This NEJM review provided a comprehensive update on secondary prevention after ischemic stroke, covering modifiable risk factors, mechanism-specific therapies, and contemporary evidence on anticoagulation, antiplatelet therapy, and lipid lowering for recurrent stroke prevention.
The risk of recurrent ischemic stroke can be reduced by managing modifiable risk factors and instituting a regimen of mechanism-specific secondary stroke prevention. Strategies for secondary prevention should be instituted as early as possible. Poststroke monitoring of risk metrics, lifestyle behaviors, and medication recommendations is of key importance.