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https://www.readbyqxmd.com/read/28447627/short-term-blood-pressure-variability-and-long-term-blood-pressure-variability-which-one-is-a-reliable-predictor-for-recurrent-stroke
#1
Y Tao, J Xu, B Song, X Xie, H Gu, Q Liu, L Zhao, Y Wang, Y Xu, Y Wang
The relationship between blood pressure variability (BPV) and stroke recurrence is controversial. This study aimed to evaluate the predictive value of short-term and long-term BPV for stroke recurrence. The data from blood pressure and clinical outcome in TIA or ischemic stroke (BOSS) study included participants with acute ischemic stroke or transient ischemic attack (TIA) within 7 days after onset. Short-term BPV was measured by 24-h ambulatory BP measurement during hospitalisation. Long-term BPV, based on home blood pressure measurement, was measured by patients or their families from discharge to 90 days after qualifying events onset (twice daily)...
April 27, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28438866/soluble-urokinase-type-plasminogen-activator-receptor-predicts-all-cause-5-year-mortality-in-ischemic-stroke-and-tia
#2
Juha Onatsu, Mikko Taina, Pirjo Mustonen, Marja Hedman, Antti Muuronen, Otso Arponen, Miika Korhonen, Pekka Jäkälä, Ritva Vanninen, Kari Pulkki
AIM: We evaluated soluble urokinase-type plasminogen activator receptor (suPAR) levels in different stroke subtypes and assessed their prognostic value regarding 5-year outcomes. MATERIALS AND METHODS: The study included 117 stroke patients (81 males; mean=age 61±11 years) with suspected cardioembolic stroke whose plasma suPAR concentration was assessed. Altogether, 20 (17.1%) patients suffered from stroke as a result of cardioembolism, 12 (10.3%) from large-artery atherosclerosis, 9 (7...
May 2017: In Vivo
https://www.readbyqxmd.com/read/28438723/long-term-outcomes-of-minimally-invasive-surgical-ablation-for-atrial-fibrillation-a-single-center-experience
#3
Aditya Saini, Yuhning L Hu, Vigneshwar Kasirajan, Frederick T Han, Muhammad Z Khan, Luke Wolfe, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
BACKGROUND: Minimally invasive surgical AF ablation delivers RF energy via a thoracoscopic approach to perform pulmonary vein isolation and LA ganglionic plexi ablation. Data on long term outcomes of MISAA is lacking. OBJECTIVE: We report 5 year follow-up data from a prospective cohort of patients who underwent MISAA at a single center. METHODS: One hundred nine consecutive patients (60 paroxysmal, 49 persistent, mean age 62.7±9.3 years) underwent MISAA with left atrial appendage exclusion by a single surgeon between 2006 and 2012...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28437244/second-transcatheter-closure-for-residual-shunt-following-percutaneous-closure-of-patent-foramen-ovale
#4
Njomeza Susuri, Slayman Obeid, Mirjam Ulmi, George Cm Siontis, Andreas Wahl, Stephan Windecker, Fabian Nietlispach, Bernhard Meier, Fabien Praz
AIMS: Residual shunt following percutaneous patent foramen ovale (PFO) closure has been described in up to 49% of the patients and is associated with recurrent cerebrovascular events. Our aim was to evaluate the safety, feasibility, and mid-term outcomes of transcatheter residual shunt closure. METHODS AND RESULTS: From 1994 to July 2016, 2679 patients underwent transcatheter PFO closure for treatment of presumed paradoxical embolism at our institution. Among them, 100 patients (3...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28433206/efficacy-and-safety-of-rivaroxaban-versus-warfarin-in-patients-from-mainland-china-with-nonvalvular-atrial-fibrillation-a-subgroup-analysis-from-the-rocket-af-trial
#5
Yihong Sun, Dayi Hu, Susanna Stevens, Yuliya Lokhnygina, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Keith A A Fox, Manesh R Patel
BACKGROUND: The ROCKET AF study evaluated once-daily rivaroxaban versus dose-adjusted warfarin for the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). In this analysis, we compared rivaroxaban with warfarin in patients with AF from China, East Asia, and the rest of the world (ROW). METHODS AND RESULTS: We assessed baseline demographics and interaction of treatment effects of rivaroxaban versus warfarin among patients from mainland China, other East Asian countries, and ROW...
April 13, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28431835/variability-in-the-use-of-neuroimaging-techniques-for-diagnosis-and-follow-up-of-stroke-patients
#6
C Valcárcel-Nazco, D Alonso-Modino, F Montón-Álvarez, R Sabatel-Hernández, M S Pastor-Santoveña, P Mesa-Blanco, J C López-Fernández, P Serrano-Aguilar
INTRODUCTION AND OBJECTIVE: Imaging diagnosis is essential for treatment planning in stroke patients. However, use of these techniques varies due to uncertainty about their effectiveness. Our purpose was to describe the use of CT and MRI in stroke and transient ischaemic attack (TIA) over 5years in hospitals belonging to the Canary Islands Health Service and analyse interhospital variability based on routinely collected administrative data. PATIENTS AND METHOD: We gathered the minimum basic dataset (MBDS) from patients diagnosed with stroke or TIA between 2005 and 2010 in 4hospitals...
April 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28431600/assessment-of-on-treatment-platelet-reactivity-and-relationship-with-cerebral-micro-embolic-signals-in-asymptomatic-and-symptomatic-carotid-stenosis
#7
Justin A Kinsella, W Oliver Tobin, Sean Tierney, Timothy M Feeley, Bridget Egan, Tara Coughlan, D Ronan Collins, Desmond O'Neill, Joseph A Harbison, Colin P Doherty, Prakash Madhavan, Dermot J Moore, Sean M O'Neill, Mary-Paula Colgan, Maher Saqqur, Raymond P Murphy, Niamh Moran, George Hamilton, Dominick J H McCabe
INTRODUCTION: The relationship between on-treatment platelet reactivity and cerebral micro-embolic signals (MES) is unknown, and has not been previously simultaneously assessed in asymptomatic and symptomatic carotid stenosis patients. METHODS: Consecutive eligible patients with ≥50% asymptomatic or recently symptomatic carotid stenosis (≤4weeks following TIA/ischaemic stroke) were recruited to this pilot study. Symptomatic patients were followed up to the 'late' phase (≥3months) following symptom onset or carotid intervention; longitudinal data were analysed from symptomatic patients with data available at both time-points...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431593/high-on-treatment-platelet-reactivity-to-aspirin-and-clopidogrel-in-ischemic-stroke-a-systematic-review-and-meta-analysis
#8
Aidonio Fiolaki, Aristeidis H Katsanos, Athanassios P Kyritsis, Styliani Papadaki, Maria Kosmidou, Iraklis C Moschonas, Alexandros D Tselepis, Sotirios Giannopoulos
Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#9
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28424269/risks-and-benefits-of-clopidogrel-aspirin-in-minor-stroke-or-tia-time-course-analysis-of-chance
#10
Yuesong Pan, Jing Jing, Weiqi Chen, Xia Meng, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S Claiborne Johnston, Yilong Wang, Yongjun Wang
OBJECTIVE: To investigate the short-term time course risks and benefits of clopidogrel with aspirin in minor ischemic stroke or TIA. METHODS: Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. The primary outcome was a new ischemic stroke. Safety outcomes included any bleeding and moderate to severe bleeding. Time course analyses were performed for the outcomes of both stroke and bleeding. RESULTS: A total of 145 (71...
April 19, 2017: Neurology
https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#11
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28420316/persistence-of-secondary-prevention-medication-and-related-factors-for-acute-ischemic-stroke-and-transient-ischemic-attack-in-china
#12
Yue Jiang, Xiaomeng Yang, Zixiao Li, Yuesong Pan, Yilong Wang, Yongjun Wang, Ruijun Ji, Chen Wang
OBJECTIVE: We recently measured the longitudinal use of secondary prevention medication following hospital discharge and the factors influencing persistence in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA) in China. METHODS: Patients with AIS and TIA who were enrolled in the China National Stroke Registry II from June 2012 to January 2013 were surveyed to determine persistence. The medications included antiplatelet therapies, warfarin, antihypertensive therapies, statins, and diabetes medications...
April 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28416587/cardiovascular-outcomes-with-an-inhaled-beta2-agonist-corticosteroid-in-patients-with-copd-at-high-cardiovascular-risk
#13
Robert D Brook, Julie A Anderson, Peter Ma Calverley, Bartolome R Celli, Courtney Crim, Martin A Denvir, Sheldon Magder, Fernando J Martinez, Sanjay Rajagopalan, Jørgen Vestbo, Julie Yates, David E Newby
OBJECTIVES: Cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) often coexist. We assessed the effect of inhaled COPD treatments on CVD outcomes and safety in patients with COPD and at heightened CVD risk. METHODS: The SUMMIT (Study to Understand Mortality and MorbidITy) was a multicentre, randomised, double-blind, placebo-controlled, event-driven trial in 16 485 patients with moderate COPD who had or were at high risk of CVD. Here, we assessed the prespecified secondary endpoint of time to first on-treatment composite CVD event (CVD death, myocardial infarction, stroke, unstable angina or transient ischaemic attack (TIA)) by Cox regression and by clinician-reported CVD adverse events across the four groups: once-daily inhaled placebo (n=4111), long-acting beta2-agonist (vilanterol (VI) 25 µg; n=4118), corticosteroid (fluticasone furoate (FF) 100 µg; n=4135) and combination therapy (FF/VI; n=4121)...
April 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28416405/development-validation-and-assessment-of-an-ischemic-stroke-or-transient-ischemic-attack-specific-prediction-tool-for-obstructive-sleep-apnea
#14
Jason J Sico, H Klar Yaggi, Susan Ofner, John Concato, Charles Austin, Jared Ferguson, Li Qin, Lauren Tobias, Stanley Taylor, Carlos A Vaz Fragoso, Vincent McLain, Linda S Williams, Dawn M Bravata
BACKGROUND: Screening instruments for obstructive sleep apnea (OSA), as used routinely to guide clinicians regarding patient referral for polysomnography (PSG), rely heavily on symptomatology. We sought to develop and validate a cerebrovascular disease-specific OSA prediction model less reliant on symptomatology, and to compare its performance with commonly used screening instruments within a population with ischemic stroke or transient ischemic attack (TIA). METHODS: Using data on demographic factors, anthropometric measurements, medical history, stroke severity, sleep questionnaires, and PSG from 2 independently derived, multisite, randomized trials that enrolled patients with stroke or TIA, we developed and validated a model to predict the presence of OSA (i...
April 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28412909/prolonged-perfusion-predicts-recurrent-ischemic-stroke-but-not-transient-ischemic-attack-in-patients-with-symptomatic-intracranial-stenosis
#15
Linfang Lan, Xinyi Leng, Vincent Ip, Thomas Leung, Yannie Soo, Jill Abrigo, Ka Sing Wong
BACKGROUND: Intracranial arterial stenosis (ICAS) is the dominant cause for ischemic stroke worldwide, with hemodynamic compromise as a crucial contributor. Prolonged perfusion is commonly observed in ICAS patients on CT perfusion (CTP) maps, while the clinical significance of this perfusion pattern has not been elucidated. METHODS: Patients having symptomatic ICAS of 50-99% stenosis with sustained downstream cerebral blood flow (CBF) were enrolled into this study...
April 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#16
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28399897/prehospital-ambulance-stroke-test-pilot-study-of-a-novel-stroke-test
#17
Gunnar Andsberg, Magnus Esbjörnsson, Arne Olofsson, Arne Lindgren, Bo Norrving, Mia von Euler
BACKGROUND: There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS). METHODS: The PreHospital Ambulance Stroke Test (PreHAST), an eight item test based on NIHSS, which scores stroke severity from 0-19 points, was designed and adapted for the ambulance services. In the pilot study the ambulance nurses used PreHAST to assess patients with suspected stroke in the prehospital setting...
April 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28398139/the-association-between-high-on-treatment-platelet-reactivity-and-early-recurrence-of-ischemic-events-after-minor-stroke-or-tia
#18
Zilong Rao, Huaguang Zheng, Fei Wang, Anxin Wang, Liping Liu, Kehui Dong, Xingquan Zhao, Yilong Wang, Yibin Cao
OBJECTIVES: To evaluate the role of HTPR in predicting early recurrence of ischemic events in patients with minor ischemic stroke or high-risk TIA. METHODS: From January 2014 to September 2014, a single center continuously enrolled patients with minor ischemic stroke or high-risk TIA and gave them antiplatelet therapy consisting of aspirin with clopidogrel. HTPR was assessed by TEG after 7 days of antiplatelet therapy and detected CYP2C19 genotype. The incidence of recurrent ischemic events was assessed 3 months after onset...
April 11, 2017: Neurological Research
https://www.readbyqxmd.com/read/28392100/risk-prediction-for-ischemic-stroke-and-transient-ischemic-attack-in-patients-without-atrial-fibrillation-a-retrospective-cohort-study
#19
Zhong Yuan, Erica A Voss, Frank J DeFalco, Guohua Pan, Patrick B Ryan, Daniel Yannicelli, Christopher Nessel
BACKGROUND: Stroke mainly occurs in patients without atrial fibrillation (AF). This study explored risk prediction models for ischemic stroke and transient ischemic attack (TIA) in patients without AF. METHODS: Three US-based healthcare databases (Truven MarketScan Commercial Claims and Encounters [CCAE], Medicare Supplemental [MDCR], and Optum Clinformatics [Optum]) were used to establish patient cohorts without AF during the index period of 2008-2012. The performance of 2 existing models (CHADS2 and CHA2DS2-VASc) for predicting stroke and TIA was examined by fitting a logistic regression to a training dataset and evaluating predictive accuracy in a validation dataset (area under the curve, AUC) using patients with complete follow-up of 1 or 3 years, separately...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28390058/acute-effects-of-exercise-posture-on-executive-function-in-transient-ischemic-attack-patients
#20
James Faulkner, Lee Stoner, Rebecca Grigg, Simon Fryer, Keeron Stone, Danielle Lambrick
In patients with stroke or transient ischemic attacks (TIA), a decline in executive function may limit an individual's ability to process motor tasks and relearn motor skills. The purpose of this study was to assess the acute effect of exercise posture (seated vs. supine cycle ergometry) on executive function and prefrontal cortex perfusion in patients with TIA. Eleven TIA patients (65 ± 10 years) and 15 age-matched, healthy controls (HC; 62 ± 7 years) completed two exercise tests to maximal capacity (one seated, one supine) and two 30-min submaximal exercise tests (one seated, one supine)...
April 8, 2017: Psychophysiology
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