Stroke Secondary Prevention

Question 1

For which patients is there the strongest evidence for carotid endarterectomy?

Answer 1

within 2 weeks of event (TIA/stroke) in relevant territory and a carotid stenosis of 70-99%

Question 2

What is the reversal agent for dabigatran?

Answer 2

idarucizumab

Question 3

What is the reversal agent for direct factor Xa inhibitors?

Answer 3

andexanet alfa

Question 4

What types of valvular pathology are contraindicated for NOAC use in AF?

Answer 4

mechanical valves
moderate to severe mitral stenosis
rheumatic mitral stenosis

Question 5

What did the CHANCE trial and POINT trial show?

Answer 5

reduction in rate of recurrent stroke in aspirin + clopidogrel compared to aspirin alone

Question 6

Which stroke patients should be started on an antihypertensive?

Answer 6

all stroke/TIA patients with BP > 140/90

Question 7

What did the SPARCL trial show?

Answer 7

Decreased risk of recurrent stroke with 80mg atorvastatin vs placebo in stroke/TIA presumed to be due to atherosclerotic cause

Question 8

When is PFO closure indicated?

Answer 8

in patients < 60 with embolic stroke with no other clear aetiology (as per RESPECT, GORE-REDUCE and CLOSE trials)