In this large prospective multi-center study of patients diagnosed with TIA, the ABCD2 score was poorly predictive of stroke at 7 or 90 days, regardless of cut-off for “high risk” used. At a high risk cut-off of >2, the sensitivity and specificity of stroke at 7 days was 95% and 13% respectively. At a high risk cut-off of 5, the sensitivity at 7 and 90 days was only about 30%. In this large prospective cohort, the ABCD2 score performed poorly at predicting stroke risk, regardless of “high risk” definition (abstract)
In this large multicenter trial, patients with minor stroke or TIA were randomized to clopidogrel+ASA or ASA alone; 90-day stroke occurred in 8% vs 12% respectively, and rates of hemorrhage or hemorrhagic stroke were the same (abstract).
These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging with heparin, and it does increase the risk of bleeding. Cessation of therapy for 7 […]
A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of 1.03 for being discharged home and 1.04 for walking independently at discharge (abstract).