The role of cardiologists in stroke prevention and treatment: position paper of the European Society of Cardiology Council on Stroke
Abstract
Stroke is a vascular disease with cerebral consequences, where the heart is a key player. It is defined as 'a clinical syndrome typified by rapidly developing signs of focal or global disturbance of cerebral functions, lasting more than 24 h or leading to death, with no apparent causes other than of vascular origin'.
The incidence of stroke varies between 100-400 per 100 000 per year and mortality ranks second after coronary heart disease. Beyond mortality stroke is the largest single cause of physical disability in adults, second cause of dementia (after Alzheimer disease), major cause of depression, falls and epilepsy in the elderly.
Stroke hence presents a tremendous burden both on patients as well as families and health care systems. Despite decreasing mortality rates in recent years, hospitalization numbers are increasing and long-term care and secondary prevention of stroke will have to move even more in the focus of clinical and health economic efforts.
Most strokes (85%) are ischaemic and 15-20% are haemorrhagic. At least 25% of ischaemic strokes are of definite cardio-embolic origin and about a further 20-25% are of suspected cardiac origin or involvement.
Most importantly, stroke is clearly recognized as a preventable disease. This article summarizes the views and aims of the recently founded European Society of Cardiology (ESC) Council on Stroke focusing on the role of cardiologists in comprehensive and state of the art stroke treatment, as in, prevention, diagnosis, rehabilitation, and long-term care of stroke.