Article
Clinical Neurology
Iain J. McGurgan, Peter J. Kelly, Tanya N. Turan, Peter M. Rothwell
Summary: Reducing blood pressure is an effective strategy for long-term stroke prevention, but there is still uncertainty surrounding the issue of BP lowering after a stroke and the risk of recurrent stroke, coronary events, and vascular death. Questions in secondary prevention include who should be treated, when should BP-lowering treatment be commenced, how intensively should BP be lowered, what drugs are best, and how should long-term BP control be optimized and monitored.
Article
Cardiac & Cardiovascular Systems
Naja Emborg Vinding, Jawad H. Butt, Marie Dam Lauridsen, Soren Lund Kristensen, Soren Paaske Johnsen, Johanna Kroll, Peter L. Graversen, Christina Kruuse, Christian Torp-Pedersen, Lars Kober, Emil L. Fosbol
Summary: The incidence of ischemic stroke after a first-time transient ischemic attack (TIA) is 6.1% during a 5-year follow-up period, which is higher than the background population but lower than patients with recurrent ischemic stroke. TIA patients also have a higher mortality rate.
Article
Clinical Neurology
Kirtipal Bhatia, Vardhmaan Jain, Devika Aggarwal, Muthiah Vaduganathan, Sameer Arora, Zeeshan Hussain, Guneesh Uberoi, Alfonso Tafur, Cen Zhang, Mark Ricciardi, Arman Qamar
Summary: This study found that early initiation of short-term DAPT following high-risk transient ischemic attack or mild-moderate ischemic stroke can reduce the risk of recurrent stroke while increasing the risk of major bleeding.
Article
Clinical Neurology
Nanxiang Ouyang, Chuning Shi, Xiaofan Guo, Yihan Chen, Yingxian Sun
Summary: The study found that the control of risk factors after IS/TIA needs to be improved in rural communities of northeastern China, especially in terms of blood pressure and achieving physical exercise targets, in order to reduce the risk of stroke recurrence.
ACTA NEUROLOGICA SCANDINAVICA
(2021)
Article
Biochemistry & Molecular Biology
Salman M. Toor, Eman K. Aldous, Aijaz Parray, Naveed Akhtar, Yasser Al-Sarraj, Essam M. Abdelalim, Abdelilah Arredouani, Omar El-Agnaf, Paul J. Thornalley, Sajitha V. Pananchikkal, Ghulam Jeelani Pir, Raheem Ayadathil, Ashfaq Shuaib, Nehad M. Alajez, Omar M. E. Albagha
Summary: Transient ischemic attack (TIA) is a temporary neurologic deficit caused by ischemic insult to the brain, spinal cord, or retina. TIA is associated with a high risk of impending acute ischemic stroke (AIS), a condition characterized by focal infarction in the brain, spinal cord, or retina. This study investigated the differences in circulating microRNA profiles between AIS and TIA patients and identified a panel of differentially regulated microRNAs. Furthermore, a multivariate classifier was developed that could potentially be used as a biomarker to distinguish AIS and TIA patients. Understanding the molecular pathways in AIS compared to TIA may have important implications for therapeutic targeting in clinical translation.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Clinical Neurology
Jiejie Li, Yuesong Pan, Jie Xu, Shiyu Li, Mengxing Wang, Kehua Quan, Xia Meng, Hao Li, Jinxi Lin, Yilong Wang, Xingquan Zhao, Liping Liu, Yongjun Wang
Summary: Residual inflammatory risk only may predict recurrent stroke and poor functional outcome in patients with acute ischemic stroke or transient ischemic attack, especially in those with large-artery atherosclerosis.
Review
Pharmacology & Pharmacy
Lorenzo Scalia, Dario Calderone, Davide Capodanno
Summary: This review provides an overview of current evidence on antiplatelet therapy for patients with non-cardioembolic stroke or TIA, and suggests recommended drug treatment options and new research directions.
EXPERT REVIEW OF CLINICAL PHARMACOLOGY
(2022)
Review
Clinical Neurology
Dawn O. Kleindorfer, Amytis Towfighi, Seemant Chaturvedi, Kevin M. Cockroft, Jose Gutierrez, Debbie Lombardi-Hill, Hooman Kamel, Walter N. Kernan, Steven J. Kittner, Enrique C. Leira, Olive Lennon, James F. Meschia, Thanh N. Nguyen, Peter M. Pollak, Pasquale Santangeli, Anjail Z. Sharrief, Sidney C. Smith, Tanya N. Turan, Linda S. Williams
Summary: Additional digital content is available in the text.
Article
Rehabilitation
Nicholas Geldens, Gary Crowfoot, Anne Sweetapple, Glade Vyslysel, Gillian Mason, Coralie English, Heidi Janssen
Summary: Patient readiness for secondary prevention and lifestyle change following transient ischemic attack is individual and complex. Individual knowledge, personal experience of the event, socio-environmental factors, and the format and content of education influence patient readiness. Logistical factors such as location, time, and cost of education, as well as timing of education delivery and patient perspectives should be considered in the development and delivery of interventions.
DISABILITY AND REHABILITATION
(2021)
Article
Pharmacology & Pharmacy
Jigang Chen, Linjin Ji, Xin Tong, Mingyang Han, Songfeng Zhao, Yongkai Qin, Zilong He, Zhiqun Jiang, Aihua Liu
Summary: This study found that early treatment with a 30-day combination therapy of ticagrelor plus aspirin is highly cost-effective for patients with acute mild-to-moderate ischemic stroke or transient ischemic attack in China.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Clinical Neurology
Mohammad Anadani, Adam de Havenon, Nils Henninger, Lindsey Kuohn, Brian Mac Grory, Karen L. Furie, Anthony S. Kim, J. Donald Easton, S. Claiborne Johnston, Shadi Yaghi
Summary: Dual antiplatelet therapy reduces the risk of ischemic stroke in patients with minor stroke and high-risk transient ischemic attack, regardless of prior antiplatelet use.
Article
Clinical Neurology
Deborah A. Levine, Anthony J. Perkins, Jason J. Sico, Laura J. Myers, Michael S. Phipps, Ying Zhang, Dawn M. Bravata
Summary: The study revealed that hospitals admitting higher percentages of TIA patients and having higher emergency physician staffing showed better performance on TIA process measures, with increased emergency physician staffing associated with improved outcomes 90 days after TIA.
Article
Radiology, Nuclear Medicine & Medical Imaging
Song Liu, Ruowei Tang, Weiwei Xie, Shengting Chai, Qingqing Zhang, Yu Luo, Yu Guo, Chao Chai, Lixiang Huang, Meizhu Zheng, Jinxia Zhu, Binge Chang, Qi Yang, Song Jin, Zhaoyang Fan, Shuang Xia
Summary: The characteristics of plaque in the middle cerebral artery (MCA) and hemodynamics may help predict the occurrence of ischemic stroke and neurological impairment. Intraplaque hemorrhage (IPH) and anterograde score (AnS) are independent predictors for stroke occurrence. Tmax > 6.0-s volume, IPH, hypertension, and AnS are associated with neurological impairment in patients.
EUROPEAN RADIOLOGY
(2021)
Article
Clinical Neurology
Paul M. Wechsler, Ava L. Liberman, Daniel Restifo, Erika L. Abramson, Babak B. Navi, Hooman Kamel, Neal S. Parikh
Summary: This study analyzed the cost-effectiveness of smoking cessation interventions in the population of stroke and transient ischemic attack survivors. The results showed that varenicline, pharmacotherapy with intensive counseling, and monetary incentives were all more effective and cost less compared to brief counseling alone in secondary stroke prevention. Overall, delivering smoking cessation therapy beyond brief counseling alone was found to be cost-effective and potentially cost-saving.
Article
Medicine, General & Internal
Masoud Nouri-Vaskeh, Neda Khalili, Alireza Sadighi, Yalda Yazdani, Ramin Zand
Summary: Cerebrovascular disease is a leading cause of long-term disability worldwide, and early diagnosis of transient ischemic attack (TIA) is crucial for reducing mortality and morbidity. Patients with TIA are at high risk for early subsequent ischemic stroke and permanent nervous system damage. TIA diagnosis relies heavily on the patient's medical history assessment. There are increasing numbers of biomarkers associated with different components of the brain's ischemic cascade, and this review focuses on the clinically important ones and their validity based on recent evidence of their reliability for practical use.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Julie Ottoy, Miracle Ozzoude, Katherine Zukotynski, Sabrina Adamo, Christopher Scott, Vincent Gaudet, Joel Ramirez, Walter Swardfager, Hugo Cogo-Moreira, Benjamin Lam, Aparna Bhan, Parisa Mojiri, Min Su Kang, Jennifer S. Rabin, Alex Kiss, Stephen Strother, Christian Bocti, Michael Borrie, Howard Chertkow, Richard Frayne, Robin Hsiung, Robert Laforce, Michael D. Noseworthy, Frank S. Prato, Demetrios J. Sahlas, Eric E. Smith, Phillip H. Kuo, Vesna Sossi, Alexander Thiel, Jean-Paul Soucy, Jean-Claude Tardif, Sandra E. Black, Maged Goubran
Summary: This study investigated the association between cerebrovascular burden and cognitive function, and found that the relationship was mainly mediated by localized neurodegeneration rather than amyloid beta deposition. The results suggest an amyloid-independent pathway through which vascular burden affects cognitive function.
ALZHEIMERS & DEMENTIA
(2023)
Article
Clinical Neurology
Nicolas Raposo, Maria Clara Zanon Zotin, David J. Seiffge, Qi Li, Martina B. Goeldlin, Andreas Charidimou, Ashkan Shoamanesh, Hans Rolf Jager, Charlotte Cordonnier, Catharina Jm Klijn, Eric E. Smith, Steven M. Greenberg, David J. Werring, Anand Viswanathan
Summary: The study developed a new classification system called CLAS-ICH for subtyping intracerebral hemorrhage (ICH) based on recent advances in neuroimaging. The system assigns scores to each category to determine the underlying causes of ICH. The system was validated in two cohorts and demonstrated reliability and consistency.
ANNALS OF NEUROLOGY
(2023)
Article
Geriatrics & Gerontology
Landon Perlett, Eric E. Smith
CLINICS IN GERIATRIC MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Muhammad Shahzeb Khan, Aymen Ahmed, Stephen J. Greene, Mona Fiuzat, Michelle M. Kittleson, Javed Butler, George L. Bakris, Gregg C. Fonarow
Summary: Heart failure and end-stage kidney disease often coexist and worsen each other's prognosis. Patients on dialysis are at high risk, but they have been excluded from major clinical trials on heart failure, resulting in a lack of data and reliance on observational evidence. In clinical practice, heart failure treatment is often reduced or discontinued in patients with end-stage kidney disease undergoing dialysis due to safety concerns. This review discusses the available evidence, challenges, and future directions for optimizing heart failure management in these high-risk patients.
JOURNAL OF CARDIAC FAILURE
(2023)
Article
Medicine, General & Internal
Brian Mac Grory, DaJuanicia N. Holmes, Roland A. Matsouaka, Shreyansh Shah, Cherylee W. J. Chang, Richard Rison, Jenelle Jindal, Christine Holmstedt, William R. Logan, Candy Corral, Jason S. Mackey, Joey R. Gee, David Bonovich, James Walker, Toby Gropen, Curtis Benesch, Jonathan Dissin, Hemant Pandey, David Wang, Martin Unverdorben, Adrian F. Hernandez, Mathew Reeves, Eric E. Smith, Lee H. Schwamm, Deepak L. Bhatt, Jeffrey L. Saver, Gregg C. Fonarow, Eric D. Peterson, Ying Xian
Summary: The use of oral vitamin K antagonists (VKAs) may increase the risk of complications for patients undergoing endovascular thrombectomy for acute ischemic stroke caused by large vessel occlusion. Recent use of VKAs with an international normalized ratio (INR) greater than 1.7 is associated with a significantly higher risk of symptomatic intracranial hemorrhage (sICH) compared to no use of anticoagulants.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Clinical Neurology
Alvin S. S. Das, Elif Gokcal, Alessandro Biffi, Robert W. W. Regenhardt, Marco Pasi, Avia A. Abramovitz Fouks, Anand Viswanathan, Joshua Goldstein, Lee H. H. Schwamm, Jonathan Rosand, Steven M. M. Greenberg, M. Edip Gurol
Summary: This study examined the association between cerebral amyloid angiopathy (CAA) markers and mixed intracerebral hemorrhage (ICH) with cortical superficial siderosis (cSS). The results showed that patients with mixed ICH/cSS(+) had higher frequencies of CAA imaging markers and a higher risk of ICH recurrence compared to patients without cSS.
Article
Clinical Neurology
Hongfei Sang, Dongjing Xie, Yan Tian, Thanh N. Nguyen, Jeffrey L. Saver, Raul G. Nogueira, Junxiong Wu, Chen Long, Zhenxuan Tian, Zhizhou Hu, Tao Wang, Rongzong Li, Yingbing Ke, Xiurong Zhu, Daizhou Peng, Mingze Chang, Lingfei Li, Jie Ruan, Deping Wu, Wenjie Zi, Qingwu Yang, Fengli Li, Zhongming Qiu
Summary: This study investigated the efficacy and safety of IV infusion of tirofiban before endovascular thrombectomy for patients with large vessel occlusion due to intracranial atherosclerotic disease. The results showed that patients in the tirofiban group had higher rates of functional independence at 90 days without increased risk of mortality or symptomatic intracranial hemorrhage. The reduction of thrombectomy passes mediated a significant portion of the effect of tirofiban on functional independence.
Article
Health Care Sciences & Services
Boshu Ru, Xi Tan, Yu Liu, Kartik Kannapur, Dheepan Ramanan, Garin Kessler, Dominik Lautsch, Gregg Fonarow
Summary: This study aimed to compare different machine learning prediction models and feature construction methods to predict readmissions and worsening heart failure events (WHFEs) in patients with heart failure with reduced ejection fraction (HFrEF). The results showed that the XGBoost model with the frequency of clinical codes as features had the best discriminative ability for predicting these events.
JMIR FORMATIVE RESEARCH
(2023)
Article
Neuroimaging
Diego J. Ojeda, Malik Ghannam, Sebastian Sanchez, Mohammad Almajali, Prateeka Koul, Jeffrey L. Saver, Rishi Gupta, Santiago Ortega-Gutierrez, Edgar A. Samaniego
Summary: The Tigertriever device shows high success rate and short puncture to reperfusion time in patients with large vessel occlusion and underlying intracranial atherosclerotic disease, without device-related complications.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Clinical Neurology
Emma A. Koemans, Jasmeer P. Chhatwal, Susanne J. van Veluw, Ellis S. van Etten, Matthias J. P. van Osch, Marianne A. A. van Walderveen, Hamid R. Sohrabi, Mariel G. Kozberg, Zahra Shirzadi, Gisela M. Terwindt, Mark A. van Buchem, Eric E. Smith, David J. Werring, Ralph N. Martins, Marieke J. H. Wermer, Steven M. Greenberg
Summary: Cerebral amyloid angiopathy, a common age-related small vessel pathology, is associated with intracerebral haemorrhage and cognitive impairment. By studying individuals with different forms of the disease and using mouse models, researchers have identified key stages in the progression of cerebral amyloid angiopathy, which may help in developing interventions for this and other cerebral small vessel diseases.
Review
Clinical Neurology
Marco Duering, Geert Jan Biessels, Amy Brodtmann, Christopher Chen, Charlotte Cordonnier, Frank-Erik de Leeuw, Stephanie Debette, Richard Frayne, Eric Jouvent, Natalia S. Rost, Annemieke ter Telgte, Rustam Al-Shahi Salman, Walter H. Backes, Hee-Joon Bae, Rosalind Brown, Hugues Chabriat, Alberto De Luca, Charles deCarli, Anna Dewenter, Fergus N. Doubal, Michael Ewers, Thalia S. Field, Aravind Ganesh, Steven Greenberg, Karl G. Helmer, Saima Hilal, Angela C. C. Jochems, Hanna Jokinen, Hugo Kuijf, Bonnie Y. K. Lam, Jessica Lebenberg, Bradley J. MacIntosh, Pauline Maillard, Vincent C. T. Mok, Leonardo Pantoni, Salvatore Rudilosso, Claudia L. Satizabal, Markus D. Schirmer, Reinhold Schmidt, Colin Smith, Julie Staals, Michael J. Thrippleton, Susanne J. van Veluw, Prashanthi Vemuri, Yilong Wang, David Werring, Marialuisa Zedde, Rufus O. Akinyemi, Oscar H. Del Brutto, Hugh S. Markus, Yi-Cheng Zhu, Eric E. Smith, Martin Dichgans, Joanna M. Wardlaw
Summary: Cerebral small vessel disease (SVD) is a common age-related condition that can cause stroke, cognitive decline, neurobehavioral symptoms, and functional impairment. STRIVE-1 classified and standardized the various visible features of SVD on structural MRI, but new information and imaging techniques have emerged since then. Quantitative imaging biomarkers and machine learning methods offer a more comprehensive understanding of the impact of SVD on the brain and can serve as intermediary outcomes in clinical trials and routine practice.
Article
Neurosciences
Zahinoor Ismail, Rebeca Leon, Byron Creese, Clive Ballard, Philippe Robert, Eric E. Smith
Summary: This study investigated the association between mild behavioral impairment (MBI) in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and found that adding MBI to MCI can better identify AD and improve dementia prognostication. Therefore, the addition of MBI is important for the detection of AD.
MOLECULAR NEURODEGENERATION
(2023)
Article
Cardiac & Cardiovascular Systems
Anping Cai, Congyi Zheng, Jiayuan Qiu, Gregg C. Fonarow, Gregory Y. H. Lip, Yingqing Feng, Zengwu Wang
Summary: The burden of heart failure (HF) in China is expected to increase due to population ageing. However, there is limited knowledge about the prevalence of HF stages in China. Therefore, this study aimed to evaluate the prevalence of HF stages in the general Chinese population and the specific prevalence by age, sex, and urbanity. The study found that both pre-clinical and clinical HF burdens are high in China and vary by age, sex, and urbanity.
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Arnaud D. Kaze, Gregg C. Fonarow, Justin B. Echouffo-Tcheugui
Summary: In a large cohort of adults with type 2 diabetes, the study found a significant association between cardiac autonomic neuropathy (CAN) and the risk of silent myocardial infarction (SMI). Low heart rate variability was significantly associated with an increased risk of incident SMI. Participants with CAN had a 1.9-fold greater risk of SMI.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Neurosciences
Sidarrth Prasad, Erica M. Jones, Mehari Gebreyohanns, Veronica Aguilera, DaiWai M. Olson, Jane A. Anderson, Sean I. Savitz, Salvador C. Flores, Steven J. Warach, Charlotte E. Rhodes, Mark P. Goldberg, Nneka L. Ifejika
Summary: This study identified the barriers and facilitators to adopting tenecteplase (TNK) as a thrombolytic treatment for acute ischemic stroke (AIS) by conducting qualitative research with stroke clinicians in Texas. The findings suggest that providing evidence and identifying key change processes can help clinicians achieve consensus on adopting TNK for AIS treatment.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
