(v) Atrial fibrillation Aggressive screening for atrial fibrillation in patients over 65 years of age by pulse check, with additional electrocardiography if necessary, in the primary care setting may be beneficial (Class IIa/Grade B). In all patients with non-valvular atrial fibrillation with a high risk of stroke (hereafter referred to as risk) and in most patients with non-valvular atrial fibrillation with a moderate risk, if medication safety can be assured Warfarin is recommended with dose adjustments to achieve an international normalized prothrombin time (INR) of 2.0-3.0 (Class I/Grade A); for low-risk patients and some intermediate-risk patients, aspirin antiplatelet therapy (Class I/Grade A) may be recommended based on patient preference, anticoagulation bleeding risk assessment, and monitoring of anticoagulation markers; for high-risk AF patients who are not candidates for anticoagulation In high-risk patients with atrial fibrillation who are not amenable to anticoagulation, dual antiplatelet therapy with clopidogrel + aspirin may provide better stroke prevention compared with aspirin alone, but also increases the risk of serious bleeding and may be justified (Class IIb/Grade B); In older patients with atrial fibrillation, antithrombotic therapy combined with aggressive blood pressure management may be beneficial (Class IIa/Grade B). (vi) Cardiac issues The American College of Cardiology and Heart Association (ACC/AHA) guidelines provide strategies related to stroke risk reduction for a variety of cardiac disorders (including heart valve disease, unstable angina, chronic stable angina, and acute myocardial infarction), which should be endorsed in this guideline; cardiac disease is not recommended for patients without neurologic pathology, or without a specific cardiac cause The use of warfarin for stroke prevention is reasonable in patients with ST-segment elevation after myocardial infarction with left ventricular appendage thrombosis or left ventricular wall segmental motion inability (Class IIa/Class A). (vii) Asymptomatic carotid stenosis Patients with asymptomatic carotid stenosis should be screened for other treatable risk factors for stroke and treated with appropriate lifestyle modification and medication (Class I/Class C). The choice of carotid angioplasty, including endarterectomy (CEA) and stenting (CAS), for patients with asymptomatic carotid stenosis should be based on an assessment of systemic disease and life expectancy. consideration of individual factors, adequate discussion of the benefits and risks of the procedure, and understanding of patient preferences (Class I/Class C); given that all carotid endarterectomy (CEA) studies used aspirin as an antiplatelet agent, the use of aspirin as an adjunctive therapy is recommended for all patients with CEA except for contraindications (Class I/Class C); in selected patients with asymptomatic carotid stenosis (angiographic stenosis > 60%, or Doppler ultrasound stenosis >70% and proven) in selected patients with asymptomatic carotid stenosis, prophylactic CEA procedures are beneficial only when residual rates and mortality are <3% (Class IIa/Class A). It is important to note that, due to advances in pharmacologic therapy, the benefits of surgery proven in previous trials may be relatively low and the proposed 3% allowance for surgical comorbidities may be high; in selected patients with asymptomatic carotid stenosis (arteriogram >60%, confirmed Doppler ultrasound >70%, or ultrasound stenosis of 50%-69% but CTA or MRA >80%), consideration may be given to Perform prophylactic carotid artery stenting (CAS). The superiority of angioplasty over current pharmacologic therapy is not well established (Class IIb/Grade B); the effectiveness of CAS as an alternative therapy in patients with asymptomatic carotid stenosis who are at greater risk for CEA surgery has not been established (Class IIb/Grade C); and screening for asymptomatic carotid stenosis in the population is not recommended (Class III/Grade B). (viii) Sickle cell disease (SCD) Children with SCD should be screened for stroke risk with transcranial Doppler cerebrovascular ultrasound (TCD) from age 2 years (Class I/Grade B); the optimal screening interval is not defined, but more frequent screening is reasonable in younger children and in children with TCD flow velocities at the borderline of abnormality for timely detection of high-risk TCD flow velocity changes requiring treatment (Class IIa/Grade B) For children at high risk of stroke, transfusion therapy (target: S-hemoglobin reduction from >90% to <30%) is effective in reducing stroke risk (Class I/Grade B); continued transfusion is likely to be required pending further study results, including those whose TCD flow rates have returned to normal (Class IIa/Grade B) For the selection of indications for transfusion for stroke prevention, the criteria for magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain have not been established and are not recommended as an alternative to TCD for this purpose (Class III/Grade B). Class A). (ix) Hormone replacement therapy during menopause Hormone therapy (estrogen ± megestrol acetate) should not be used for primary stroke prevention in postmenopausal women (Class III/Class A); selective stimulant receptor modulators (raloxifene, tamoxifen, tibolone, etc.) should not be used for primary stroke prevention (Class III/Class A).