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Table 3 Numbers and proportions of community physicians’ (N = 1,910) answers to multiple-choice questions on acute treatment and secondary prevention of ischemic stroke or TIAa

From: Community physicians’ knowledge of secondary prevention after ischemic stroke: a questionnaire survey in Shanxi Province, China

Questions & Answers

Numbers

Proportions

Q1. For eligible ischemic stroke patients, what is the recommended time window for intravenous fibrinolytic therapy with rtPA?

  

 3 hours

686

35.9 %

 4 hours

180

9.4 %

 4.5 hoursb

275

14.4 %

 6 hours

769

40.3 %

Q2. In secondary prevention for ischemic stroke or TIA, which of the following antihypertensive recommendations should be used in patients with elevated blood pressure?

  

 20/15 mmHg

330

17.3 %

 15/10 mmHg

600

31.4 %

 10/5 mmHgb

945

49.5 %

 5/0 mmHg

35

1.8 %

Q3. If necessary to prevent recurrent stroke or other vascular events in ischemic stroke or TIA patients, when is it recommended to initiate antihypertensive therapy?

  

 Immediately

344

18.0 %

 Beyond 24 hoursb

1,112

58.2 %

 Beyond 1 week

260

13.6 %

 Beyond 2 weeks

194

10.2 %

Q4. What is the approximate percentage of cardiogenic cerebral embolism in all ischemic strokes?

  

 5 %

319

16.7 %

 10 %

386

20.2 %

 15 %

405

21.2 %

 20%b

800

41.9 %

Q5. For ischemic stroke or TIA patients with AF, what is the recommended first-choice medication, if no contraindication exists?

  

 Antiplatelet medication

524

27.4 %

 Oral anticoagulantb

1,247

65.3 %

 Defibrase

105

5.5 %

 Others, i.e., traditional Chinese medicine

34

1.8 %

Q6. What is the target INR for ischemic stroke or TIA patients with AF receiving anticoagulation with a vitamin K antagonist?

  

 1–2

180

9.4 %

 2–3b

1,507

78.9 %

 3–4

195

10.2 %

 4–5

28

1.5 %

Q7. For ischemic stroke or TIA patients with AF who are unable to take oral anticoagulants, what medication is recommended?

  

 Aspirin aloneb

504

26.4 %

 Clopidogrel alone

398

20.8 %

 Combination of clopidogrel and aspirin

1,008

52.8 %

 Do not use any other medications

0

0

Q8. For ischemic stroke or TIA with acute myocardial infarction complicated by left ventricular mural thrombus formation identified by echocardiography or other cardiac imaging techniques, for at least how long should the patients be treated with oral anticoagulation?

  

 3 monthsb

514

26.9 %

 6 months

760

39.8 %

 9 months

120

6.3 %

 12 months

516

27.0 %

Q9. For ischemic stroke or TIA patients with rheumatic mitral valve disease, is long-term warfarin therapy recommended whether or not AF is present?

  

 Yesb

1,215

63.6 %

 No

487

25.5 %

 No idea

208

10.9 %

Q10. For patients with noncardioembolic ischemic stroke or TIA, what medications are recommended to reduce the risk of recurrent stroke and other cardiovascular events?

  

 Antiplateletsb

1,280

67.0 %

 Oral anticoagulants

29

26.1 %

 Traditional Chinese medicine

131

6.9 %

Q11. Is aspirin plus clopidogrel recommended for routine secondary prevention after ischemic stroke or TIA?

  

 Yes

886

46.4 %

 Nob

774

40.5 %

 No idea

250

13.1 %

Q12. Is there evidence that reducing homocysteine levels prevents stroke recurrence in ischemic stroke or TIA patients?

  

 Yes

1,322

69.2 %

 Nob

217

11.4 %

 No idea

371

19.4 %

Q13. Is postmenopausal hormone therapy recommended for women with ischemic stroke or TIA?

  

 Yes

562

29.4 %

 Nob

894

46.8 %

 No idea

454

23.8 %

  1. AF atrial fibrillation, INR international normalized ratio, rtPA recombinant tissue-type plasminogen activator, TIA transient ischemic attack
  2. aThe questions and answers were designed to reflect relevant American Heart Association/American Stroke Association guidelines (AHA/ASA) [7, 10]
  3. bRecommendations from relevant AHA/ASA guidelines [7, 10]