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Int J Stroke. 2018 Jun;13(4):420-443. doi: 10.1177/1747493017743062. Epub 2017 Nov 24.

Canadian stroke best practice recommendations: Secondary prevention of stroke, sixth edition practice guidelines, update 2017.

Author information

1
1 McGill University, Canada.
2
2 Montreal General Hospital, Canada.
3
3 282184 Heart and Stroke Foundation , Canada.
4
4 Western University, Canada.
5
6 workHORSE Consulting, London.
6
5 JBN Medical Diagnostic Services, Canada.
7
7 Champlain Regional Stroke Network, Canada.
8
8 Division of Neurology, Department of Medicine, University of Alberta, Canada.
9
9 Department of Medicine, Dalhousie University, Canada.
10
10 41694 Valley Regional Hospital , Nova Scotia, Canada.
11
11 Stroke Program, Ottawa Civic Hospital, Canada.
12
12 Divisions of General Internal Medicine, Hematology and Thromboembolism, 152997 McMaster University Department of Medicine , Canada.
13
13 Thrombosis Canada, Canada.
14
14 59140 Kelowna General Hospital , Canada.
15
15 Faculty of Medicine, University of British Columbia, Canada.
16
16 Department of Neurosciences, CHUM-Centre Hospitalier de l'Université de Montréal, Hôpital Notre Dame, Canada.
17
17 Queen Elizabeth II Stroke Program, Nova Scotia, Canada.
18
18 Department of Family and Community Medicine, University of Toronto, Canada.
19
19 Thunder Bay Regional Health Sciences Centre, Canada.
20
20 Department of Emergency Medicine, The 6363 University of Ottawa , Canada.
21
21 Winnipeg Children's Hospital, Canada.
22
22 423136 University of Manitoba , Canada.
23
23 Regina Qu'Appellle Health Region, Canada.
24
24 Population Health Research Institute, McMaster University, Canada.
25
25 Brandon Regional Hospital, Manitoba, Canada.
26
26 Sunnybrook Health Sciences Centre, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada.
27
27 University of Toronto Department of Medicine, Toronto, Canada.

Abstract

The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions. Notable changes in this sixth edition include the development of core elements for delivering secondary stroke prevention services, the addition of a section on cervical artery dissection, new recommendations regarding the management of patent foramen ovale, and the removal of the recommendations on management of sleep apnea. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations. The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists regardless of patient location, and the need to overcome geographic barriers to ensure equity in access within a universal health care system.

KEYWORDS:

Stroke; guidelines; management; prevention; risk assessment

PMID:
29171361
DOI:
10.1177/1747493017743062
[Indexed for MEDLINE]

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