![]() ![]() Definition of Classes and Levels of Evidence Used in AHA Recommendations Class IĬonditions for which there is evidence for and/or general agreement that the procedure or treatment is useful and effectiveĬonditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment Recommendations follow the American Heart Association (AHA) and the American College of Cardiology (ACC) methods of classifying the level of certainty of the treatment effect and the class of evidence ( Tables 1 and 2). All members of the committee had frequent opportunities to review drafts of the document and reach a consensus with the final recommendations. The references selected for this document are exclusively for peer-reviewed papers that are representative but not all-inclusive, with priority given to references with higher levels of evidence. Because of the scope and importance of certain ongoing clinical trials and other emerging information, published abstracts were cited for informational purposes when they were the only published information available, but recommendations were not based on abstracts alone. Literature citations were generally restricted to published manuscripts appearing in journals listed in Index Medicus and reflected literature published as of August 1, 2009. ![]() Searches were limited to English-language sources and human subjects. The committee reviewed all compiled reports from computerized searches and conducted additional searches by hand. The writing group conducted a comprehensive review and synthesis of the relevant literature. A writing committee roster was developed and approved by the Stroke Council with representatives from neurology, cardiology, radiology, surgery, nursing, pharmacy, and epidemiology/biostatistics. A writing committee chair and vice chair were designated by the Stroke Council Manuscript Oversight Committee. The aim of this statement is to provide clinicians with the most up-to-date evidence-based recommendations for the prevention of ischemic stroke among survivors of ischemic stroke or TIA. Notably, much of the existing data come from studies with limited numbers of older adults, women, and diverse ethnic groups, and additional research is needed to confirm the generalizability of the published findings. 1 On the basis of epidemiological data defining the determinants of recurrent stroke and the results of clinical trials, it is possible to derive evidence-based recommendations to reduce stroke risk. The true prevalence of TIA is difficult to gauge because a large proportion of patients who experience a TIA fail to report it to a healthcare provider. Approximately one quarter of the 795 000 strokes that occur each year are recurrent events. Survivors of a transient ischemic attack (TIA) or stroke represent a population at increased risk of subsequent stroke. Stroke is a major source of mortality and morbidity in the United States. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB). ![]()
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