diener HC, Algra A et al (2012) Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack: systematic review and meta-analysis of randomized controlled trials. Stroke 43:1058–1066PubMedCrossRef Geeganage CM, Diener HC, Algra A et al (2012) Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack: systematic review and meta-analysis of randomized controlled trials. Stroke 43:1058–1066PubMedCrossRef
36.
Zurück zum Zitat Chimowitz MI, Lynn MJ, Derdeyn CP et al (2011) Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 365:993–1003PubMedCrossRef Chimowitz MI, Lynn MJ, Derdeyn CP et al (2011) Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 365:993–1003PubMedCrossRef
37.
Zurück zum Zitat Wong KS, Chen C, Fu J et al (2010) Clopidogrel plus aspirin versus aspirin alone for reducing embolisation in patients with acute symptomatic cerebral or carotid artery stenosis (CLAIR study): a randomised, open-label, blinded-endpoint trial. Lancet Neurol 9:489–497PubMedCrossRef Wong KS, Chen C, Fu J et al (2010) Clopidogrel plus aspirin versus aspirin alone for reducing embolisation in patients with acute symptomatic cerebral or carotid artery stenosis (CLAIR study): a randomised, open-label, blinded-endpoint trial. Lancet Neurol 9:489–497PubMedCrossRef
38.
Zurück zum Zitat Antithrombotic Trialists‘ (ATT) Collaboration; Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373:1849–1860CrossRef Antithrombotic Trialists‘ (ATT) Collaboration; Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373:1849–1860CrossRef
39.
Zurück zum Zitat ESPRIT Study Group; Halkes PH, Gijn J van, Kappelle LJ et al (2006) Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 367:1665–1673CrossRef ESPRIT Study Group; Halkes PH, Gijn J van, Kappelle LJ et al (2006) Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 367:1665–1673CrossRef
40.
Zurück zum Zitat Diener HC, Bogousslavsky J, Brass LM et al (2004) Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 364:331–337PubMedCrossRef Diener HC, Bogousslavsky J, Brass LM et al (2004) Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 364:331–337PubMedCrossRef
41.
Zurück zum Zitat Halkes PH, Gray LJ, Bath PM et al (2008) Dipyridamole plus aspirin versus aspirin alone in secondary prevention after TIA or stroke: a meta-analysis by risk. J Neurol Neurosurg Psychiatry 79:1218–1223PubMedCrossRef Halkes PH, Gray LJ, Bath PM et al (2008) Dipyridamole plus aspirin versus aspirin alone in secondary prevention after TIA or stroke: a meta-analysis by risk. J Neurol Neurosurg Psychiatry 79:1218–1223PubMedCrossRef
42.
Zurück zum Zitat Kerenyi L, Kardos L, Szasz J et al (2006) Factors influencing hemorrhagic transformation in ischemic stroke: a clinicopathological comparison. Eur J Neurol 13:1251–1255PubMedCrossRef Kerenyi L, Kardos L, Szasz J et al (2006) Factors influencing hemorrhagic transformation in ischemic stroke: a clinicopathological comparison. Eur J Neurol 13:1251–1255PubMedCrossRef
43.
Zurück zum Zitat Diener HC, Grond M, Röther J et al (2011) Dabigatran in der Schlaganfallprävention bei Patienten mit Vorhofflimmern nach TIA oder ischämischem Insult: praktische Aspekte der Anwendung. Akt Neurol 38:261–266CrossRef Diener HC, Grond M, Röther J et al (2011) Dabigatran in der Schlaganfallprävention bei Patienten mit Vorhofflimmern nach TIA oder ischämischem Insult: praktische Aspekte der Anwendung. Akt Neurol 38:261–266CrossRef
44.
Zurück zum Zitat EAFT (European Atrial Fibrillation Trial) Study Group (1993) Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 342:1255–1262 EAFT (European Atrial Fibrillation Trial) Study Group (1993) Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 342:1255–1262
45.
Zurück zum Zitat Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817PubMedCrossRef Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817PubMedCrossRef
46.
Zurück zum Zitat Harenberg J, Marx S, Diener HC et al (2012) Comparison of efficacy and safety of dabigatran, rivaroxaban and apixaban in patients with atrial fibrillation using network meta-analysis. Int Angiol 31:330–339PubMed Harenberg J, Marx S, Diener HC et al (2012) Comparison of efficacy and safety of dabigatran, rivaroxaban and apixaban in patients with atrial fibrillation using network meta-analysis. Int Angiol 31:330–339PubMed
47.
Zurück zum Zitat Eckstein HH, Kühnl A, Berkefeld J et al (2012) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der extracraniellen Carotisstenose. AWMF-Registernummer 004-028 Eckstein HH, Kühnl A, Berkefeld J et al (2012) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der extracraniellen Carotisstenose. AWMF-Registernummer 004-028
48.
Zurück zum Zitat Inzitari D, Eliasziw M, Sharpe BL et al (2000) Risk factors and outcome of patients with carotid artery stenosis presenting with lacunar stroke. North American Symptomatic Carotid Endarterectomy Trial Group. Neurology 54:660–666PubMedCrossRef Inzitari D, Eliasziw M, Sharpe BL et al (2000) Risk factors and outcome of patients with carotid artery stenosis presenting with lacunar stroke. North American Symptomatic Carotid Endarterectomy Trial Group. Neurology 54:660–666PubMedCrossRef
49.
Zurück zum Zitat Rothwell PM, Eliasziw M, Gutnikov SA et al (2004) Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 363:915–924PubMedCrossRef Rothwell PM, Eliasziw M, Gutnikov SA et al (2004) Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 363:915–924PubMedCrossRef
50.
Zurück zum Zitat Bonati LH, Lyrer P, Ederle J et al (2012) Percutaneous transluminal balloon angioplasty and stenting for carotid artery stenosis. Cochrane Database Syst Rev 9:CD000515PubMed Bonati LH, Lyrer P, Ederle J et al (2012) Percutaneous transluminal balloon angioplasty and stenting for carotid artery stenosis. Cochrane Database Syst Rev 9:CD000515PubMed
51.
Zurück zum Zitat Shinton R, Beevers G (1989) Meta-analysis of relation between cigarette smoking and stroke. BMJ 298:789–794PubMedCrossRef Shinton R, Beevers G (1989) Meta-analysis of relation between cigarette smoking and stroke. BMJ 298:789–794PubMedCrossRef
52.
Zurück zum Zitat Bonita R, Duncan J, Truelsen T et al (1998) Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control 8:156–160CrossRef Bonita R, Duncan J, Truelsen T et al (1998) Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control 8:156–160CrossRef
53.
Zurück zum Zitat Djousse L, Ellison RC, Beiser A et al (2002) Alcohol consumption and risk of ischemic stroke: the Framingham Study. Stroke 33:907–912PubMedCrossRef Djousse L, Ellison RC, Beiser A et al (2002) Alcohol consumption and risk of ischemic stroke: the Framingham Study. Stroke 33:907–912PubMedCrossRef
54.
Zurück zum Zitat Lee CD, Folsom AR, Blair SN (2003) Physical activity and stroke risk: a meta-analysis. Stroke 34:2475–2481PubMedCrossRef Lee CD, Folsom AR, Blair SN (2003) Physical activity and stroke risk: a meta-analysis. Stroke 34:2475–2481PubMedCrossRef
55.
Zurück zum Zitat Duncan P, Studenski S, Richards L et al (2003) Randomized clinical trial of therapeutic exercise in subacute stroke. Stroke 34:2173–2180PubMedCrossRef Duncan P, Studenski S, Richards L et al (2003) Randomized clinical trial of therapeutic exercise in subacute stroke. Stroke 34:2173–2180PubMedCrossRef
56.
Zurück zum Zitat Chimowitz MI, Lynn MJ, Howlett-Smith H et al (2005) Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 352:1305–1316PubMedCrossRef Chimowitz MI, Lynn MJ, Howlett-Smith H et al (2005) Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 352:1305–1316PubMedCrossRef
57.
Zurück zum Zitat Mas JL, Arquizan C, Lamy C et al (2001) Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med 345:1740–1746PubMedCrossRef Mas JL, Arquizan C, Lamy C et al (2001) Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N Engl J Med 345:1740–1746PubMedCrossRef
58.
Zurück zum Zitat Homma S, Sacco RL, Di Tullio MR et al; PFO in Cryptogenic Stroke Study (PICSS) Investigators (2002) Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation 105:2625–2631PubMedCrossRef Homma S, Sacco RL, Di Tullio MR et al; PFO in Cryptogenic Stroke Study (PICSS) Investigators (2002) Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. Circulation 105:2625–2631PubMedCrossRef
59.
Zurück zum Zitat Furlan AJ, Reisman M, Massaro J et al; CLOSURE I Investigators (2012) Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med 366:991–999PubMedCrossRef Furlan AJ, Reisman M, Massaro J et al; CLOSURE I Investigators (2012) Closure or medical therapy for cryptogenic stroke with patent foramen ovale. N Engl J Med 366:991–999PubMedCrossRef
60.
Zurück zum Zitat Macleod MR, Amarenco P, Davis SM, Donnan GA (2004) Atheroma of the aortic arch: an important and poorly recognised factor in the aetiology of stroke. Lancet Neurol 3:408–414PubMedCrossRef Macleod MR, Amarenco P, Davis SM, Donnan GA (2004) Atheroma of the aortic arch: an important and poorly recognised factor in the aetiology of stroke. Lancet Neurol 3:408–414PubMedCrossRef
61.
62.
Zurück zum Zitat Georgiadis D, Arnold M, Buedingen HC von et al (2009) Aspirin vs. anticoagulation in carotid artery dissection: a study of 298 patients. Neurology 72:1810–1815PubMedCrossRef Georgiadis D, Arnold M, Buedingen HC von et al (2009) Aspirin vs. anticoagulation in carotid artery dissection: a study of 298 patients. Neurology 72:1810–1815PubMedCrossRef
63.
Zurück zum Zitat Davis S, Donnan GA (2012) Secondary prevention after ischemic stroke or transient ischemic attack. N Engl J Med 366:1914–1922PubMedCrossRef Davis S, Donnan GA (2012) Secondary prevention after ischemic stroke or transient ischemic attack. N Engl J Med 366:1914–1922PubMedCrossRef
64.
Zurück zum Zitat Granger CB, Alexander JH, McMurray JJ et al; ARISTOTLE Committees and Investigators (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365:981–992PubMedCrossRef Granger CB, Alexander JH, McMurray JJ et al; ARISTOTLE Committees and Investigators (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365:981–992PubMedCrossRef
65.
Zurück zum Zitat Antithrombotic Trialists‘ Collaboration (2002) Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86CrossRef Antithrombotic Trialists‘ Collaboration (2002) Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86CrossRef
66.
Zurück zum Zitat CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348:1329–1339CrossRef CAPRIE Steering Committee (1996) A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 348:1329–1339CrossRef
67.
Zurück zum Zitat Diener HC, Cunha L, Forbes C et al (1996) European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 143:1–13PubMedCrossRef Diener HC, Cunha L, Forbes C et al (1996) European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 143:1–13PubMedCrossRef
68.
Zurück zum Zitat North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325:445–453CrossRef North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 325:445–453CrossRef
69.
Zurück zum Zitat PROGRESS Collaborative Group (2001) Randomised trial of a perindopril-based bloodpressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 358:1033–1041CrossRef PROGRESS Collaborative Group (2001) Randomised trial of a perindopril-based bloodpressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 358:1033–1041CrossRef
70.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151PubMedCrossRef Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151PubMedCrossRef
71.
Zurück zum Zitat Connolly SJ, Ezekowitz M, Yusuf S et al (2010) Newly Identified Events in the RE-LY Trial. N Engl J Med 363:1877CrossRef Connolly SJ, Ezekowitz M, Yusuf S et al (2010) Newly Identified Events in the RE-LY Trial. N Engl J Med 363:1877CrossRef
72.
Zurück zum Zitat Patel MR, Mahaffey KW, Garg J et al (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365:883–891PubMedCrossRef Patel MR, Mahaffey KW, Garg J et al (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365:883–891PubMedCrossRef
73.
Zurück zum Zitat Amarenco P, Bogousslavsky J, Callahan A 3rd et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators (2006) High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 355:549–559PubMedCrossRef Amarenco P, Bogousslavsky J, Callahan A 3rd et al; Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators (2006) High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 355:549–559PubMedCrossRef
74.
Zurück zum Zitat Holmes DR, Reddy VY, Turi ZG et al (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542PubMedCrossRef Holmes DR, Reddy VY, Turi ZG et al (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542PubMedCrossRef
Metadaten
Titel
Sekundärprophylaxe des Schlaganfalls aus neurologischer Perspektive
verfasst von
Prof. Dr. G. Seidel
Publikationsdatum
01.05.2013
Verlag
Urban and Vogel
Erschienen in
Herz / Ausgabe 3/2013
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-013-3774-6

Weitere Artikel der Ausgabe 3/2013

Herz 3/2013 Zur Ausgabe

e-Herz: Original article

Aortic elastic properties

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.