Cardiovascular care of patients with stroke and high risk of stroke: The need for interdisciplinary action: A consensus report from the European Society of Cardiology Cardiovascular Round Table

Author:

Doehner Wolfram123,Mazighi Mikael4,Hofmann Bernd M5,Lautsch Dominik6,Hindricks Gerhard7,Bohula Erin A8,Byrne Robert A910,Camm A John11,Casadei Barbara1213,Caso Valeria14,Cognard Christophe15,Diener Hans-Christoph16,Endres Matthias31718,Goldstein Patrick19,Halliday Alison20,Hopewell Jemma C21,Jovanovic Dejana R22,Kobayashi Adam23,Kostrubiec Maciej24,Krajina Antonin25,Landmesser Ulf182627,Markus Hugh S28,Ntaios George29,Pezzella Francesca R30,Ribo Marc31,Rosano Giuseppe MC3233,Rubiera Marta31,Sharma Mike34,Touyz Rhian M35,Widimsky Petr36

Affiliation:

1. Department of Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK), partner site Berlin, Universitätsmedizin Berlin, Germany

2. BCRT – Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany

3. Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Germany

4. Department of Neurology, Lariboisière Hospital, University of Paris, France

5. Siemens Healthcare GmbH, Germany

6. Merck and Co., Inc., Kenilworth, USA

7. Department of Cardiac Electrophysiology, University of Leipzig, Germany

8. Cardiovascular Division, Harvard Medical School, USA

9. Deutsches Herzzentrum München, Technische Universität München, Germany

10. German Centre for Cardiovascular Research (DZHK), Partner site Munich, Germany

11. Molecular and Clinical Sciences Research Institute, St George's University of London, UK

12. Division of Cardiovascular Medicine, University of Oxford, UK

13. British Heart Foundation Centre of Research Excellence, Oxford

14. Santa Maria della Misericordia Hospital, University of Perugia, Italy

15. Service de Neuroradiology, Hopital Purpan, France

16. Faculty of Medicine, University Duisburg-Essen, Germany

17. Department of Neurology, Charité-Universitätsmedizin Berlin, Germany

18. German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany

19. Emergency Department, University Hospital of Lille, France

20. Nuffield Department of Surgical Sciences, John Radcliffe Hospital, UK

21. CTSU Nuffield Department of Population Health, University of Oxford, UK

22. Neurology Clinic, University of Belgrade, Serbia

23. Kazimierz Pulaski University of Technology and Humanities, Poland

24. Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland

25. Department of Radiology, Charles University and University Hospital, Hradec Kralove Czech Republic

26. Department of Cardiology, Charité-Universitätsmedizin Berlin, Germany

27. Berlin Institute of Health (BIH), Germany

28. Stroke Research Group, University of Cambridge, UK

29. Department of Medicine, University of Thessaly, Greece

30. Stroke Unit Emergency Department, S. Camillo-Forlanini Hospital, Italy

31. Stroke Unit, Vall d'Hebron University Hospital, Spain

32. IRCCS San Raffaele Hospital Roma, Italy

33. Cardiovascular and Cell Sciences Institute, St George's University of London, UK

34. Population Health Research Institute, McMaster University and Hamilton Health Sciences, Canada

35. Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK

36. Cardicenter, Charles University, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Prague, Czech Republic

Abstract

Comprehensive stroke care is an interdisciplinary challenge. Close collaboration of cardiologists and stroke physicians is critical to ensure optimum utilisation of short- and long-term care and preventive measures in patients with stroke. Risk factor management is an important strategy that requires cardiologic involvement for primary and secondary stroke prevention. Treatment of stroke generally is led by stroke physicians, yet cardiologists need to be integrated care providers in stroke units to address all cardiovascular aspects of acute stroke care, including arrhythmia management, blood pressure control, elevated levels of cardiac troponins, valvular disease/endocarditis, and the general management of cardiovascular comorbidities. Despite substantial progress in stroke research and clinical care has been achieved, relevant gaps in clinical evidence remain and cause uncertainties in best practice for treatment and prevention of stroke. The Cardiovascular Round Table of the European Society of Cardiology together with the European Society of Cardiology Council on Stroke in cooperation with the European Stroke Organisation and partners from related scientific societies, regulatory authorities and industry conveyed a two-day workshop to discuss current and emerging concepts and apparent gaps in stroke care, including risk factor management, acute diagnostics, treatments and complications, and operational/logistic issues for health care systems and integrated networks. Joint initiatives of cardiologists and stroke physicians are needed in research and clinical care to target unresolved interdisciplinary problems and to promote the best possible outcomes for patients with stroke.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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