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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#1
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28739344/design-and-rationale-of-the-intima-medial-thickness-sub-study-of-the-prevention-of-cardiovascular-events-in-ischemic-stroke-patients-with-high-risk-of-cerebral-hemorrhage-picasso-imt-study
#2
Woo-Keun Seo, Yong Jae Kim, Juneyoung Lee, Sun U Kwon
BACKGROUND: Atherosclerosis is one of the main mechanisms of stroke and cardiovascular diseases and is associated with increased risk of recurrent stroke and cardiovascular events. Intima-medial thickness (IMT) is a well-known surrogate marker of atherosclerosis and has been used to predict stroke and cardiovascular events. However, the clinical significance of IMT and IMT change in stroke has not been investigated in well-designed studies. The PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage-Intima-Media Thickness (PICASSO-IMT) sub-study is designed to investigate the effects of cilostazol, probucol, or both on IMT in patients with stroke...
July 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28739198/efficacy-and-safety-of-apixaban-versus-warfarin-in-patients-with-atrial-fibrillation-and-a-history-of-cancer-insights-from-the-aristotle-trial
#3
Chiara Melloni, Allison Dunning, Christopher B Granger, Laine Thomas, Michel G Khouri, David A Garcia, Elaine M Hylek, Michael Hanna, Lars Wallentin, Bernard J Gersh, Pamela S Douglas, John H Alexander, Renato D Lopes
BACKGROUND: Cancer is associated with a prothrombotic state and increases risk of thrombotic events in patients with atrial fibrillation. We described clinical characteristics and outcomes and assessed safety and efficacy of apixaban versus warfarin in patients with atrial fibrillation and cancer in ARISTOTLE. METHODS AND RESULTS: The association between cancer and clinical outcomes was assessed using Cox regression models. At baseline, 1236 (6.8%) patients had a history of cancer; 12...
July 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28738901/stroke-in-a-resource-constrained-hospital-in-madagascar
#4
Pål Sigurd Stenumgård, Miadana Joshua Rakotondranaivo, Olav Sletvold, Turid Follestad, Hanne Ellekjær
BACKGROUND: Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke. METHODS: We registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014...
July 24, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28738762/effects-of-neuroserpin-on-clinical-outcomes-and-inflammatory-markers-in-chinese-patients-with-acute-ischemic-stroke
#5
Weiwen Wu, Tetsuya Asakawa, Qianghong Yang, Jun Zhao, Lixia Lu, Yunhe Luo, Ping Gong, Sha Han, Wei Li, Hiroki Namba, Liang Wang
OBJECTIVE: Neuroserpin (NSP) is known for its neuroprotective effects. The aim of this study was to investigate the relationship between NSP level and clinical outcomes and inflammatory markers in Chinese patients with acute ischemic stroke. METHODS: A total of 133 patients with acute cerebral infarction (ischemia group) and 44 controls were recruited. The modified Rankin Scale (mRS) was used to determine the functional outcome three months after onset. We investigated the relationship between serum NSP levels [on admission and a decrease in NSP levels (10 days after admission versus on admission)] and serum levels of several inflammatory markers...
July 24, 2017: Neurological Research
https://www.readbyqxmd.com/read/28738485/-impact-and-clinical-outcome-of-intra-aortic-balloon-pump-use-during-percutaneous-coronary-intervention
#6
J J Xu, Z Gao, Y Song, Y L Ma, X F Tang, Y Yao, C He, H H Wang, Y J Yang, R L Gao, S B Qiao, B Xu, J Q Yuan
Objective: To observe the impact and clinical outcome of intra-aortic balloon pump(IABP) use in patients underwent percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were enrolled.After 2 years' follow-up, the incidence of major adverse cardiovascular and cerebrovascular events such as death, myocardial infarction, stent thrombosis, revascularization, recurrent stroke were recorded, propensity score was used to match baseline data, and the clinical outcomes in patients with IABP and non-IABP were compared...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28738423/continued-statin-prescriptions-after-adverse-reactions-and-patient-outcomes-a-cohort-study
#7
Huabing Zhang, Jorge Plutzky, Maria Shubina, Alexander Turchin
Background: Many patients discontinue statin treatment, often after having a possible adverse reaction. The risks and benefits of continued statin therapy after an adverse reaction are not known. Objective: To examine the relationship between continuation of statin therapy (any prescription within 12 months after an adverse reaction) and clinical outcomes. Design: Retrospective cohort study. Setting: Primary care practices affiliated with 2 academic medical centers...
July 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28737516/pre-therapy-neural-state-of-bilateral-motor-and-premotor-cortices-predicts-therapy-gain-after-subcortical-stroke-a-pilot-study
#8
Carmen M Cirstea, Phil Lee, Sorin C Craciunas, In-Young Choi, Joseph E Burris, Randolph J Nudo
OBJECTIVE: The aim of the study was to examine whether neural state of spared motor and premotor cortices captured before a therapy predicts therapy-related motor gains in chronic subcortical stroke. DESIGN: Ten survivors, presenting chronic moderate upper limb impairment, underwent proton magnetic resonance spectroscopy, magnetic resonance imaging, clinical, and kinematics assessments before a 4-wk impairment-oriented training. Clinical/kinematics assessments were repeated after therapy, and motor gain was defined as positive values of clinical upper limb/elbow motion changes and negative values of trunk motion changes...
July 22, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28737109/clinical-outcome-prediction-after-thrombectomy-of-proximal-middle-cerebral-artery-occlusions-by-the-appearance-of-lenticulostriate-arteries-on-magnetic-resonance-angiography-a-retrospective-analysis
#9
Johannes Kaesmacher, Kornelia Kreiser, Nathan W Manning, Alexandra S Gersing, Silke Wunderlich, Claus Zimmer, Justus F Kleine, Benedikt Wiestler, Tobias Boeckh-Behrens
Post-ischemic vasodynamic changes in infarcted brain parenchyma are common and range from hypo- to hyperperfusion. In the present study, appearance of the lenticulostriate arteries (LSAs) on postinterventional 3T time-of-flight (TOF)-MRA suggestive for altered post-stroke vasodynamics following thrombectomy was investigated. Patients who underwent thrombectomy for a proximal MCA occlusion and for whom postinterventional 3T TOF-MRA (median at day 3) was available, were included in this retrospective analysis (n=98)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28736385/thromboembolic-risk-bleeding-outcomes-and-effect-of-different-antithrombotic-strategies-in-very-elderly-patients-with-atrial-fibrillation-a-sub-analysis-from-the-prefer-in-af-prevention-of-thromboembolic-events-european-registry-in-atrial-fibrillation
#10
Giuseppe Patti, Markus Lucerna, Ladislav Pecen, Jolanta M Siller-Matula, Ilaria Cavallari, Paulus Kirchhof, Raffaele De Caterina
BACKGROUND: Increasing age predisposes to both thromboembolic and bleeding events in patients with atrial fibrillation; therefore, balancing risks and benefits of antithrombotic strategies in older populations is crucial. We investigated 1-year outcome with different antithrombotic approaches in very elderly atrial fibrillation patients (age ≥85 years) compared with younger patients. METHODS AND RESULTS: We accessed individual patients' data from the prospective PREFER in AF (PREvention oF thromboembolic events-European Registry in Atrial Fibrillation), compared outcomes with and without oral anticoagulation (OAC), and estimated weighed net clinical benefit in different age groups...
July 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28736129/clinical-and-radiological-predictors-of-malignant-middle-cerebral-artery-infarction-development-and-outcomes
#11
Angelique F Albert, Matthew A Kirkman
BACKGROUND: Optic nerve sheath diameter (ONSD) can predict intracranial hypertension and outcomes in severe traumatic brain injury. Its utility in middle cerebral artery (MCA) stroke is unknown. AIMS: We reviewed serial radiological measurements, including ONSD, in patients with MCA stroke undergoing decompressive craniectomy (DC) for malignant MCA syndrome and compared demographic, clinical, and radiological data with an age- and gender-matched group of nonmalignant MCA stroke patients...
July 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28734791/association-between-nocturnal-blood-pressure-variation-and-wake-up-ischemic-stroke
#12
Hyuk Sung Kwon, Ji Young Kim, Hojin Choi, Seok Joon Lee, Seong-Ho Koh, Young Joo Lee, Hyun Young Kim, Hee-Tae Kim, Juhan Kim, Young Seo Kim
Ischemic stroke during nocturnal sleep, known as wake-up stroke (WUS), has been reported to have more severe symptoms and worse outcomes than non-WUS. However, studies on risk factors for WUS are scarce and the association between nocturnal blood pressure (BP) and WUS is unclear. In this study, we used ambulatory blood pressure monitoring (ABPM) to examine the association between WUS and variation in nocturnal BP. A total of 369 patients with ischemic stroke within one week were consecutively enrolled. ABPM was applied 1-2weeks after the ictus because of possible reactive increments of BP; antihypertensive medications were delayed until ABPM...
July 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28734575/outcomes-associated-to-serum-phosphate-levels-in-patients-with-suspected-acute-coronary-syndrome
#13
Hong Xu, Marie Evans, Alessandro Gasparini, Karolina Szummer, Jonas Spaak, Johan Ärnlöv, Bengt Lindholm, Tomas Jernberg, Juan Jesús Carrero
BACKGROUND: We investigated the association between phosphate and the risk of adverse clinical outcomes in patients with manifest cardiovascular disease (CVD). METHODS: Observational study of patients hospitalized during 2006-2011 in Stockholm, Sweden, because of suspected acute coronary syndrome (ACS). The exposure was serum phosphate during the hospitalization. We modeled the association between phosphate and in-hospital death or in-hospital events (composite of myocardial infarction, cardiogenic shock, resuscitated cardiac arrest, atrial fibrillation, or atrioventricular block) as well as the one-year post-discharge risk of death or cardiovascular event (composite of myocardial re-infarction, heart failure and stroke)...
July 17, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28733467/acromegaly-at-diagnosis-in-3173-patients-from-the-li%C3%A3-ge-acromegaly-survey-las-database
#14
Patrick Petrossians, Adrian F Daly, Emil Natchev, Luigi Maione, Karin Blijdorp, Mouna Sahnoun Fathallah, Renata Auriemma, Alpha M Diallo, Anna-Lena Hulting, Diego Ferone, Vaclav Hana, Silvia Filipponi, Caroline Sievers, Claudia Nogueira, Carmen Fajardo Montañana, Davide M C Carvalho, Vaclav Hana, Günter K Stalla, Marie-Lise Jaffrain-Réa, Brigitte Delemer, Annamaria A L Colao, Thierry Brue, Sebastian J C M M Neggers, Sabina Zacharieva, Philippe Chanson, Albert Beckers
Acromegaly is a rare disorder caused by chronic growth hormone (GH) hypersecretion. While diagnostic and therapeutic methods have advanced, little information exists on trends in acromegaly characteristics over time. The Liège Acromegaly Survey (LAS) database, a relational database, is designed to assess the profile of acromegaly patients at diagnosis and during long-term follow-up at multiple treatment centers. The study population consisted of 3173 acromegaly patients from ten countries; 54.5% were female...
July 21, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28733435/different-implications-of-heart-failure-ischemic-stroke-and-mortality-between-nonvalvular-atrial-fibrillation-and-atrial-flutter-a-view-from-a-national-cohort-study
#15
Yu-Sheng Lin, Tien-Hsing Chen, Ching-Chi Chi, Ming-Shyan Lin, Tao-Hsin Tung, Chi-Hung Liu, Yung-Lung Chen, Mien-Cheng Chen
BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes between nonvalvular AF and AFL. METHODS AND RESULTS: AF and AFL patients without any prescribed anticoagulation were enrolled from a 13-year national cohort database. Under series exclusion criteria, ischemic stroke, heart failure hospitalization, and all-cause mortality were compared between the groups in real-world conditions and after propensity score matching...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733434/added-value-of-patient-reported-outcome-measures-in-stroke-clinical-practice
#16
Irene L Katzan, Nicolas R Thompson, Brittany Lapin, Ken Uchino
BACKGROUND: There is uncertainty regarding the clinical utility of the data obtained from patient-reported outcome measures (PROMs) for patient care. We evaluated the incremental information obtained by PROMs compared to the clinician-reported modified Rankin Scale (mRS). METHODS AND RESULTS: This was an observational study of 3283 ischemic stroke patients seen in a cerebrovascular clinic from September 14, 2012 to June 16, 2015 who completed the routinely collected PROMs: Stroke Impact Scale-16 (SIS-16), EQ-5D, Patient Health Questionnaire-9, PROMIS Physical Function, and PROMIS fatigue...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733340/biological-age-is-better-than-chronological-as-predictor-of-3-month-outcome-in-ischemic-stroke
#17
Carolina Soriano-Tárraga, Marina Mola-Caminal, Eva Giralt-Steinhauer, Angel Ois, Ana Rodríguez-Campello, Elisa Cuadrado-Godia, Alejandra Gómez-González, Rosa M Vivanco-Hidalgo, Israel Fernández-Cadenas, Natalia Cullell, Jaume Roquer, Jordi Jiménez-Conde
OBJECTIVE: To analyze the effect of age-related DNA methylation changes in multiple cytosine-phosphate-guanine (CpG) sites (biological age [b-age]) on patient outcomes at 3 months after an ischemic stroke. METHODS: We included 511 patients with first-ever acute ischemic stroke assessed at Hospital del Mar (Barcelona, Spain) as the discovery cohort. Demographic and clinical data, including chronological age (c-age), vascular risk factors, initial stroke severity, recanalization treatment, and previous and 3-month modified Rankin Scale (p-mRS and 3-mRS, respectively) were registered...
July 21, 2017: Neurology
https://www.readbyqxmd.com/read/28733071/long-term-stroke-and-bleeding-risk-in-patients-with-atrial-fibrillation-treated-with-oral-anticoagulants-in-contemporary-practice-providing-evidence-for-shared-decision-making
#18
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
BACKGROUND: Oral anticoagulation is recommended as a lifelong therapy for most patients with atrial fibrillation (AF). However, data on long-term outcomes in clinical practice on these drugs are scarce, particularly for the recently approved agents. We aimed to describe differences in characteristics between patients in everyday practice and those enrolled in the pivotal trials, and to report long-term outcomes on oral anticoagulation in practice. METHODS: We performed a retrospective cohort analysis using a large U...
July 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28730951/penumbra-and-re-canalization-acute-computed-tomography-in-ischemic-stroke-evaluation-practise-study-protocol
#19
Salwa El-Tawil, Joanna Wardlaw, Ian Ford, Grant Mair, Tom Robinson, Lalit Kalra, Keith W Muir
Rationale Multimodal imaging, including computed tomography angiography and computed tomography perfusion imaging, yields additional information on intracranial vessels and brain perfusion and can differentiate between ischemic core and penumbra which may affect patient selection for intravenous thrombolysis. Hypothesis The use of multimodal imaging will increase the number of patients receiving intravenous thrombolysis and lead to better treatment outcomes. Sample size 400 patients. Methods and design PRACTISE is a prospective, multicenter, randomized, controlled trial in which patients presenting within 4...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#20
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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