Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke

Author:

Lip Gregory Y H1234ORCID,Lane Deirdre A12,Lenarczyk Radosław3,Boriani Giuseppe5ORCID,Doehner Wolfram6ORCID,Benjamin Laura A7,Fisher Marc8,Lowe Deborah9,Sacco Ralph L10,Schnabel Renate11,Watkins Caroline12,Ntaios George13ORCID,Potpara Tatjana414ORCID

Affiliation:

1. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital , Liverpool , UK

2. Department of Clinical Medicine, Aalborg University , Aalborg , Denmark

3. Division of Medical Sciences in Zabrze, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, The Medical University of Silesia, Silesian Center of Heart Diseases , Curie-Sklodowska Str 9, 41-800 Zabrze , Poland

4. School of Medicine, Belgrade University , Belgrade , Serbia

5. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena , Modena , Italy

6. BIH Center for Regenerative Therapies (BCRT) and Department of Internal Medicine and Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK) partner site Berlin and Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin , Berlin , Germany

7. Laboratory of Molecular and Cell Biology, University College London National Hospital for Neurology and Neurosurgery , Queen Square, London

8. Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA , USA

9. Wirral University Teaching Hospital NHS Foundation Trust , Wirral CH49 5PE , UK

10. UM Clinical & Translational Science Institute, University of Miami, Miller School of Medicine , Miami, FL , USA

11. University Heart & Vascular Center Hamburg Eppendorf, German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck , Hamburg , Germany

12. Faculty of Health and Care, University of Central Lancashire , Preston PR1 2HE , UK

13. Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Thessaly , Larissa , Greece

14. Cardiology Clinic, Clinical Centre of Serbia , Belgrade , Serbia

Abstract

AbstractThe management of patients with stroke is often multidisciplinary, involving various specialties and healthcare professionals. Given the common shared risk factors for stroke and cardiovascular disease, input may also be required from the cardiovascular teams, as well as patient caregivers and next-of-kin. Ultimately, the patient is central to all this, requiring a coordinated and uniform approach to the priorities of post-stroke management, which can be consistently implemented by different multidisciplinary healthcare professionals, as part of the patient ‘journey’ or ‘patient pathway,’ supported by appropriate education and tele-medicine approaches. All these aspects would ultimately aid delivery of care and improve patient (and caregiver) engagement and empowerment. Given the need to address the multidisciplinary approach to holistic or integrated care of patients with heart disease and stroke, the European Society of Cardiology Council on Stroke convened a Task Force, with the remit to propose a consensus on Integrated care management for optimizing the management of stroke and associated heart disease. The present position paper summarizes the available evidence and proposes consensus statements that may help to define evidence gaps and simple practical approaches to assist in everyday clinical practice. A post-stroke ABC pathway is proposed, as a more holistic approach to integrated stroke care, would include three pillars of management: A: Appropriate Antithrombotic therapy.B: Better functional and psychological status.C: Cardiovascular risk factors and Comorbidity optimization (including lifestyle changes).

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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