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Antithrombotic therapy to prevent cognitive decline in people with small vessel disease on neuroimaging but without dementia
CONCLUSIONS: We found no convincing evidence to suggest any clinically relevant cognitive benefit of using antithrombotic therapy in addition to standard treatment in people with cerebral small vessel disease but without dementia, but there may be an increased bleeding risk with this approach. There was marked heterogeneity across the trials and the certainty of the evidence was generally poor.PMID:35833913 | PMC:PMC9281623 | DOI:10.1002/14651858.CD012269.pub2
Source: Cochrane Database of Systematic Reviews - July 14, 2022 Category: General Medicine Authors: Joseph Kwan Melanie Hafdi Lorraine L W Chiang Phyo K Myint Li Siang Wong Terry J Quinn Source Type: research

Duplex ultrasound for diagnosing symptomatic carotid stenosis in the extracranial segments
CONCLUSIONS: This review provides evidence that the diagnostic accuracy of DUS is high, especially at discriminating between the presence or absence of significant carotid artery stenosis (< 50% or 50% to 99%). This evidence, plus its less invasive nature, supports the early use of DUS for the detection of carotid artery stenosis. The accuracy for 70% to 99% carotid artery stenosis and occlusion is high. Clinicians should exercise caution when using DUS as the single preoperative diagnostic method, and the limitations should be considered. There was little evidence of the accuracy of DUS when compared with CTA or MRA. T...
Source: Cochrane Database of Systematic Reviews - July 11, 2022 Category: General Medicine Authors: Nicolle Cassola Jose Cc Baptista-Silva Luis Cu Nakano Carolina Dq Flumignan Ricardo Sesso Vladimir Vasconcelos Nelson Carvas Junior Ronald Lg Flumignan Source Type: research

Marine-derived n-3 fatty acids therapy for stroke
CONCLUSIONS: We are very uncertain of the effect of marine-derived n-3 PUFAs therapy on functional outcomes and dependence after stroke as there is insufficient high-certainty evidence. More well-designed RCTs are needed, specifically in acute stroke, to determine the efficacy and safety of the intervention. Studies assessing functional outcome might consider starting the intervention as early as possible after the event, as well as using standardised, clinically relevant measures for functional outcomes, such as the modified Rankin Scale. Optimal doses remain to be determined; delivery forms (type of lipid carriers) and m...
Source: Cochrane Database of Systematic Reviews - June 29, 2022 Category: General Medicine Authors: Celia Gabriela Alvarez Campano Mary Joan Macleod Lorna Aucott Frank Thies Source Type: research

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
CONCLUSIONS: This Cochrane Review provides low- to moderate-certainty evidence indicating that there are no significant differences in either short- or long-term risks of stroke, death, or TIA between people with symptomatic vertebral artery stenosis treated with ET plus MT and those treated with MT alone.PMID:35579383 | DOI:10.1002/14651858.CD013692.pub2
Source: Cochrane Database of Systematic Reviews - May 17, 2022 Category: General Medicine Authors: Ran Xu Xiao Zhang Sihua Liu Xue Wang Wenjiao Wang Kun Yang Tao Wang Adam A Dmytriw Xuesong Bai Yan Ma Liqun Jiao Bin Yang Source Type: research

Antiepileptic drugs for the primary and secondary prevention of seizures after stroke
CONCLUSIONS: There is insufficient evidence to support the routine use of AEDs on the primary and secondary prevention of seizures after stroke. Further well-conducted studies are warranted for this important clinical problem.PMID:35129214 | DOI:10.1002/14651858.CD005398.pub4
Source: Cochrane Database of Systematic Reviews - February 7, 2022 Category: General Medicine Authors: Richard S Chang William Cy Leung Michael Vassallo Lucy Sykes Emma Battersby Wood Joseph Kwan Source Type: research

Oral antiplatelet therapy for acute ischaemic stroke
CONCLUSIONS: Antiplatelet therapy with aspirin 160 mg to 300 mg daily, given orally (or by nasogastric tube or per rectum in people who cannot swallow) and started within 48 hours of onset of presumed ischaemic stroke, significantly decreased death and dependency, and reduced the risk of early recurrent ischaemic stroke without a major risk of early haemorrhagic complications; long-term outcomes were improved.PMID:35028933 | DOI:10.1002/14651858.CD000029.pub4
Source: Cochrane Database of Systematic Reviews - January 14, 2022 Category: General Medicine Authors: Jatinder S Minhas Tamara Chithiramohan Xia Wang Sam C Barnes Rebecca H Clough Meeriam Kadicheeni Lucy C Beishon Thompson Robinson Source Type: research

Calcium supplementation for prevention of primary hypertension
CONCLUSIONS: An increase in calcium intake slightly reduces both systolic and diastolic blood pressure in normotensive people, particularly in young people, suggesting a role in the prevention of hypertension. The effect across multiple prespecified subgroups and a possible dose response effect reinforce this conclusion. Even small reductions in blood pressure could have important health implications for reducing vascular disease. A 2 mmHg lower systolic blood pressure is predicted to produce about 10% lower stroke mortality and about 7% lower mortality from ischaemic heart disease. There is a great need for adequately-pow...
Source: Cochrane Database of Systematic Reviews - January 11, 2022 Category: General Medicine Authors: Gabriela Cormick Agust ín Ciapponi Mar ía Luisa Cafferata Mar ía Sol Cormick Jos é M Belizán Source Type: research

Endovascular versus open surgical repair for complicated chronic Type B aortic dissection
CONCLUSIONS: Due to lack of RCTs or CCTs investigating the effectiveness and safety of TEVAR compared to OSR for patients with complicated CBAD, we are unable to provide any evidence to inform decision-making on the optimal intervention for these patients. High-quality RCTs or CCTs addressing this objective are necessary. However, conducting such studies will be challenging for this life-threatening disease.PMID:34905228 | DOI:10.1002/14651858.CD012992.pub2
Source: Cochrane Database of Systematic Reviews - December 14, 2021 Category: General Medicine Authors: Fionnuala Jordan Brian FitzGibbon Edel P Kavanagh Peter McHugh Dave Veerasingam Sherif Sultan Niamh Hynes Source Type: research

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