New ideas and inspiration of the updated guidelines for secondary prevention of ischemic stroke

Guidelines for secondary prevention of ischemic stroke had been updated recently as more and more evidences emerged. These updated guidelines emphasize more on the universality and clinical relevance. For example, intensified statin therapy and aggressive anti-platelet therapy are important for atherosclerotic stroke, while aggressive anti-hypertension therapy is the most important treatment for stroke caused by cerebral small vessel diseases. For prevention of cardioembolic stroke, new oral anticoagulants (NOACs) are more effective and safer than warfarin. In patients with intracranial atherosclerotic stenosis, intensified medication therapy is superior to endovascular intervention. Because of lacking evidences, the routine screening of carotid stenosis in asymptomatic adults and treating hyperhomocysteinemia are not recommended. DOI: 10.3969/j.issn.1672-6731.2015.03.003