Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke

Abstract

The management of patients with stroke is often multidisciplinary, involving various specialties and healthcare professionals. Given the common shared risk factors for stroke and cardiovascular disease, input may also be required from the cardiovascular teams, as well as patient caregivers and next-of-kin. Ultimately, the patient is central to all this, requiring a coordinated and uniform approach to the priorities of post-stroke management, which can be consistently implemented by different multidisciplinary healthcare professionals, as part of the patient ‘journey’ or ‘patient pathway,’ supported by appropriate education and tele-medicine approaches. All these aspects would ultimately aid delivery of care and improve patient (and caregiver) engagement and empowerment. Given the need to address the multidisciplinary approach to holistic or integrated care of patients with heart disease and stroke, the European Society of Cardiology Council on Stroke convened a Task Force, with the remit to propose a consensus on Integrated care management for optimizing the management of stroke and associated heart disease. The present position paper summarizes the available evidence and proposes consensus statements that may help to define evidence gaps and simple practical approaches to assist in everyday clinical practice. A post-stroke ABC pathway is proposed, as a more holistic approach to integrated stroke care, would include three pillars of management: • A: Appropriate Antithrombotic therapy. • B: Better functional and psychological status. • C: Cardiovascular risk factors and Comorbidity optimization (including lifestyle changes).

Transient ischemic attack events and incident cardiovascular and non-cardiovascular complications: Observations from a large diversified multimorbid cohort

“…Given the high risk of incident major adverse cardiovascular events following presentation with a cerebrovascular event, the ESC recently published a position paper on integrated care for post-stroke management. 11 This proposes a framework for holistic post-stroke management, based on the ABC strategy devised by Lip. 20 One way to prevent future complications for TIA (i.e.…”

“…This has led to a recent position paper from the European Society of Cardiology Council on Stroke, advocating an integrated care approach to post-stroke management. 11 While transient ischemic attack (TIA) is one of the strong signals for subsequent stroke complications, there is currently a lack of information on cardiovascular and noncardiovascular complications of TIA as well as the potential risk factors associated with these complications, in population health studies from large/diversified populations including a wide age spectrum and varied levels of combined socio-economic status and disability.…”

“…This has led to a recent position paper from the European Society of Cardiology Council on Stroke, advocating an integrated care approach to post-stroke management. 11…”

Faktor Risiko, Gangguan Hemorheologi dan Outcome pada Pasien Stroke Iskemik Pasca Pandemi Corona Virus Disease (COVID-19) di RSUD dr. Zainoel Abidin Banda Aceh

“…Untuk menurunkan prevalensi, morbiditas, mortalitas, dan kecacatan akibat stroke, program penanganannya harus dilaksanakan secara komprehensif terutama pada era pandemi dan pasca corona virus disease . Manajemen komprehensif stroke harus dilakukan secara terpadu dan holistik sejak fase akut (Lip dkk., 2022), dengan prinsip tatalaksana perawatan stroke dengan sumber daya manusia yang handal (Rodgers dkk., 2021). Pada era pandemi COVID-19, tatalaksana stroke (terutama stroke akut) harus menggunakan protected code stroke (Johansson and Wild, 2010;Norrving dkk., 2018).…”

Acute ischaemic stroke: recent advances in reperfusion treatment

“…The growing evidence supporting the role of stroke thrombectomy triggered interest among interventional cardiologists to help with the widespread implementation of thrombectomy into stroke services. The European Society of Cardiology Council on Stroke published two position papers, 3 , 4 defining several roles cardiologists should have in stroke—including thrombectomy in regions, where this treatment is not available. Interventional cardiologists, who plan to join the interdisciplinary stroke teams, should undergo a formal training in stroke thrombectomy 5 with full respect to the leading role of neurologists in acute stroke treatment.…”