In 2011, the American Heart Association/American Stroke Association recommended alpha-galactosidase enzyme replacement therapy for prevention of stroke in patients with ischaemic stroke or transient ischaemic attack with Fabry disease (class I; level B evidence); however, this recommendation was removed in the subsequent 2014 edition of the guidelines given "the rarity and specialized nature of this condition" [44]. The gene discussed is GLA; the disease is Fabry disease.