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stroke aha/asa

Sami Al Kasab, Michael J Lynn, Tanya N Turan, Colin P Derdeyn, David Fiorella, Bethany F Lane, L Scott Janis, Marc I Chimowitz
BACKGROUND: An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting <24 hours should be considered a stroke. We analyzed the impact of considering CITS as equivalent to stroke on the results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Michael W Rich, Deborah A Chyun, Adam H Skolnick, Karen P Alexander, Daniel E Forman, Dalane W Kitzman, Mathew S Maurer, James B McClurken, Barbara M Resnick, Win K Shen, David L Tirschwell
The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease (CVD) is the leading cause of death and major disability in adults aged 75 and older. Despite the effect of CVD on quality of life, morbidity, and mortality in older adults, individuals aged 75 and older have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older adults with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in nursing homes and assisted living facilities...
November 2016: Journal of the American Geriatrics Society
(no author information available yet)
No abstract text is available yet for this article.
August 2016: American Journal of Nursing
Meir H Scheinfeld, Amichai J Erdfarb, Daniel A Krieger, Deepa Bhupali, Richard L Zampolin
In 2015, five trials demonstrated the efficacy of endovascular treatment for acute stroke, culminating in the revised American Heart Association/American Stroke Association (AHA/ASA) recommendations for stroke management. The different clinical scales used in these trials may be unfamiliar to emergency and on-call radiologists. The modified Rankin Scale was used to describe patient disability for prestroke assessment in three of the trials and for the 90-day follow up in all five trials. The Barthel index was used in one trial to score prestroke ability to perform activities of daily living...
October 2016: Emergency Radiology
Peter Vanacker, Dimitris Lambrou, Ashraf Eskandari, Pascal J Mosimann, Ali Maghraoui, Patrik Michel
BACKGROUND AND PURPOSE: Endovascular treatment (EVT) is a new standard of care for selected, large vessel occlusive strokes. We aimed to determine frequency of potentially eligible patients for intravenous thrombolysis (IVT) and EVT in comprehensive stroke centers. In addition, predictors of EVT eligibility were derived. METHODS: Patients from a stroke center-based registry (2003-2014), admitted within 24 hours of last proof of usual health, were selected if they had all data to determine IVT and EVT eligibility according to American Heart Association/American Stroke Association (AHA/ASA) guidelines (class I-IIa recommendations)...
July 2016: Stroke; a Journal of Cerebral Circulation
Digvijaya D Navalkele, Kristian Barlinn, Alireza Minagar, Oleg Y Chernyshev
BACKGROUND: Frequency of sleep-disordered breathing (SDB) among stroke and transient ischemic attack (TIA) patients ranges from 30-80% and is associated with poor neurological outcomes. Per current stroke prevention guidelines from American Heart Association/American Stroke Association (AHA/ASA), SDB is included in the list of modifiable risk factors for stroke and TIA prevention. Goal of our study is to determine screening practices for SDB in stroke medical community. METHODS: A web-based survey was sent to physicians taking care of stroke patients across North America and Europe...
June 2016: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Neha Rai, Kameshwar Prasad, Rohit Bhatia, Deepti Vibha, Mamta Bhushan Singh, Vinod K Rai, Amit Kumar
BACKGROUND: In-hospital care of stroke patients can reduce the risk of death and disability. There is an emerging evidence for the routine use of care pathways (CPs) for acute stroke management. Our aim was to develop evidence-based CPs and test the hypothesis that acute stroke management by CPs is superior to that provided by conventional care. MATERIALS AND METHODS: An acute stroke CP was designed in accordance with the recent American Stroke Association (ASA)/American Heart Association (AHA) stroke guidelines and the Indian Academy of Neurology (IAN) stroke management guidelines in India...
March 2016: Neurology India
Badih Daou, Maureen Deprince, Robin D'Ambrosio, Stavropoula Tjoumakaris, Robert H Rosenwasser, Daniel J Ackerman, Rodney Bell, Diana L Tzeng, Michelle Ghobrial, Andres Fernandez, Qaisar Shah, Dan J Gzesh, Deborah Murphy, John E Castaldo, Claranne Mathiesen, Maria Carissa Pineda, Pascal Jabbour
OBJECTIVE: Recently, the FDA guidelines regarding the eligibility of patients with acute ischemic stroke to receive IV rt-PA have been modified and are not in complete accord with the latest AHA/ASA guidelines. The resultant differences may result in discrepancies in patient selection for intravenous thrombolysis. METHODS: Several comprehensive stroke centers in the state of Pennsylvania have undertaken a collaborative effort to clarify and unify our own recommendations regarding how to reconcile these different guidelines...
December 2015: Clinical Neurology and Neurosurgery
Shoichiro Sato, Cheryl Carcel, Craig S Anderson
Elevated blood pressure (BP), which presents in approximately 80 % of patients with acute intracerebral hemorrhage (ICH), is associated with increased risk of poor outcome. The Second Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) study, a multinational, multicenter, randomized controlled trial published in 2013, demonstrated better functional outcomes with no harm for patients with acute spontaneous ICH within 6 h of onset who received target-driven, early intensive BP lowering (systolic BP target <140 mmHg within 1 h, continued for 7 days) and suggested that greater and faster reduction in BP might enhance the treatment effect by limiting hematoma growth...
December 2015: Current Treatment Options in Neurology
Tomasz Grzegorski, Natalia Andrzejewska, Radosław Kaźmierski
In the last few years, there has been a rapid increase in patients being treated with various anticoagulation and antiplatelet agents. In clinical neurology, these drugs are administered for primary and secondary stroke prevention or to avoid the consequences of immobilization of severe stroke patients. Additionally, thrombolytic intravenous therapy and, recently, intra-arterial therapy for stroke have been increasingly employed all over the world. These therapies are associated with an increased risk of hemorrhage, including the most dangerous, intracranial hemorrhage...
2015: Neurologia i Neurochirurgia Polska
Puja K Mehta, Margo Minissian, C Noel Bairey Merz
Cardiovascular disease (CVD) is the leading health threat to American women. In addition to establish risk factors for hypertension, hyperlipidemia, diabetes, smoking, and obesity, adverse pregnancy outcomes (APOs) including pre-eclampsia, eclampsia, and gestational diabetes are now recognized as factors that increase a woman's risk for future CVD. CVD risk factor burden is disproportionately higher in those of low socioeconomic status and in ethnic/racial minority women. Since younger women often use their obstetrician/gynecologist as their primary health provider, this is an opportune time to diagnose and treat CVD risk factors early...
June 2015: Seminars in Perinatology
Mitch Hargis, Jharna N Shah, Janine Mazabob, Chethan Venkatasubba Rao, Jose I Suarez, Eric M Bershad
OBJECTIVE: The logistics involved in administration of IV tPA for acute ischemic stroke patients are complex, and may contribute to variability in door-to-needle times between different hospitals. We sought to identify practice patterns in stroke centers related to IV tPA use. We hypothesized that there would be significant variability in logistics related to ancillary staff (i.e. nursing, pharmacists) processes in the emergency room setting. METHODS: A 21 question survey was distributed to attendees of the AHA/ASA Southwest Affiliate Stroke Coordinators Conference to evaluate potential barriers and delays with regards to thrombolysis for acute strokes patients in the Emergency Department setting...
August 2015: Clinical Neurology and Neurosurgery
Andrea Freixa, Tiago Moreira, Olivier Bill, Nadim Anani
Due to the prevalence and severity of stroke, and the emergency of its management, the need of reaching a consensus towards its treatment is of prime importance. This paper's aim is to compare two stroke guidelines by using eGLIA in order to evaluate their implementability. Methods included a systematic assessment of the European (ESO) and American (AHA/ASA) guidelines with eGLIA and a review of literature and analysis of each recommendation with the program. The ESO performs better in Executability and Decidability, as 91...
2015: Studies in Health Technology and Informatics
Stephen J Marks, Sahil Khera
Cryptogenic stroke (CS) accounts for 20% to 40% of ischemic strokes. CS is defined as a cortical infarct suggestive of an embolic stroke with no identifiable cardiac etiology, large vessel occlusive disease, or small vessel lacunar stroke. The likely etiologies for CS are patent foramen ovale (PFO) and paroxysmal atrial fibrillation, which can be detected by transesophageal echocardiography and long-term cardiac rhythm monitoring. In a busy academic hospital, the stroke service is frequently asked to provide a rational approach to patients with such a presentation...
July 2016: Cardiology in Review
Adam de Havenon, Ali Sultan-Qurraie, Peter Hannon, David Tirschwell
The organization of stroke care has undergone a dramatic evolution in the USA over the last two decades. Beginning with the recommendation for Primary Stroke Centers (PSCs) in 1994, there has been a concerted effort by physicians, the American Heart Association/American Stroke Association (AHA/ASA), National Institutes of Health (NIH), and state legislatures to advance an evidence-based system of care with several tiers of stroke centers. At the apex of this structure are Regional Stroke Centers (RSCs), which do not have official recognition like PSCs and Comprehensive Stroke Centers (CSCs), but their existence as a hub for the many disparate spokes of stroke care in their region is increasingly necessary...
May 2015: Current Neurology and Neuroscience Reports
Eric E Smith, Jeffrey L Saver, David N Alexander, Karen L Furie, L Nelson Hopkins, Irene L Katzan, Jason S Mackey, Elaine L Miller, Lee H Schwamm, Linda S Williams
No abstract text is available yet for this article.
November 2014: Stroke; a Journal of Cerebral Circulation
Rufus O Akinyemi, Louise Allan, Mayowa O Owolabi, Joshua O Akinyemi, Godwin Ogbole, Akinlolu Ajani, Michael Firbank, Adesola Ogunniyi, Raj N Kalaria
OBJECTIVE: Sub-Saharan Africa faces a potential epidemic of non-communicable diseases including stroke and dementia but little is known about the burden of stroke-related cognitive dysfunction. We assessed the baseline profile and factors associated with vascular cognitive impairment (VCI) in stroke survivors participating in the Cognitive Function After STroke (CogFAST) Nigeria Study. METHODS: We recruited 217 subjects (>45 years old) comprising 143 stroke survivors and 74 demographically matched stroke-free healthy controls...
November 15, 2014: Journal of the Neurological Sciences
Hamidreza Kafi, Jamshid Salamzadeh, Nahid Beladimoghadam, Mohammad Sistanizad, Mehran Kouchek
Ischemic stroke is amongst the top four causes of mortality and the leading cause of disability in the world. The aim of this study was to evaluate the efficacy of a high dose memantine on neurological function of patients with ischemic stroke. In a randomized, 2 armed, open-label study, patients with mild to moderate cerebral thromboembolic event (CTEE) who admitted to Imam Hossein Hospital, Tehran, Iran, during preceding 24 hours, entered the study. Patients allocated in two study groups of memantine (as add-on therapy) and control...
2014: Iranian Journal of Pharmaceutical Research: IJPR
Sydney A Jones, Rebecca F Gottesman, Eyal Shahar, Lisa Wruck, Wayne D Rosamond
BACKGROUND AND PURPOSE: Characterizing International Classification of Disease 9th Revision, Clinical Modification (ICD-9-CM) code validity is essential given widespread use of hospital discharge databases in research. Using the Atherosclerosis Risk in Communities (ARIC) Study, we estimated the accuracy of ICD-9-CM stroke codes. METHODS: Hospitalizations with ICD-9-CM codes 430 to 438 or stroke keywords in the discharge summary were abstracted for ARIC cohort members (1987-2010)...
November 2014: Stroke; a Journal of Cerebral Circulation
Ganesh Asaithambi, Xin Tong, Mary G George, Albert W Tsai, James M Peacock, Russell V Luepker, Kamakshi Lakshminarayan
BACKGROUND: The American Heart Association/American Stroke Association (AHA/ASA) recommended an expansion of the time window for acute ischemic stroke (AIS) reperfusion with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) from 3 to 4.5 hours after symptom onset. We examine rates of IV and intra-arterial (IA) reperfusion before and after the recommendations to track guideline adoption in community practice. METHODS: Patients with AIS in the Paul Coverdell National Acute Stroke Registry spanning years 2007-2012 were identified...
October 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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