Abstract
The study demonstrated a 17% absolute risk reduction (ARR) in reducing recurrent stroke in patients with symptomatic carotid disease who underwent carotid endarterectomy (CEA) compared to best medical management, mainly aspirin and risk factor reduction. [4] Medical management of large artery atherosclerosis-related stroke management underwent a dramatic change with wider implementation of risk factor reduction strategies and introduction of HMG-CoA Reductase Inhibitors (statins), nonexistent at the time of the NASCET or ECST trials. [4] In this issue, the investigators at a large university teaching hospital in Hyderabad, India, report the results of best medical therapy (vascular risk factor reduction, high-dose statins, dual antiplatelet therapy for 3 months and blood pressure reduction to <140/90 mmHg versus carotid intervention in symptomatic carotid artery disease.
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1 UMass Memorial Medical Center, Worcester, Massachusetts