Introduction
The Chinese Stroke Association has recently updated its guidelines for the clinical management of ischaemic cerebrovascular diseases. This comprehensive update includes 136 new recommendations and revisions of 15 existing ones, offering significant insights into stroke care. For practitioners, implementing these guidelines can enhance patient outcomes and ensure evidence-based care.
Key Updates to Enhance Your Practice
1. Reperfusion Therapy
The guidelines recommend using Tenecteplase (TNK) at 0.25 mg/kg, which has been proven non-inferior to the standard dosage of recombinant tissue plasminogen activator (rt-PA) for treating acute ischaemic stroke (AIS) within 4.5 hours of onset. This approach might offer better reperfusion outcomes without increasing the risk of symptomatic intracerebral hemorrhage.
2. Antiplatelet Therapy
For patients with non-cardioembolic minor ischaemic stroke or high-risk transient ischaemic attack, the guidelines suggest considering CYP2C19 genetic testing. If the patient carries CYP2C19 loss-of-function alleles, a combination of ticagrelor and aspirin is recommended for 21 days, followed by ticagrelor monotherapy for 90 days.
3. Brain Cytoprotection
Edaravone dexborneol, administered intravenously, may improve clinical outcomes in patients with AIS. This novel neuroprotective agent offers synergistic antioxidant and anti-inflammatory effects, which could be beneficial in acute stroke management.
Encouraging Further Research
The updated guidelines emphasize the importance of continuous research and adaptation of new findings into clinical practice. Practitioners are encouraged to stay informed about ongoing trials and emerging therapies to provide the best care possible.
Implementing the Guidelines
- Stay updated with the latest guidelines through professional development opportunities such as conferences and webinars.
- Incorporate genetic testing into your practice to personalize antiplatelet therapy for stroke patients.
- Consider adopting new therapeutic agents like edaravone dexborneol to enhance treatment outcomes.
Conclusion
By integrating these updated guidelines into your practice, you can improve patient outcomes and ensure compliance with the latest standards in stroke care. For a detailed exploration of these guidelines, practitioners are encouraged to read the full research paper.
To read the original research paper, please follow this link: Chinese Stroke Association guidelines for clinical management of ischaemic cerebrovascular diseases: executive summary and 2023 update.
