Stroke: February 2018, Volume 49, Number 2
About this course
- Released: 1/22/2018
- Expires: 1/23/2019
STARTING-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Intravenous Thrombolysis for Stroke
Educational Objective for This Article
After reviewing this article, the participant should be able to:
- Define symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke.
- Identify the most important predictors of symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke.
- Explain how the STARTING-SICH (systolic blood pressure, age, onset-to-treatment time for thrombolysis, the National Institutes of Health Stroke Scale score, glucose, aspirin alone, aspirin plus clopidogrel, anticoagulant with international normalized ratio ≤1.7, current infarction sign, hyperdense artery sign) nomogram compares with other scales for assessment of risk of symptomatic intracerebral hemorrhage.
THIS PAGE IS REQUIRED READING BEFORE BEGINNING ALL ACCME-ACCREDITED COURSES
AHA MISSION AND CME GOALS
Since 1900, cardiovascular disease (CVD) has been the No. 1 killer in the United States every year but 1918. Nearly 2,150 Americans die of CVD each day, an average of 1 death every 40 seconds. CVD claims about as many lives each year as the next 2 leading causes of death combined, which are cancer and chronic lower respiratory tract diseases. On average, every 40 seconds, someone in the United States has a stroke, and someone dies of one approximately every 4 minutes (2014 Heart and Stroke Update).
Physicians who treat patients with CVD and stroke have expressed a desire to stay current and for increased knowledge of all areas of cardiovascular disease and stroke. The AHA journals have been at the forefront of cardiovascular disease and stroke research for more than 75 years. The format and design of the AHA journals allow the journals to serve as an effective learning tool for physicians interested in refining their problem solving skills, learning about the cutting edge advances in the fields, and applying this knowledge to patient care.
Readers of the “AHA Journals CME” program should be able to reach the following educational objectives:
- Refine their problem-solving skills and learn about cutting-edge advances in the field.
- Apply knowledge gained by reading the selected article to patient care.
This educational activity is intended for physicians who treat patients with CVDs and stroke.
ACCREDITATION AND CREDIT DESIGNATION STATEMENT
The American Heart Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The American Heart Association designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
As a provider that is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the American Heart Association must ensure fair balance, independence, objectivity, and scientific rigor in all its individually provided or jointly provided educational activities. Therefore, the CME editors participating in continuing medical education (CME) activities provided by the American Heart Association must disclose to the audience: (1) any significant financial relationships with the manufacturer(s) of products from the commercial supporter(s) and/or the manufacturer(s) of products or devices discussed in the activity, and (2) unlabeled/unapproved uses of drugs or devices discussed in the activity. The intent of this disclosure is not to prevent a CME editor with a significant financial or other relationship from contributing, but rather to provide participants with information with which they can make their own judgments. It remains for the participants to determine whether the CME editor's interests or relationships may influence the content.
- Erica Camargo Faye, MD, PhD, MMSC, CME Editor for Stroke, discloses the following:
- Dr Camargo Faye has no financial interests to disclose.
- Vasileios-Arsenios Lioutas, MD, CME Editor for Stroke, discloses the following:
- Dr Lioutas has no financial interests to disclose.
Authors of articles selected for inclusion in the AHA Journals CME, an educational activity provided by the American Heart Association, have disclosed to journal readers (1) significant financial relationships with the manufacturer(s) of products from the commercial supporter(s) and /or the manufacturer(s) of products or devices discussed in their article, and (2) unlabeled/unapproved uses of drugs or devices discussed in their article. Such disclosures appear with each article in the section labeled "Disclosures". If the article authors have no relationships to disclose, "None" will be listed in this section.
*A relationship is considered to be "significant" if (a) the person receives $10,000 or more during any 12-month period, or 5% or more of the person's gross income; or (b) the person owns 5% or more of the voting stock or share of the entity, or owns $10,000 or more of the fair market value of the entity. A relationship is considered to be "modest" if it is less than "significant" under the preceding definition.