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. 2012 Jan 23;141(2 Suppl):e601S–e636S. doi: 10.1378/chest.11-2302

Table 1.

—Structured Clinical Questions

Rec. Table S-Tablea Population Intervention(s) Comparator Outcome Method
Ischemic stroke: acute management

2.1.1 2, 3, 4 1, 2, 3, 4 Patients with acute ischemic stroke IV r-tPA No IV r-tPA Mortality, good functional outcome R

2.1.2

2.1.3

2.2.1 5 5, 6 Patients with acute ischemic stroke Intraarterial r-tPA No IA r-tPA Same as above R

2.2.2 6 5, 7 Patients with acute ischemic stroke Intraarterial+IV r-tPA IV r-tPA Same as above C

2.3 8, 9, 10 Patients with acute ischemic stroke Mechanical thrombectomy No mechanical thrombectomy Same as above C

2.4 7 11, 12 Patients with acute ischemic stroke or TIA Aspirin No aspirin Mortality, good functional outcome, nonfatal major extracranial bleed R

2.5 8 13, 14 Patients with acute ischemic stroke or TIA Therapeutic anticoagulation Aspirin Same as above R

VTE prevention in stroke patients

3.1.1 9 15, 16 Patients with acute ischemic stroke and restricted mobility Prophylactic-dose heparin No prophylactic-dose heparin Mortality, PE, symptomatic DVT, symptomatic intracranial hemorrhage, major extracranial hemorrhage R

3.1.2 10 15, 17 Patients with acute stroke (ischemic or hemorrhagic) and restricted mobility Prophylactic-dose unfractionated heparin Prophylactic-dose LMWH Same as above R

3.2.2

3.1.1 11 15, 18 Patients with acute stroke (ischemic or hemorrhagic) and restricted mobility Intermittent pneumatic compression stockings No intermittent pneumatic compression stockings Mortality, PE, symptomatic DVT R

3.2.1

3.1.3 12 15, 19 Patients with acute stroke (ischemic or hemorrhagic) and restricted mobility Elastic compression stockings No elastic compression stockings Mortality, PE, symptomatic DVT, skin complications R

3.2.3

3.2.1 13 15, 20 Patients with primary ICH and restricted mobility Prophylactic-dose heparin No prophylactic-dose heparin Mortality, PE, symptomatic DVT, rebleeding R

3.2.1 14 15, 21 Patients with primary ICH and restricted mobility Early (day 2) prophylactic-dose heparin Late (day 4) prophylactic-dose heparin Same as above R

Secondary stroke prevention

4.1.1 15 22, 23 Patients with a history of noncardioembolic ischemic stroke or TIA Aspirin No aspirin Mortality, nonfatal recurrent stroke, nonfatal MI, nonfatal major extracranial bleeding R

4.1.1 16 22, 24 Patients with a history of noncardioembolic ischemic stroke or TIA Clopidogrel Aspirin Same as above R

4.1.2

4.1.1 17 22, 25 Patients with a history of noncardioembolic ischemic stroke or TIA Aspirin plus dipyridamole Aspirin Same as above R

4.1.2

4.1.1 18 22, 26 Patients with a history of noncardioembolic ischemic stroke or TIA Aspirin plus dipyridamole Clopidogrel Same as above R

4.1.2

4.1.1 19 22, 27 Patients with a history of noncardioembolic ischemic stroke or TIA Aspirin plus clopidogrel Clopidogrel Same as above R

4.1.1 20 22, 28 Patients with a history of noncardioembolic ischemic stroke or TIA Cilostazol Aspirin Same as above R

4.1.2

4.1.1 21 22, 29 Patients with a history of noncardioembolic ischemic stroke or TIA Triflusal Aspirin Same as above R

4.1.1 22 30, 31 Patients with a history of noncardioembolic ischemic stroke or TIA Oral anticoagulation Aspirin Same as above R

4.2.1 23 Patients with AF and a history of stroke or TIA Oral anticoagulation No Oral anticoagulation Same as above R

4.2.2 See You et al3 Patients with AF and a history of stroke or TIA Dabigatran No antiplatelets Same as above R


4.2.3 Patients with AF and a history of stroke or TIA Aspirin and clopidogrel Aspirin Same as above R

4.3 Patients with a history of a primary ICH and an indication for Coumadin for ischemic stroke prevention Antithrombotic therapy No antithrombotic therapy QALY D

Cerebral venous sinus thrombosis

5.1 24 32, 33 Patients with cerebral venous sinus thrombosis Therapeutic anticoagulation No therapeutic anticoagulation Mortality, good functional outcome, nonfatal major bleeding R

AF=atrial fibrillation; C=cohort study; D=decision model; ICH=intracerebral hemorrhage; MI=myocardial infarction; PE=pulmonary embolism; QALY=quality-adjusted life-year; Rec.=recommendation; R=randomized controlled trial; r-tPA=recombinant tissue plasminogen activator; TIA=transient ischemic attack.

a

See supplemental tables in the online supplement.