Singapore ministry of health clinical practice guidelines on stroke and transient ischemic attacks

International Journal of Stroke

Volumn 6, Issue 3, 2011, Pages 251-258

  Venketasubramanian, N ^a   Pwee, K H ^b   Chen, C P L ^a  

^a NATIONAL UNIVERSITY HEALTH SYSTEM   (Singapore)

^b MINISTRY OF HEALTH   (Singapore)

Author keywords

Clinical practice guidelines; Stroke; Transient ischemic attack

Indexed keywords

ACETYLSALICYLIC ACID; ALTEPLASE; CLOPIDOGREL; DIPYRIDAMOLE; HEPARIN; HEPARINOID; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOW MOLECULAR WEIGHT HEPARIN; METFORMIN; PARACETAMOL; PLACEBO; PROUROKINASE; TICLOPIDINE; WARFARIN;

ACUTE DISEASE; ANGIOPLASTY; ARTICLE; BLOOD CLOT LYSIS; BLOOD PRESSURE MONITORING; BRAIN HEMATOMA; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CAROTID ARTERY OBSTRUCTION; CAROTID ARTERY STENTING; CAROTID ENDARTERECTOMY; CLINICAL ASSESSMENT; CLINICAL PROTOCOL; DECOMPRESSION SURGERY; DEEP VEIN THROMBOSIS; DIABETES MELLITUS; FAMILY MEDICINE; FEVER; HEALTH CARE DELIVERY; HEALTH CARE PERSONNEL; HEART INFARCTION; HOSPITAL ADMINISTRATOR; HOSPITAL ADMISSION; HOSPITAL DEPARTMENT; HUMAN; HYPERGLYCEMIA; HYPOGLYCEMIA; LIFESTYLE MODIFICATION; LUNG EMBOLISM; MEDICAL AUDIT; MEDICAL SOCIETY; NURSING; OCCUPATIONAL THERAPY; PATIENT CARE; PHYSICIAN; PRACTICE GUIDELINE; PRIORITY JOURNAL; RECURRENT DISEASE; RISK FACTOR; SECONDARY PREVENTION; SINGAPORE; SPEECH THERAPY; STROKE; TRANSIENT ISCHEMIC ATTACK; VENOUS THROMBOEMBOLISM;

ANGIOPLASTY; ANTICOAGULANTS; BLOOD PRESSURE; CEREBRAL INFARCTION; ENDARTERECTOMY, CAROTID; EVIDENCE-BASED MEDICINE; FEVER; HOSPITALS, PRIVATE; HOSPITALS, PUBLIC; HUMANS; HYPERGLYCEMIA; HYPOGLYCEMIA; ISCHEMIC ATTACK, TRANSIENT; NEUROSURGICAL PROCEDURES; PLATELET AGGREGATION INHIBITORS; QUALITY IMPROVEMENT; RISK MANAGEMENT; SINGAPORE; STENTS; STROKE; VENOUS THROMBOEMBOLISM;

EID: 79955785949     PISSN: 17474930     EISSN: 17474949     Source Type: Journal    
DOI: 10.1111/j.1747-4949.2011.00602.x     Document Type: Article

References (85)

1. Venketasubramanian N, Chen C. Burden of stroke in Singapore. Int J Stroke 2008; 3:51-4.
2. Venketasubramanian N, Sadasivan B, Tan AKY. Stroke patterns in a Singapore hospital-based stroke data bank. Cerebrovasc Dis 1994; 4:250.
3. Ministry of Health Singapore. Available at (accessed August 15, 2010).
4. Scottish Intercollegiate Guidelines Network (SIGN). Clinical Practice Guidelines on the Management of Patients with Stroke: Assessment, Investigation, Immediate Management and Secondary Prevention. Scottish Intercollegiate Guidelines Network (SIGN), 1997
5. Stroke Unit Trialists' Collaboration. Organised inpatient (stroke unit) care for stroke (Review). The Cochrane Library 2007, Issue 3, CD000197.
6. Mohr JP, Biller J, Hilal SK et al. Magnetic resonance versus computed tomographic imaging in acute stroke. Stroke 1995; 26:807-12.
7. Fiebach JB, Schellinger PD, Jansen O et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 2002; 33:2206-10.
8. Esteban JM, Cervera V. Perfusion CT and angio CT in the assessment of acute stroke. Neuroradiology 2004; 46:705-15.
9. National Institute of Neurological Disorders and Stroke rt-PA Study Group. Tissue plasminogen activator for the treatment of acute ischaemic stroke. New Engl J Med 1995; 333:1581-7.
10. Kwiatkowski TG, Libman RB, Frankel M et al. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. Effects of tissue plasminogen activator for acute ischemic stroke at one year. N Engl J Med 1999; 340:1781-7.
11. Wahlgren N, Ahmed N, SITS-MOST investigators et al. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet 2007; 369:275-82.
12. Hacke W, Kaste M, for the ECASS Investigators et al. Thrombolysis with Alteplase 3 to 4·5 Hours after Acute Ischemic Stroke. N Engl J Med 2008; 359:1317-29.
13. Furlan A, Higashida R, Wechsler L et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 1999; 282:2003-11.
14. Flint AC, Duckwiler GR, Budzik RF, Liebeskind DS, Smith WS, for the Merci and Multi Merci Writing Committee. Mechanical thrombectomy of intracranial internal carotid occlusion: Pooled results of the MERCI and multi MERCI part I trials. Stroke 2007; 38:1274-80.
15. Smith WS, Sung G, Multi MERCI investigators et al. Mechanical thrombectomy for acute ischemic stroke. Final results of the multi MERCI trial. Stroke 2008; 39:1205-12.
16. Alexandrov AV, Molina CA, CLOTBUST Investigators et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med 2004; 351:2170-8.
17. Gubitz G, Sandercock P, Counsell C. Anticoagulants for acute ischaemic stroke. Cochrane Database Syst Rev 2004: CD000024.
18. International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet 1997; 349:1569-81.
19. Chinese Acute Stroke Trial (CAST) Collaborative Group. A randomised placebo-controlled trial of early aspirin use in 20000 patients with acute ischaemic stroke. Lancet 1997; 349:1641-9.
20. Vahedi K, Hofmeijer J, for the DECIMAL, DESTINY, and HAMLET investigators et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 2007; 6:215-22.
21. Norris JW, Hachinski VC. High dose steroid treatment in cerebral infarction. BMJ 1986; 292:21-3.
22. Poungvarin N, Bhoopat W, Viriyavejakui A, Rodprasert P, Buranasiri P, Sukhondabant S. Effects of dexamethasone in primary supratentorial intracerebral haemorrhage. N Eng J Med 1987; 316:1229-33.
23. Asplund K, Israelsson K, Schampi I. Haemodilution for acute ischaemic stroke. Cochrane Database Syst Rev 2000: CD000103.
24. Liebeskind DS, Kasner SE. Neuroprotection for ischaemic stroke: an unattainable goal? CNS Drugs 2001; 15:165-74.
25. The Blood Pressure in Acute Stroke Collaboration (BASC). Vasoactive drugs for acute stroke (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software
26. Adams HP Jr, del Zoppo G, Alberts MJ et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American heart association/American stroke association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups. Stroke 2007; 38:1655-711.
27. Mendelow DA, Gregson BA, Fernandes HM et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet 2005; 365:387-97.
28. Ojemann RG, Heros RC. Spontaneous brain haemorrhage. Stroke 1983; 14:468-74.
29. Gray CS, Hildreth AJ, Sandercock PA et al. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol 2007; 6:397-406.
30. Dippel DWJ, van Breda EJ, van der Worp HB et al. Effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute ischemic stroke PAIS, a phase II double-blind, randomized, placebo-controlled trial. BMC Cardiovasc Disord 2003; 3:2.
31. The CLOTS Trials Collaboration. Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet 2009; 373:1958-65.
32. Black PM, Crowell RM, Abbott WM. External pneumatic calf compression reduces deep venous thrombosis in patients with ruptured intracranial aneurysms. Neurosurgery 1986; 18:25-8.
33. Pulmonary Embolism Prevention (PEP) Trial Collaborative Group. Prevention of pulmonary embolism and deep vein thrombosis with low-dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 2000; 355:1295-302.
34. Antiplatelet Trialists' Collaboration. Collaborative overview of randomised trials of antiplatelet therapy, III: reduction in venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients. BMJ 1994; 308:235-46.
35. Bath PMW, Iddenden R, Bath FJ. Low molecular weight heparins and heparinoids in acute ischaemic stroke: a systematic review. Stroke 2000; 31:311-4.
36. André C, de Freitas GR, Fukujima MM. Prevention of deep venous thrombosis and pulmonary embolism following stroke: a systematic review of published articles. Eur J Neurol 2007; 14:21-32.
37. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324:71-86.
38. The ESPRIT Study Group. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet 2006; 367:1665-73.
39. Diener HC, Bogousslavsky J, for the MATCH Investigators et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004; 364:331-7.
40. Bhatt DL, Fox KAA, for the CHARISMA Investigators et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354:1706-17.
41. EAFT (European Atrial Fibrillation Trial) Study Group. Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet 1993; 342:1255-62.
42. Hylek EM, Singer DE. Risk factors for intracranial hemorrhage in outpatients taking warfarin. Ann Intern Med 1994; 120:897-902.
43. Rothwell PM, Elaiswiz M, Gutriknov SA et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet 2003; 361:107-16.
44. Kastrup A, Groschel K. Carotid endarterectomy versus carotid stenting: an updated review of randomized trials and subgroup analyses. Acta Chir Belg 2007; 107:119-28.
45. Eckstein HH, Ringleb P, Allenberg JR et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol 2008; 7:893-902.
46. Mas JL, Trinquart L, EVA-3S investigators et al. Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicentre trial. Lancet Neurol 2008; 7:885-92.
47. Gurm HS, Yadav JS, for the SAPPHIRE investigators et al. Long-term results of carotid stenting versus endarterectomy in high-risk patients. N Engl J Med 2008; 358:1572-9.
48. Chimowitz MI, Kokkinos J, Strong J et al. The warfarin-aspirin symptomatic intracranial disease study. Neurology 1995; 45:1488-93.
49. SSYLVIA Study Investigators. Stenting of Symptomatic Atherosclerotic Lesion in the Vertebral or Intracranial Arteries (SSYLVIA): Study results. Stroke 2004; 35:1388-92.
50. Bose A, Hartmann M, Henkes H et al. A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses the wingspan study. Stroke 2007; 38:1531-7.
51. Fiorella D, Levy EI, Turk AS et al. US multicenter experience with the wingspan stent system for the treatment of intracranial atheromatous disease periprocedural results. Stroke 2007; 38:881-7.
52. Rashid P, Leonardi-Bee J, Bath P. Blood pressure reduction and secondary prevention of stroke and other vascular events: a systematic review. Stroke 2003; 34:2741-8.
53. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358:1033-41.
54. Heart Protection Study Collaborative Group. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20 536 people with cerebrovascular disease or other high-risk conditions. Lancet 2004; 363:757-67.
55. Amarenco P, Bogousslavsky J, Callahan A III et al. High dose atorvastatin after stroke or transient ischemic attack (SPARCL). N Engl J Med 2006; 355:549-59.
56. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352:854-65.
57. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005; 353:2643-53.
58. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet 2006; 367:320-6.
59. He K, Song Y, Daviglus ML et al. Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke 2004; 35:1538-42.
60. Wannamethee SG, Shaper AG, Whincup PH, Walker M. Smoking cessation and the risk of stroke in middle-aged men. JAMA 1995; 274:155-60.
61. Reynolds K, Lewis B, Nolen JD, Kinney GL, Sathya B, He J. Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003; 289:579-88.
62. Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002; 162:1867-72.
63. Wendel-Vos GC, Schuit AJ, Feskens EJ et al. Physical activity and stroke. A meta-analysis of observational data. Int J Epidemiol 2004; 33:787-98.
64. Langhorne P, Duncan P. Does the organization of postacute stroke care really matter? Stroke 2001; 32:268-74.
65. Maulden SA, Gassaway J, Horn SD, Smout RJ, DeJong G. Timing of initiation of rehabilitation after stroke. Arch Phys Med Rehabil 2005; 86 (Suppl. 2): S34-40.
66. Salter K, Jutai J, Hartley M et al. Impact of early versus delayed admission to rehabilitation on functional outcomes in persons with stroke. J Rehabil Med 2006; 38:113-7.
67. Horn SD, DeJong G, Smout RJ et al. Stroke rehabilitation patients, practice, and outcomes: Is earlier and more aggressive therapy better? Arch Phys Med Rehabil 2005; 86 (Suppl. 2): S101-14.
68. Kwakkel G, va Peppen R, Wagenaar RC et al. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke 2004; 35:2529-36.
69. Kwan J, Sandercock P. In-hospital care pathways for stroke: a Cochrane systematic review. Stroke 2003; 34:587-8.
70. Pollock A, Baer G, Langhorne P, Pomeroy V. Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: a systematic review. Clin Rehabil 2007; 21:395-410.
71. Legg LA, Drummond AE, Langhorne P. Occupational therapy for patients with problems in activities of daily living after stroke. Cochrane Database Syst Rev 2006: CD003585.
72. Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol 2006; 5:31-7.
73. Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev 2000: CD000425.
74. West C, Hesketh A, Bowen A. Interventions for apraxia of speech following stroke. Cochrane Database Syst Rev 2005: CD004298.
75. Sellars C, Hughes T, Langhorne P. Speech and language therapy for dysarthria due to non-progressive brain damage. Cochrane Database Syst Rev 2005: CD002088.
76. Wolf SL, Winstein CJ, Miller JP et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA 2006; 296:2095-104.
77. Wolf SL, Winstein CJ, Miller JP et al. Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomized trial. Lancet Neurol 2008; 7:33-40.
78. Mosely AM, Stark A, Cameron ID, Pollock A. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev 2005: CD002840.
79. Wu HM, Tang JL, Lin XP et al. Acupuncture for stroke rehabilitation. Cochrane Database Syst Rev 2006: CD004131.
80. Rothwell PM, Giles MF, Chandratheva A et al. Early use of Existing Preventive Strategies for Stroke (EXPRESS) study. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 2007; 370:1432-42.
81. Lavallée PC, Meseguer E, Abboud H et al. A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects. Lancet Neurol 2007; 6:953-60.
82. Govan L, Langhorne P, Weir CJStroke Unit Trialists Collaboration. Does the prevention of complications explain the survival benefit of organized inpatient (stroke unit) care? Further analysis of a systematic review. Stroke 2007; 38:2536-40.
83. American Stroke Association's Task Force on the Development of Stroke Systems. Recommendations for the establishment of stroke systems of care. Stroke 2005; 36:690-703.
84. Brain Attack Coalition. Recommendations for the establishment of primary stroke centres. JAMA 2000; 283:3102-9.
85. Brain Attack Coalition. Recommendations for comprehensive stroke centers. Stroke 2005; 36:1597-618.