Primary stroke prevention. Medical therapy versus revascularization

Marc P. Bonaca; Joshua A. Beckman

doi:10.1016/j.iccl.2013.08.003

Primary stroke prevention. Medical therapy versus revascularization

Research output: Contribution to journal › Review article › peer-review

Abstract

Asymptomatic carotid-artery atherosclerotic vascular disease identifies patients at heightened risk of major adverse cardiovascular events including ischemic stroke. Observational and registry analyses demonstrate that this risk extends beyond that attributable to carotid atherosclerosis itself and includes events manifesting in other vascular territories, such as myocardial infarction. However, randomized trials aimed specifically at treating carotid stenosis have shown benefit in terms of reducing ischemic stroke in appropriately selected patients. Therefore, the approach to primary prevention in patients with stable carotid disease must include a comprehensive strategy to reduce cerebrovascular-specific and overall cardiovascular risk through lifestyle changes and intensive medical therapies.

Original language	English (US)
Pages (from-to)	1-11
Number of pages	11
Journal	Interventional Cardiology Clinics
Volume	3
Issue number	1
DOIs	https://doi.org/10.1016/j.iccl.2013.08.003
State	Published - Jan 2014
Externally published	Yes

Keywords

Asymptomatic carotid disease
Atherosclerotic vascular disease
Carotid artery disease
Carotid stenosis
Stroke prevention

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.iccl.2013.08.003

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title = "Primary stroke prevention. Medical therapy versus revascularization",

abstract = "Asymptomatic carotid-artery atherosclerotic vascular disease identifies patients at heightened risk of major adverse cardiovascular events including ischemic stroke. Observational and registry analyses demonstrate that this risk extends beyond that attributable to carotid atherosclerosis itself and includes events manifesting in other vascular territories, such as myocardial infarction. However, randomized trials aimed specifically at treating carotid stenosis have shown benefit in terms of reducing ischemic stroke in appropriately selected patients. Therefore, the approach to primary prevention in patients with stable carotid disease must include a comprehensive strategy to reduce cerebrovascular-specific and overall cardiovascular risk through lifestyle changes and intensive medical therapies.",

keywords = "Asymptomatic carotid disease, Atherosclerotic vascular disease, Carotid artery disease, Carotid stenosis, Stroke prevention",

author = "Bonaca, {Marc P.} and Beckman, {Joshua A.}",

note = "Funding Information: Disclosures: Dr M.P. Bonaca is an investigator for the TIMI Study Group, which has received research grant support through Brigham and Women{\textquoteright}s Hospital from Abbott , Amgen , AstraZeneca , Beckman Coulter , BG Medicine , BRAHMS , Bristol-Myers Squibb , Buhlmann , Critical Diagnostics , CV Therapeutics , Daiichi Sankyo Co Ltd , Eli Lilly and Co , GlaxoSmithKline , Genzyme , Merck and Co , Intarcia , Merck , Nanosphere , Novartis Pharmaceuticals , Ortho-Clinical Diagnostics , Pfizer , Randox , Roche Diagnostics , Sanofi-Aventis , Siemens , Singulex , and Takeda . In addition he has received consulting fees from Roche Diagnostics. Dr J.A. Beckman serves as a board member for VIVA Physicians, Inc. Dr J.A. Beckman consults for Astra Zeneca, Ferring Pharmaceutical, Merck, and Novartis. He receives grant support from Bristol-Myers Squibb. ",

year = "2014",

month = jan,

doi = "10.1016/j.iccl.2013.08.003",

language = "English (US)",

volume = "3",

pages = "1--11",

journal = "Interventional Cardiology Clinics",

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AU - Bonaca, Marc P.

AU - Beckman, Joshua A.

N1 - Funding Information: Disclosures: Dr M.P. Bonaca is an investigator for the TIMI Study Group, which has received research grant support through Brigham and Women’s Hospital from Abbott , Amgen , AstraZeneca , Beckman Coulter , BG Medicine , BRAHMS , Bristol-Myers Squibb , Buhlmann , Critical Diagnostics , CV Therapeutics , Daiichi Sankyo Co Ltd , Eli Lilly and Co , GlaxoSmithKline , Genzyme , Merck and Co , Intarcia , Merck , Nanosphere , Novartis Pharmaceuticals , Ortho-Clinical Diagnostics , Pfizer , Randox , Roche Diagnostics , Sanofi-Aventis , Siemens , Singulex , and Takeda . In addition he has received consulting fees from Roche Diagnostics. Dr J.A. Beckman serves as a board member for VIVA Physicians, Inc. Dr J.A. Beckman consults for Astra Zeneca, Ferring Pharmaceutical, Merck, and Novartis. He receives grant support from Bristol-Myers Squibb.

PY - 2014/1

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N2 - Asymptomatic carotid-artery atherosclerotic vascular disease identifies patients at heightened risk of major adverse cardiovascular events including ischemic stroke. Observational and registry analyses demonstrate that this risk extends beyond that attributable to carotid atherosclerosis itself and includes events manifesting in other vascular territories, such as myocardial infarction. However, randomized trials aimed specifically at treating carotid stenosis have shown benefit in terms of reducing ischemic stroke in appropriately selected patients. Therefore, the approach to primary prevention in patients with stable carotid disease must include a comprehensive strategy to reduce cerebrovascular-specific and overall cardiovascular risk through lifestyle changes and intensive medical therapies.

AB - Asymptomatic carotid-artery atherosclerotic vascular disease identifies patients at heightened risk of major adverse cardiovascular events including ischemic stroke. Observational and registry analyses demonstrate that this risk extends beyond that attributable to carotid atherosclerosis itself and includes events manifesting in other vascular territories, such as myocardial infarction. However, randomized trials aimed specifically at treating carotid stenosis have shown benefit in terms of reducing ischemic stroke in appropriately selected patients. Therefore, the approach to primary prevention in patients with stable carotid disease must include a comprehensive strategy to reduce cerebrovascular-specific and overall cardiovascular risk through lifestyle changes and intensive medical therapies.

KW - Asymptomatic carotid disease

KW - Atherosclerotic vascular disease

KW - Carotid artery disease

KW - Carotid stenosis

KW - Stroke prevention

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Primary stroke prevention. Medical therapy versus revascularization

Abstract

Keywords

ASJC Scopus subject areas

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