AHA/ASA guideline recommendations for prevention of stroke in women prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]
Overview
2014 AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (DO NOT EDIT)
| Class I |
| "1. Women with asymptomatic carotid stenosis should be screened for other treatable risk factors for stroke, and appropriate lifestyle changes and medical therapies should be instituted. (Level of Evidence: C) " |
| "2. In women who are to undergo CEA, aspirin is recommended unless contraindicated, because aspirin was used in every major trial that demonstrated efficacy of CEA. (Level of Evidence: C) " |
| "3. For women with recent TIA or IS within the past 6 months and ipsilateral severe (70%–99%) carotid artery stenosis, CEA is recommended if the perioperative morbidity and mortality risk is estimated to be <6%(Level of Evidence: A) " |
| "4. For women with recent TIA or IS and ipsilateral moderate (50%–69%) carotid stenosis, CEA is recommended depending on patient-specific factors, such as age and comorbidities, if the perioperative morbidity and mortality risk is estimated to be <6%. (Level of Evidence: B) " |
| "5. If a high-risk (ie, 10-year predicted CVD risk ≥10%) woman has an indication for aspirin but is intolerant of aspirin therapy, clopidogrel should be substituted. (Level of Evidence: B) " |
| Class IIa |
| "1. Prophylactic CEA performed with <3% morbidity/mortality can be useful in highly selected patients with an asymptomatic carotid stenosis (minimum 60% by angiography, 70% by validated Doppler ultrasound). (Level of Evidence: A) " |
| "2. When CEA is indicated for women with TIA or stroke, surgery within 2 weeks is reasonable rather than delaying surgery, if there are no contraindications to early revascularization. (Level of Evidence: B) " |
| "3. Aspirin therapy (75–325 mg/d) is reasonable in women with diabetes mellitus unless contraindicated (Level of Evidence: B) " |
| "4. Aspirin therapy can be useful in women ≥65 years of age (81 mg/d or 100 mg every other day) if BP is controlled and the benefit for IS and MI prevention is likely to outweigh the risk of gastrointestinal bleeding and hemorrhagic stroke. (Level of Evidence: B) " |
| Class IIb |
| "1. Aspirin therapy may be reasonable for women <65 years of age for IS prevention. (Level of Evidence: B) " |