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Recurrent stroke: where do we stand with the secondary prevention of noncardioembolic ischaemic strokes?

¹ Institute of Neurology, Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL), Queen SQ, Box 146, London WC1N 3BG, UK
² The National Hospital for Neurology and Neurosurgery, University College London Hospitals, Queen Sq, London WC1N 3BG, United Kingdom

^* To whom correspondence should be addressed.

	Abstract

Strokes recur in 6–20% of the patients, most commonly within the first year; after a TIA or minor stroke; most recurrences will occur within the first 90 days. Our ability to identify patients at high risk is poor and most recurrent strokes cannot be explained by traditional risk factors. In 30–45% of the cases the second stroke will be of a different subtype. Moreover, patients are faced with other risks, like cardiac events and cognitive decline. With the population aging, the need for timely and effective secondary prevention strategies is more pressing than ever. This paper summarizes recent advances in pharmacological secondary prevention after a non-cardioembolic ischaemic stroke, and highlights critical questions still in need of answers.

Key Words: Recurrent stroke, noncardioembolic stroke, secondary prevention, antiplatelets, statins, antihypertensive medication, lipid-lowering medication

First published on August 21, 2008, doi:10.1177/1753944708093411

Therapeutic Advances in Cardiovascular Disease 2008;2:387.

A more recent version of this article appeared on October 1, 2008


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