From the Research
Stroke management in Colombia should prioritize primary prevention with medications such as aspirin 81-100mg daily, statins like atorvastatin 20-40mg daily, and antihypertensives like enalapril 5-20mg daily or losartan 25-100mg daily, as well as acute treatment with intravenous alteplase and mechanical thrombectomy, to reduce morbidity, mortality, and improve quality of life. According to the most recent study 1, a multicenter descriptive study was conducted in Colombia using data from the Registry of Stroke Care-Quality (RES-Q) spanning the years 2017 to 2021, which included 7,963 patients. The study found that 14.5% of patients received intravenous thrombolysis therapy, and the door-to-needle time was 53 minutes. Some key points to consider in stroke management in Colombia include:
- Primary prevention with medications such as aspirin, statins, and antihypertensives to reduce the risk of stroke in patients with risk factors 1, 2
- Acute stroke treatment with intravenous alteplase (0.9mg/kg, maximum 90mg) recommended for eligible patients within 4.5 hours of symptom onset, and mechanical thrombectomy available in major urban centers for large vessel occlusions within 24 hours of onset 1
- Post-stroke care typically includes dual antiplatelet therapy (aspirin 100mg plus clopidogrel 75mg daily) for 21 days followed by single antiplatelet therapy, along with rehabilitation services 1
- Public health initiatives focus on risk factor modification through programs targeting hypertension control, smoking cessation, and diabetes management, which are particularly important given the country's increasing rates of obesity and metabolic syndrome 3
- Urban-rural disparities in access to specialized stroke units and advanced imaging are a challenge in Colombia, and efforts should be made to address these disparities to improve stroke care 1