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International Journal of Stroke: Official Journal of the International Stroke Society

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https://www.readbyqxmd.com/read/28381202/tranexamic-acid-for-acute-intracerebral-hemorrhage-growth-predicted-by-spot-sign-trial-rationale-and-design
#1
Liping Liu, Yilong Wang, Xia Meng, Na Li, Ying Tan, Ximing Nie, Dacheng Liu, Xingquan Zhao
Rationale Acute intracerebral hemorrhage inflicts a high-economic and -health burden. Computed tomography angiography spot sign is a predictor of hematoma expansion, is associated with poor clinical outcome and is an important stratifying variable for patients treated with haemostatic therapy. Aims We aim to compare the effect of treatment with tranexamic acid to placebo for the prevention of hemorrhage growth in patients with high-risk acute intracerebral hemorrhage with a positive spot sign. Design The tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign (TRAIGE) is a prospective, multicenter, placebo-controlled, double-blind, investigator-led, randomized clinical trial that will include an estimated 240 participants...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381201/etiology-and-pathogenesis-of-moyamoya-disease-an-update-on-disease-prevalence
#2
Shuo Huang, Zhen-Ni Guo, Mingchao Shi, Yi Yang, Mingli Rao
Moyamoya disease is a chronic cerebrovascular occlusive disease that is characterized by progressive stenosis of the terminal portion of the internal carotid artery and its main branches. The occurrence of Moyamoya disease is related to immune, genetic, and other factors. Though the research of Moyamoya disease has made great strides in the past 60 years, the etiology and pathogenesis are largely unknown. This review will focus on the genetic pathogenic and inflammation factors of Moyamoya disease.
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381200/stroke-care-quality-in-china-substantial-improvement-and-a-huge-challenge-and-opportunity
#3
Yilong Wang, Zixiao Li, Xingquan Zhao, David Wang, Hao Li, Ying Xian, Liping Liu, Yongjun Wang
Stroke is The first two authors contributed equally. the leading cause of death and adult disability in China. Although evidence-based clinical interventions have been identified to improve care and outcomes in stroke, significant gaps still exist between guideline recommendations and clinical practice in China. Regional and national stroke registries have been used to assess the benchmark of stroke care quality, provide feedback on compliance with evidence-based performance measures to health care providers, and continuously improve stroke care quality without increasing additional medical costs in the past several decades worldwide...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381199/2014-chinese-guidelines-for-secondary-prevention-of-ischemic-stroke-and-transient-ischemic-attack
#4
Yongjun Wang, Ming Liu, Chuanqiang Pu
Ischemic stroke and transient ischemic attack (TIA) are the most common cerebrovascular disorder and leading cause of death in China. The Effective secondary prevention is the vital strategy for reducing stroke recurrence. The aim of this guideline is to provide the most updated evidence-based recommendation to clinical physicians from the prior version. Control of risk factors, intervention for vascular stenosis/occlusion, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke are all recommended, and the prevention of recurrent stroke in a variety of uncommon causes and subtype provided as well...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381198/effect-of-ticagrelor-with-clopidogrel-on-high-on-treatment-platelet-reactivity-in-acute-stroke-or-transient-ischemic-attack-prince-trial-rationale-and-design
#5
Yilong Wang, Yi Lin, Xia Meng, Weiqi Chen, Guohua Chen, Zhimin Wang, Jialing Wu, Dali Wang, Jianhua Li, Yibin Cao, Yuming Xu, Guohua Zhang, Xiaobo Li, Yuesong Pan, Hao Li, Liping Liu, Xingquan Zhao, Yongjun Wang
Rationale and aim Little is known about the safety and efficacy of the combination of ticagrelor and aspirin in acute ischemic stroke. This study aimed to evaluate whether the combination of ticagrelor and aspirin was superior to that of clopidogrel and aspirin in reducing the 90-day high on-treatment platelet reactivity for acute minor stroke or transient ischemic attack, especially for carriers of cytochrome P450 2C19 loss-of-function allele. Sample size and design This study was designed as a prospective, multicenter, randomized, open-label, active-controlled, and blind-endpoint, phase II b trial...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381197/assessment-and-provision-of-rehabilitation-among-patients-hospitalized-with-acute-ischemic-stroke-in-china-findings-from-the-china-national-stroke-registry-ii
#6
Janet Prvu Bettger, Zixiao Li, Ying Xian, Liping Liu, Xingquan Zhao, Hao Li, Chunxue Wang, Chunjuan Wang, Xia Meng, Anxin Wang, Yuesong Pan, Eric D Peterson, Yilong Wang, Yongjun Wang
Background Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke. Aims We examined the frequency and determinants of an assessment for rehabilitation among acute ischemic stroke patients from the China National Stroke Registry II. Methods Data for 19,294 acute ischemic stroke patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381196/decision-making-interventions-to-stop-the-global-atrial-fibrillation-related-stroke-tsunami
#7
Joshua O Cerasuolo, Manuel Montero-Odasso, Agustin Ibañez, Shannon Doocy, Gregory Yh Lip, Luciano A Sposato
Atrial fibrillation affects 33.5 million people worldwide and its prevalence is expected to double by 2050 because of the aging population. Atrial fibrillation confers a 5-fold higher risk of ischemic stroke compared to sinus rhythm. We present our view of the role of shared medical decision-making to combat global underutilization of oral anticoagulation for stroke prevention in atrial fibrillation patients. Oral anticoagulation underuse is widespread as it is present within atrial fibrillation patients of all risk strata and in countries across all income levels...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28381195/focus-on-china-edition
#8
Geoffrey A Donnan
No abstract text is available yet for this article.
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#9
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28134056/statistical-analysis-plan-for-the-family-led-rehabilitation-after-stroke-in-india-attend-trial-a-multicenter-randomized-controlled-trial-of-a-new-model-of-stroke-rehabilitation-compared-to-usual-care
#10
Laurent Billot, Richard I Lindley, Lisa A Harvey, Pallab K Maulik, Maree L Hackett, Gudlavalleti Vs Murthy, Craig S Anderson, Bindiganavale R Shamanna, Stephen Jan, Marion Walker, Anne Forster, Peter Langhorne, Shweta J Verma, Cynthia Felix, Mohammed Alim, Dorcas Bc Gandhi, Jeyaraj Durai Pandian
Background In low- and middle-income countries, few patients receive organized rehabilitation after stroke, yet the burden of chronic diseases such as stroke is increasing in these countries. Affordable models of effective rehabilitation could have a major impact. The ATTEND trial is evaluating a family-led caregiver delivered rehabilitation program after stroke. Objective To publish the detailed statistical analysis plan for the ATTEND trial prior to trial unblinding. Methods Based upon the published registration and protocol, the blinded steering committee and management team, led by the trial statistician, have developed a statistical analysis plan...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28134054/gathering-the-evidence-always-a-need
#11
Geoffrey A Donnan
No abstract text is available yet for this article.
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28134053/what-is-the-value-of-conducting-a-trial-of-r-tpa-for-the-treatment-of-mild-stroke-patients
#12
Gregory F Guzauskas, Er Chen, Deepa Lalla, Elaine Yu, Darren Tayama, David L Veenstra
Background The Phase IIIb, Double-Blind, Multicenter Study to Evaluate the Efficacy and Safety of Alteplase in Patients With Mild Stroke: Rapidly Improving Symptoms and Minor Neurologic Deficits (PRISMS) trial will assess r-tPA in ischemic stroke patients who present with mild deficits (i.e. mild stroke). Aims To assess PRISMS's societal value in clarifying the optimal care for patients with mild ischemic stroke. Methods A value of information (VOI) decision model was developed to compare the outcomes of mild stroke patients treated vs...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28134052/risk-of-incident-ischemic-stroke-according-to-the-metabolic-health-and-obesity-states-in-the-vascular-metabolic-cun-cohort
#13
Laura Sánchez-Iñigo, David Navarro-González, Alejandro Fernández-Montero, Juan Pastrana-Delgado, J A Martínez
Background Whether obesity is a major risk factor for cardiovascular disease in the absence of metabolic comorbidities remains under debate. Indeed, some obese individuals may be at low risk of metabolic-related complications, while normal-weight individuals may not be "healthy." Aims To assess the incidence of ischemic stroke according to the metabolic health and obesity states of 5171 participants from the Vascular-Metabolic CUN cohort. Methods A Cox proportional-hazard analysis was conducted to estimate the hazard ratio and their 95% confidence interval of stroke according to the metabolic health and obesity states based on TyG index and Adult Treatment Panel-III criteria, during 9...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28093966/physical-inactivity-is-a-strong-risk-factor-for-stroke-in-the-oldest-old-findings-from-a-multi-ethnic-population-the-northern-manhattan-study
#14
Joshua Z Willey, Yeseon P Moon, Ralph L Sacco, Heather Greenlee, Keith M Diaz, Clinton B Wright, Mitchell Sv Elkind, Yuen K Cheung
Background The fastest growing segment of the population is those age ≥80 who have the highest stroke incidence. Risk factor management is complicated by polypharmacy-related adverse events. Aims To characterize the impact of physical inactivity for stroke by age in a multi-ethnic prospective cohort study (NOMAS, n = 3298). Methods Leisure time physical activity was assessed by a validated questionnaire and our primary exposure was physical inactivity (PI). Participants were followed annually for incident stroke...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27742914/statistical-analysis-plan-of-the-head-position-in-acute-ischemic-stroke-trial-pilot-headpost-pilot
#15
Verónica V Olavarría, Hisatomi Arima, Craig S Anderson, Alejandro Brunser, Paula Muñoz-Venturelli, Laurent Billot, Pablo M Lavados
Background The HEADPOST Pilot is a proof-of-concept, open, prospective, multicenter, international, cluster randomized, phase IIb controlled trial, with masked outcome assessment. The trial will test if lying flat head position initiated in patients within 12 h of onset of acute ischemic stroke involving the anterior circulation increases cerebral blood flow in the middle cerebral arteries, as measured by transcranial Doppler. The study will also assess the safety and feasibility of patients lying flat for ≥24 h...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27694313/stroke-epidemiology-in-an-australian-rural-cohort-search
#16
Jonathan Newbury, Tim Kleinig, James Leyden, Hisatomi Arima, Sally Castle, Jennifer Cranefield, Tracey Paterson, Jim Jannes, Maria Crotty, Craig S Anderson
Background Stroke rates in Australia and New Zealand have been declining since 1990 but all studies have been completed in large urban centers. Aim We report the first Australasian stroke incidence study in a rural population. Methods The authors applied the principle of complete ascertainment, used the WHO standard definition of stroke and classified ischemic stroke by the TOAST criteria. Data were collected from five rural centers defined by postcode of residence, over a 2-year period with 12 months of follow up of all cases...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27694312/performance-of-short-ecg-recordings-twice-daily-to-detect-paroxysmal-atrial-fibrillation-in-stroke-and-transient-ischemic-attack-patients
#17
Mai B Poulsen, Zeynep Binici, Helena Dominguez, Anne Mb Soja, Christina Kruuse, Agnete H Hornnes, Rune S Rasmussen, Karsten Overgaard
Aims Prolonged cardiac monitoring after stroke is recommended though there is no consensus on optimal methods. Short-term ECG recordings with a "thumb-ECG" device have shown promising preliminary results regarding effectiveness and cost benefit. We aimed to examine the performance of thumb-ECG and five days' Holter monitoring in a prospective trial. A secondary endpoint was the inter-observer agreement of the thumb-ECG. Methods Patients older than 65 years with no history of atrial fibrillation who suffered an acute stroke or transient ischemic attack of unknown origin were prospectively included...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27649737/hyperlipidemia-is-associated-with-lower-risk-of-poststroke-mortality-independent-of-statin-use-a-population-based-study
#18
Samrat Yeramaneni, Dawn O Kleindorfer, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Matthew L Flaherty, Daniel Woo, Opeolu Adeoye, Simona Ferioli, Felipe de Los Rios La Rosa, Sharyl Martini, Jason Mackey, Pooja Khatri, Brett M Kissela, Jane C Khoury
Background Although statin therapy is associated with reduced stroke and mortality risk, some studies report that higher lipid levels are associated with improved outcomes following ischemic stroke. Aims We examined the association of hyperlipidemia (HLD) combined with statin therapy on all-cause mortality in stroke patients. Methods All stroke patients in the Greater Cincinnati Northern Kentucky region of ∼1.3 million were identified using ICD-9 discharge codes in 2005 and 2010. Stroke patients with and without HLD were categorized based on their reported statin use at baseline or discharge into three groups: no-HLD/no-statins, HLD/no-statins, and HLD/on-statins...
February 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436307/choice-of-anesthesia-for-endovascular-treatment-of-acute-ischemic-stroke-protocol-for-a-randomized-controlled-canvas-trial
#19
Yuming Peng, Yan Li, Minyu Jian, Xiaoyuan Liu, Jian Sun, Bo Jia, Jia Dong, Min Zeng, Nan Lin, Li Zhang, Adrian W Gelb, Matthew Tv Chan, Ruquan Han
Background Observational studies indicate that the type of anesthesia, local or general, may be associated with the post-procedural neurological function in patients with acute ischemic stroke undergoing endovascular treatment. However, these results need further confirmation, and the causal relationship has not yet been established. Methods This is a randomized controlled equivalence trial. Permuted block randomization stratified by culprit vessels will be used. Six hundred and forty patients with acute ischemic stroke undergoing endovascular recanalization will be randomized one to one to receive either general anesthesia or local anesthesia...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436306/cardiac-magnetic-resonance-imaging-has-limited-additional-yield-in-cryptogenic-stroke-evaluation-after-transesophageal-echocardiography
#20
Ava L Liberman, Rizwan E Kalani, Jessie Aw-Zoretic, Matthew Sondag, Vistasp J Daruwalla, Sumeet S Mitter, Richard Bernstein, Jeremy D Collins, Shyam Prabhakaran
Background The use of cardiac magnetic resonance imaging is increasing, but its role in the diagnostic work-up following ischemic stroke has received limited study. We aimed to explore the added yield of cardiac magnetic resonance imaging to identify cardio-aortic sources not detected by transesophageal echocardiography among patients with cryptogenic stroke. Methods A retrospective single-center cohort study was performed from 01 January 2009 to 01 March 2013. Consecutive patients who had both a stroke protocol cardiac magnetic resonance imaging and a transesophageal echocardiography preformed during a single hospitalization were included...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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