Evidence mapPaperPMID 41745720Full record

ReviewNeurology international2026

Primary and Secondary Prevention of Ischemic Stroke in Elderly Patients with Cardiovascular Disease: The Role of Frailty and Care Pathways.

Fabiana Lucà, Roberto Ceravolo, Michele Massimo Gulizia, Sandro Gelsomino, Carmelo Massimiliano Rao, Nadia Ingianni, Giuseppina Vitale, Giovanna Geraci, Attilio Iacovoni, Pietro Scicchitano and 8 more

Abstract readReview
In one paragraph

Review in Neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Fabiana LucàCardiology Department, Grande Ospedale Metropolitano of Reggio Calabria, 89124 Reggio Calabria, Italy.ORCID 0000-0002-5369-5382
Roberto CeravoloCardiology Unit, Giovanni Paolo II Hospital, 88046 Lamezia Terme, Italy.
Michele Massimo GuliziaCardiology Department, Garibaldi Nesima Hospital, 95122 Catania, Italy.
Sandro GelsominoCardiothoracic Department, Maastricht University Hospital, 6229 Maastricht, The Netherlands.ORCID 0000-0002-7746-989X
Carmelo Massimiliano RaoCardiology Unit, Santa Maria Degli Ungheresi Hospital, Polistena, 89024 Reggio Calabria, Italy.
Nadia IngianniCardiologic District, Azienda Sanitaria Provinciale Trapani, 91016 Trapani, Italy.
Giuseppina VitaleNeurology Department, ARNAS Garibaldi Hospital, 95124 Catania, Italy.
Giovanna GeraciCardiology Department, Sant'Antonio Abate Hospital, Erice, 91016 Trapani, Italy.ORCID 0000-0003-0092-8717
Attilio IacovoniDepartment of Transplant Surgery and Surgical Treatment of Heart Failure, Cardiovascular Department, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy.
Pietro ScicchitanoCardiology Section, Hospital "F. Perinei", Altamura, 70022 Bari, Italy.ORCID 0000-0003-0471-0053
Adriano MurroneCardiology, Citta di Castello Hospital, 06012 Citta di Castello, Italy.ORCID 0000-0003-3184-1921
Claudio BilatoCardiology Department, Ovest Vicentino Hospitals, Azienda ULSS 8 Berica, 36100 Vicenza, Italy.ORCID 0000-0003-3474-0579
Luigina GuastiDepartment of Medicine and Surgery, University of Insubria, 21100 Varese, Italy.
Furio ColivicchiClinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, 00135 Roma, Italy.
Fabrizio OlivaCardiology Unit, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy.
Federico NardiCardiology Department, Santo Spirito Hospital, Casale Monferrato, 15033 Alessandria, Italy.ORCID 0000-0002-7743-2587
Massimo GrimaldiCardiology Department, General Regional Hospital "F. Miulli'', Acquaviva delle Fonti, 70021 Bari, Italy.ORCID 0000-0002-9347-8884
Iris ParriniCardiology Unit, Koelliker Hospital, 10134 Torino, Italy.ORCID 0000-0002-0038-9445

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Stroke is a major global health concern, particularly among the elderly, who frequently present with multiple comorbidities, most notably cardiovascular diseases. Importantly, atrial fibrillation confers a nearly fivefold increase in stroke risk and accounts for up to one-quarter of ischemic strokes in older adults. Stroke is a neurological disease characterised by a strong cardiovascular interplay, and its multifactorial nature requires an integrated preventive approach. This review focuses on primary and secondary prevention in this population, with a frailty-informed perspective. We synthesise evidence on blood pressure control, lipid-lowering (including LDL-C targets), glycemic management, and antithrombotic strategies-particularly oral anticoagulation for atrial fibrillation-as well as the role of frailty indices in guiding individualised risk-benefit decisions. We also discuss practical care pathways, including structured post-discharge programs, continuity of care, and the need for multidisciplinary collaboration involving cardiologists, neurologists, and primary care. We highlight how frailty indices refine risk-benefit assessments without justifying therapeutic nihilism, and how sex- and age-related factors shape treatment effectiveness and safety. By narrowing scope and emphasising practical, multidisciplinary prevention strategies, this review aims to support clinicians in reducing recurrent events, disability, and mortality in very old patients. Future work should prioritise pragmatic trials, including those involving the oldest old and the use of standardised frailty metrics, to inform prevention decisions.

Indexed as

atrial fibrillationcardiovascular diseases (CVD)elderly patientsfrailtyintegrated care pathwaysLDL cholesterolmultidisciplinary approachoral anticoagulationsecondary preventionstroke

Identifiers

PMID41745720
PMCPMC12942942

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.