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Prevention of Stroke in Women

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Î For women with recent transient ischemic attack (TIA) or ischemic stroke (IS) and ipsilateral moderate (50%-69%) carotid stenosis, carotid endarterectomy (CEA) is recommended depending on patient-specific factors, such as age and comorbidities, if the perioperative morbidity and mortality risk is estimated to be <6% (I-B). Î When CEA is indicated for women with TIA or stroke, surgery within 2 weeks is reasonable rather than delaying surgery, if there are no contraindications to early revascularization (IIa-B). Î Aspirin therapy (75-325 mg/d) is reasonable in women with diabetes mellitus unless contraindicated (IIa-B). Î If a high-risk (ie, 10-year predicted CVD risk ≥10%) woman has an indication for aspirin but is intolerant of aspirin therapy, clopidogrel should be substituted (I-B). Î Aspirin therapy can be useful in women ≥65 years of age (81 mg/d or 100 mg every other day) if BP is controlled and the benefit for IS and MI prevention is likely to outweigh the risk of gastrointestinal bleeding and hemorrhagic stroke (IIa-B) and may be reasonable for women <65 years of age for IS prevention (IIb-B). Treatment

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