2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association
Рекомендации 2026 года по раннему ведению пациентов с острым ишемическим инсультом: рекомендации Американской кардиологической ассоциации/Американской ассоциации инсульта
2026-01-26
SCID: 54.1/pbsy5w8b
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acute ischemic strokedysphagia managementendovascular thrombectomyhyperglycemia managementthrombolytic therapy
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Abstract (AI)
AIM: The "2026 Guideline for the Early Management of Patients With AIS" replaces the "2018 Guidelines for the Early Management of Patients With AIS" and the 2019 update to reflect recent advances in evidence. This updated guideline is intended to provide a comprehensive, up-to-date, evidence-based set of recommendations, advising management from prehospital evaluation through acute treatment and early in-hospital management of complications and initiation of early secondary prevention measures. The intended audience includes prehospital care professionals, physicians, allied health professionals, and hospital administrators. METHODS: A search for literature derived from research principally involving human subjects, published in English since the last AIS guideline in 2018 and the 2019 update, and indexed in MEDLINE, PubMed, Cochrane Library, and other selected databases relevant to this guideline, was conducted between September and December 2024. Additional high impact studies and articles published through March 2025 were added later, where appropriate. STRUCTURE: This guideline represents the most current and comprehensive evidence available in AIS care. Key updates include the incorporation of new evidence related to thrombolytic choice and eligibility, determination of eligibility for endovascular thrombectomy, and management of hyperglycemia and dysphagia; a focused consideration of the pediatric population; and modification of the approach to thrombolysis contraindications. Although this guideline reflects significant advances, it also highlights gaps in knowledge and underscores the urgent need for continued research to further refine and improve treatment strategies.
Key Findings
1
It provides comprehensive, evidence-based recommendations spanning prehospital evaluation, acute treatment, early in-hospital complication management, and initiation of secondary prevention.
2
Major updates address thrombolytic selection and eligibility, endovascular thrombectomy eligibility, hyperglycemia and dysphagia management, pediatric stroke, and thrombolysis contraindications.
3
The 2026 guideline replaces the 2018 acute ischemic stroke guideline and its 2019 update, incorporating evidence published through March 2025.
4
The guideline identifies persistent knowledge gaps and emphasizes the need for continued research to refine acute ischemic stroke treatment strategies.
Research Object
Patients with acute ischemic stroke (AIS) undergoing prehospital evaluation, acute treatment, and early in-hospital management
Research Subject
Evidence-based early management, including thrombolytic selection and eligibility, endovascular thrombectomy eligibility, complication management, hyperglycemia and dysphagia management, thrombolysis contraindications, and early secondary prevention
Publication Details
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2026-01-26
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References available in scid.ai3
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association2019
Guidelines for Adult Stroke Rehabilitation and Recovery2016
2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association2021