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AHA/ASA ischemic stroke

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
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
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
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
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
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
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
Harsh R Aggarwal, Ameer E Hassan, Gustavo J Rodriguez, M Fareed K Suri, Robert A Taylor, Adnan I Qureshi
OBJECTIVE: To determine the rates of symptomatic intracerebral hemorrhages (sICH), parenchymal hematoma type 2 (PH2), and favorable outcomes in patients with borderline elevation of international normalized ratio (INR) or recent anticoagulation use prior to treatment with intravenous recombinant tissue plasminogen activator (IV rt-PA) for acute ischemic stroke. METHODS: Consecutive patients with acute ischemic stroke that received IV rt-PA were identified. History of recent use of anticoagulation and the INR at presentation and after use of thrombolytics, up to 72 h was recorded...
December 2013: Journal of Vascular and Interventional Neurology
Flavio Augusto de Carvalho, Lee H Schwamm, Gustavo W Kuster, Monique Bueno Alves, Miguel Cendoroglo Neto, Gisele Sampaio Silva
BACKGROUND: Stroke is the fourth leading killer in the US, the first in Brazil and a leading cause of adult long-term disability in both countries. In spite of widespread recommendation, clinical practice guidelines have had limited effect on changing physician behavior. Recognizing that both knowledge and acceptance of guidelines do not necessarily imply guideline adherence, the American Heart Association/American Stroke Association (AHA/ASA) developed a national stroke quality improvement program, the 'Get With The Guidelines (GWTG) stroke'...
January 2012: Cerebrovascular Diseases Extra
Kathleen A Baldwin, Stacey L McCoy
Stroke is the third leading cause of death in the United States and the number one cause of adult long-term disability. Disability in stroke survivors includes hemiparesis, aphasia, inability to walk without assistance, dependence on others for activities of daily living, depression, and institutionalization. Immediate recognition of acute ischemic stroke (AIS) signs and symptoms is required because many treatment options are time sensitive. Hospital transport via activation of 911 and emergency medical services (EMSs) removes delays to urgent diagnosis and intervention...
October 2010: Journal of Pharmacy Practice
Molly A Hatcher, Jessica A Starr
OBJECTIVE: To evaluate the literature regarding the use of intravenous tissue plasminogen activator (tPA) in the treatment of acute ischemic stroke, focusing on the appropriate usage criteria and administration time window. DATA SOURCES: A PubMed and MEDLINE search was performed (1990-November 2010) using the key words alteplase, tissue plasminogen activator, thrombolytic, ischemic stroke, and cerebrovascular accident. STUDY SELECTION AND DATA EXTRACTION: Clinical trials published in English were evaluated and relevant primary literature evaluating the use of tPA in acute ischemic stroke was included...
March 2011: Annals of Pharmacotherapy
Joana Patrícia dos Santos Carvalho, Dora Lopes Castelo Branco Catre, Cláudia Margarida Brito Pereira, Marina Costa
BACKGROUND AND OBJECTIVES: Neoplasias can be associated with autoimmune hemolytic anemia (AHA) with the consequent blood incompatibility that hinders blood transfusion. The authors describe and discuss the conduct in three patients undergoing surgical intervention for neoplastic disease with positive Coombs Test (CT), and the impossibility to determine the blood type. CASE REPORT: 1st case: 87-year old male patient, ASA III, scheduled for surgery for colon neoplasia...
January 2010: Revista Brasileira de Anestesiologia
Andrea Brassard
PURPOSE: To review the identification of patients at risk of secondary ischemic events, discuss the therapies available for their medical management, and identify the role of the nurse practitioner (NP) in their primary and long-term care. DATA SOURCES: ACC/AHA 2007 guidelines for the management of patients with unstable angina and non-ST-elevation myocardial infarction, ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease, AHA/ASA 2006 guidelines for patients with ischemic stroke, AHA/ACC 2006 guidelines update for patients with coronary and other atherosclerotic vascular disease, and selected clinical articles identified through PubMed...
December 2009: Journal of the American Academy of Nurse Practitioners
Joseph P Vande Griend, Joseph J Saseen
Stroke is a leading cause of death and the primary cause of serious, long-term disability in the United States. Joint guidelines from the American Heart Association (AHA) and American Stroke Association (ASA), as well as recent guidelines from the Eighth American College of Chest Physicians (ACCP) Conference on Antithrombotic and Antiplatelet Therapy, recommend aspirin, clopidogrel, or extended-release dipyridamole plus aspirin as acceptable first-line options for secondary prevention of ischemic events in patients with a history of ischemic stroke or transient ischemic attack (TIA)...
October 2008: Pharmacotherapy
Robert J Adams, Greg Albers, Mark J Alberts, Oscar Benavente, Karen Furie, Larry B Goldstein, Philip Gorelick, Jonathan Halperin, Robert Harbaugh, S Claiborne Johnston, Irene Katzan, Margaret Kelly-Hayes, Edgar J Kenton, Michael Marks, Ralph L Sacco, Lee H Schwamm
No abstract text is available yet for this article.
May 2008: Stroke; a Journal of Cerebral Circulation
Matthew Underwood, Bob L Lobo, Christopher Finch, James Wang
BACKGROUND: The Stroke Council of the American Heart Association/American Stroke Association (AHA/ASA) recommends conservative management of hypertension (HTN) during acute ischemic stroke (AIS), although clinicians often manage blood pressure more aggressively. Our hypothesis was that aggressive management of HTN in patients with AIS is associated with hypotensive events and worsened neurologic outcomes. METHODS: The study was a retrospective, observational cohort of patients who were admitted to the hospital with AIS...
November 2006: Southern Medical Journal
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