Abstract
The major risk factors related with ICAD include diabetes mellitus (DM), hypertension (HTN), metabolic syndrome, hyperlipidemia, sedentary lifestyle, and smoking. [3],[4] Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis trial (SAMMPRIS) demonstrated that aggressive management of the risk factors [dual antiplatelet treatment with aspirin and clopidogrel (DAPT) for 3 months, high-dose statins, control of DM and HTN, and life-style modification] reduced recurrent ischemic stroke and was superior to management with added stenting of the symptomatic intracranial artery (absolute benefit of 8.9%). Increasing awareness and early recognition and management of risk factors, especially diabetes and hyperlipidemia must be the first step in reducing ICAD-related strokes in this high-risk population.
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1 Professor of Neurology and Psychiatry, Director of Stroke Services and Fellowship Program, UMass Memorial Medical Center, Worcester, Massachusetts; Director of Stroke and Sleep Programs, Day Kimball Hospital, Putnam Connecticut, Putnam, CT