美国心脏学会/美国卒中学会卒中一级预防指南：十年磨一剑 The 2024 Guideline for the Primary Prevention of Stroke: Ten Years of Hard and Persistent Effort

Abstract

“十年磨一剑”——2024年12月，美国心脏学会/美国卒中学会发布了新版卒中一级预防指南。与2014年发布的上一版卒中一级预防指南相比，新指南强调关注宏观社会因素、整体评估和控制危险因素、全面预防（包括非动脉粥样硬化性卒中）、重视特殊人群和特殊危险因素。对于中等心脑血管疾病风险人群，目前卒中一级预防的研究证据尚不足以证实阿司匹林的有效性和安全性。需要结合多组学、人工智能、大数据和模拟随机对照试验等方法，选择以患者为中心的研究终点来完善证据，指导实践。 Abstract: A ten-year effort is just for this day, the 2024 guideline for the primary prevention of stroke from the American Heart Association/American Stroke Association was published in December 2024. Compared to the previous edition in 2014, the 2024 guideline focuses on macro-social factors, overall evaluation and management of the risk factors, holistic prevention (including non-atherosclerotic stroke), and paying attention to special populations and specific risk factors. For people with a moderate risk of cardiovascular and cerebrovascular disease, the current research evidence for the primary prevention of stroke is not yet sufficient to confirm the effectiveness and safety of aspirin. Methods such as multi-omics, artificial intelligence, big data, and simulated randomized controlled trials need to be combined to select patient-centered research endpoints to refine the evidence and guide practice.

Keywords

• 卒中
• 一级预防
• 指南
• stroke
• primary prevention
• guideline