Stroke is the second most common cause of death worldwide and a major source of morbidity. Stroke is strongly associated with atrial fibrillation, the most prevalent cardiac arrhythmia, and with transcatheter aortic valve therapeutics, the use of which is becoming more widespread. This collection of articles from Nature Reviews Cardiology and Nature Reviews Neurology comprises a selection of three Reviews, one Perspectives article and five News & Views, which explore advances in our understanding of the pathophysiology, assessment, prevention and management of ischemic stroke.


REVIEWS

Anticoagulant therapy for patients with ischaemic stroke

Graeme J. Hankey

doi:10.1038/nrneurol.2012.77

Nature Reviews Neurology 8, 319-328 (2012)

Anticoagulant therapy aims to prevent recurrent ischaemic stroke and venous thromboembolism; however, anticoagulant drugs currently in use or in trials have limitations. In this article, Graeme Hankey provides an update of the clinical data on the safety and efficacy of anticoagulant therapies, and discusses the clinical implications and future directions.

Oral direct factor Xa inhibitors for stroke prevention in atrial fibrillation

Katherine P. Cabral & Jack Ansell

doi:10.1038/nrcardio.2012.19

Nature Reviews Cardiology 9, 385-391 (2012)

Oral direct factor Xa inhibitors, particularly apixaban and rivaroxaban, are novel and promising alternatives to warfarin for stroke prevention in patients with atrial fibrillation. Drs Cabral and Ansell review the data from clinical trials of these drugs, and also discuss the challenges of reversing their anticoagulant effects, interactions with other medications, patient compliance, and therapeutic monitoring.

The immunology of acute stroke

Ángel Chamorro, Andreas Meisel, Anna M. Planas, Xabier Urra, Diederik van de Beek & Roland Veltkamp

doi:10.1038/nrneurol.2012.98

Nature Reviews Neurology 8, 401-410 (2012)

The immune response is increasingly recognised as a complex modulator of outcome after acute stroke. Chamorro and colleagues review key players of the innate and adaptive immune systems that are activated following brain ischaemia, and discuss stroke-induced immunodepression and the associated increased risk of infection in patients with stroke.

PERSPECTIVES

Time to rethink management strategies in asymptomatic carotid artery disease

A. Ross Naylor

doi:10.1038/nrcardio.2011.151

Nature Reviews Cardiology 9, 116-124 (2012)

No worldwide consensus exists regarding the best way to manage patients with asymptomatic carotid artery stenosis (CAS). In this thought-provoking article, Professor A. Ross Naylor presents his argument against the use of a 'one size fits all' approach involving the costly widespread use of surgical or percutaneous interventions, a high percentage of which are unnecessary. Instead, he recommends that the medical community should increase efforts to identify those at particularly high risk for stroke, who are the only patients likely to really benefit from these interventions

NEWS & VIEWS

Stroke: Expanded indications for stroke thrombolysis—what next?

Geoffrey A. Donnan & Stephen M. Davis

doi:10.1038/nrneurol.2012.151

Nature Reviews Neurology 8, 482-483 (2012)

Stroke: Optimization of the timing of carotid endarterectomy

Fiona Kennedy & Martin M. Brown

doi:10.1038/nrneurol.2012.116

Nature Reviews Neurology 8, 367-368 (2012)

Stroke: TOAST to CASCADE—a childhood stroke classification system

Meredith R. Golomb

doi:10.1038/nrneurol.2012.32

Nature Reviews Neurology 8, 184-185 (2012)

Interventional cardiology: Delayed stroke after TAVI—the role of new-onset AF

Jörg Kempfert & Thomas Walther

doi:10.1038/nrcardio.2012.6

Nature Reviews Cardiology 9, 129-130 (2012)

Stroke: Geometry is destiny for carotid atherosclerotic plaques

Mark Fisher

doi:10.1038/nrneurol.2012.1

Nature Reviews Neurology 8, 127-129 (2012)

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