300 Efficacy of a global atherosclerosis management on the reduction of cardiovascular risk and events after an ischemic stroke

BackgroundAfter an ischemic stroke, the risk of cardiovascular (CV) event is high. The effect of optimal control of risk factors on this high morbi-mortality has not been established in these patients.AimTo evaluate the effect of optimized secondary prevention including dietetic and therapeutic education, on CV risk factor control and CV events occurrence.Patients and method95 selected consecutive patients at high CV risk profile (>3 CVRF) benefited from a 2 days hospitalization 3 months after a stroke focused on evaluating risk factors and atherosclerosis lesions, and on optimizing treatment and education.ResultsIn this high risk population (mean age 60.4±8), we found respectively 24% and 23% of the patients with previously unknown peripheral vascular disease or coronaropathy, and 31% with left ventricular hypertrophy. At follow-up (median 684 days), 81% of the patients still received a combination of antiagregant + blood pressure drugs + statin. In term of secondary prevention goals, 73% of the patients had a normal blood pressure, 72% had a LDL <1g/l, 84% of the diabetics had HbA1c< 7%. 53% of the subjects practiced recommended physical activity. 24% still smoked.ConclusionA global atherosclerosis management and educational program of high-risk patients following stroke is beneficial for the long-term control of cardiovascular risk factors and the sustainability of drug treatments.StudyREACH France populationCardiovascular deaths01,7%Major CV events7,6%10,3%Minor CV events10,0%15,3