title: Canadian Stroke Best Practice Recommendations: secondary prevention of stroke guidelines, update 2014.
abstract: Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2014 update of the Canadian Secondary Prevention of Stroke guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. Notable changes in this 5th edition include an emphasis on treating the highest risk patients who present within 48 h of symptom onset with transient or persistent motor or speech symptoms, who need to be transported to the closest emergency department with capacity for advanced stroke care; a recommendation for brain and vascular imaging (of the intra- and extracranial vessels) to be completed urgently using computed tomography/computed tomography angiography; prolonged cardiac monitoring for patients with suspective cardioembolic stroke but without evidence for atrial fibrillation on electrocardiogram or holter monitoring; and de-emphasizing the need for routine echocardiogram. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations using a standardized approach. The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists regardless of patient location, and the need to overcome geographical barriers to ensure equity in access within a universal health-care system.
authors.affiliation: Calgary Stroke Program, Department of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Wein
authors.forename: M Patrice
authors.initials: MP
authors.lastname: Lindsay
authors.forename: Brian
authors.initials: B
authors.lastname: Buck
authors.forename: Robert
authors.initials: R
authors.lastname: Cote
authors.forename: Paul
authors.initials: P
authors.lastname: Ellis
authors.forename: Norine
authors.initials: N
authors.lastname: Foley
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hill
authors.forename: Sharon
authors.initials: S
authors.lastname: Jaspers
authors.forename: Albert Y
authors.initials: AY
authors.lastname: Jin
authors.forename: Brenda
authors.initials: B
authors.lastname: Kwiatkowski
authors.forename: Carolyn
authors.initials: C
authors.lastname: MacPhail
authors.forename: Dana
authors.initials: D
authors.lastname: McNamara-Morse
authors.forename: Michael S
authors.initials: MS
authors.lastname: McMurtry
authors.forename: Tania
authors.initials: T
authors.lastname: Mysak
authors.forename: Andrew
authors.initials: A
authors.lastname: Pipe
authors.forename: Karen
authors.initials: K
authors.lastname: Silver
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.forename: Gord
authors.initials: G
authors.lastname: Gubitz
mesh_terms: D001794:Blood Pressure; D002170:Canada; D017408:Guidelines as Topic; D006801:Humans; D008019:Life Style; D050356:Lipid Metabolism; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016730:Program Development / Q000592:standards; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods* / Q000592:standards*; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: guidelines; ischemic stroke; prevention; transient ischemic attack