New recommendation Drug abuse Referral to an appropriate therapeutic program is reasonable for patients who abuse drugs that have been associated with stroke, including cocaine, khat, and amphetamines (Class IIa; Level of Evidence C). Wording slightly revised to specifically list drugs associated with stroke Sleep-disordered breathing Because of its association with stroke risk, screening for sleep apnea through a detailed history, including structured questionnaires such as the Epworth Sleepiness Scale and Berlin Questionnaire, physical examination, and, if indicated, polysomnography may be considered (Class IIb; Level of Evidence C). Wording slightly revised to include polysomnography and use of specific questionnaires. Recommendation class and LOE have been downgraded. Elevated lipoprotein(a) The clinical benefit of using lipoprotein(a) in stroke risk prediction is not well established (Class IIb; Level of Evidence B). New recommendation Inflammation and infection Treatment of patients with high-sensitivity C-reactive protein >2.0 mg/dL with a statin to decrease stroke risk might be considered (Class IIb; Level of Evidence B). The revised recommendation now defines elevated high-sensitivity C-reactive protein as >2.0 mg/ dL in the context of considering statin initiation Antiplatelet agents and aspirin The use of aspirin for cardiovascular (including but not specific to stroke) prophylaxis is reasonable for people whose risk is sufficiently high (10-y risk >10%) for the benefits to outweigh the risks associated with treatment. A cardiovascular risk calculator to assist in estimating 10-y risk can be found online at http://my.americanheart.org/cvriskcalculator (Class IIa; Level of Evidence A). Reworded to include cardiovascular risk calculator and link; changed from Class I to IIa Aspirin might be considered for the prevention of a first stroke in people with chronic kidney disease (ie, estimated glomerular filtration rate <45 mL min 1 ) (Class IIb; Level of Evidence C). 