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Transient ischemic stroke

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https://www.readbyqxmd.com/read/29792215/adding-left-atrial-appendage-closure-to-open-heart-surgery-provides-protection-from-ischemic-brain-injury-six-years-after-surgery-independently-of-atrial-fibrillation-history-the-laacs-randomized-study
#1
Jesper Park-Hansen, Susanne J V Holme, Akhmadjon Irmukhamedov, Christian L Carranza, Anders M Greve, Gina Al-Farra, Robert G C Riis, Brian Nilsson, Johan S R Clausen, Anne S Nørskov, Christina R Kruuse, Egill Rostrup, Helena Dominguez
BACKGROUND: Open heart surgery is associated with high occurrence of atrial fibrillation (AF), subsequently increasing the risk of post-operative ischemic stroke. Concomitant with open heart surgery, a cardiac ablation procedure is commonly performed in patients with known AF, often followed by left atrial appendage closure with surgery (LAACS). However, the protective effect of LAACS on the risk of cerebral ischemia following cardiac surgery remains controversial. We have studied whether LAACS in addition to open heart surgery protects against post-operative ischemic brain injury regardless of a previous AF diagnosis...
May 23, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29791706/use-of-a-noblestitch%C3%A2-el-device-for-pfo-closure
#2
Emanuela de Cillis, Tommaso Acquaviva, Pasquale D'Alessandro, Alessandro Santo Bortone
Cryptogenic stroke is the final diagnosis in almost 40% of ischemic acute cerebrovascular events. There is currently no definitive clinical evidence that percutaneous closure of patent foramen ovale (PFO) can prevent the recurrence of stroke or transient ischemic attack (TIA). Identification of the causes of neurologic ischemic syndromes is essential for any strategy intended to prevent the catastrophic consequences of cerebral infarction. Since the initial reports of an unexpectedly high prevalence of PFO in younger patients with cryptogenic stroke in 1988, there has been growing interest and experience in diagnosing and treating these patients, both medically and/or with percutaneous closure, in particular for the potential to eliminate paradoxical embolism via PFO, which is a likely mechanism for stroke in these patients...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29788021/predictors-of-cardioembolic-stroke-in-japanese-patients-with-atrial-fibrillation-in-the-fushimi-af-registry
#3
Ken Yasuda, Shunichi Fukuda, Michikazu Nakamura, Ryo Ohtani, Yasuhiro Kuwata, Masaki Takata, Makoto Sainouchi, Masahiro Gotou, Yuichi Masuda, Satoru Kawarazaki, Yasuhiro Kawabata, Nagako Murase, Tomokazu Aoki, Naohiro Yonemoto, Masaharu Akao, Tetsuya Tsukahara
BACKGROUND: Large-scale clinical trials have analyzed risk factors for any ischemic stroke in patients with atrial fibrillation (AF). However, the risk factors for cardioembolic stroke (CES), specifically, have not been reported. To clarify the risk factors for CES and clinically significant cardioembolic infarction, we examined the incidence of CES and larger infarct volume (IV) (> 30 mL) CES, employing the Fushimi AF Registry, a community-based prospective cohort of AF patients in the Fushimi ward, Kyoto, Japan...
May 22, 2018: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29779587/meta-analysis-of-studies-comparing-dual-versus-mono-antiplatelet-therapy-following-transcatheter-aortic-valve-implantation
#4
Shadi Al Halabi, Joshua Newman, Michael E Farkouh, David Fortuin, Fred Leya, John Sweeney, Amir Darki, John Lopez, Lowell Steen, Bruce Lewis, John Webb, Martin B Leon, Verghese Mathew
Current guidelines recommend dual-antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI), although some studies suggest mono-antiplatelet therapy is equally efficacious with an improved safety profile. We performed a meta-analysis of studies comparing DAPT with mono-antiplatelet therapy after TAVI. Study quality and heterogeneity were assessed using Jadad score, Newcastle-Ottawa Scale, and Cochran's Q statistics. Mantel-Haenszel odds ratios (ORs) were calculated using fixed effect models as the primary analysis...
March 28, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29777578/sirt3-deficiency-impairs-neurovascular-recovery-in-ischemic-stroke
#5
Xiao Yang, Ke-Yi Geng, Yan-Shuang Zhang, Jin-Fan Zhang, Ke Yang, Jia-Xiang Shao, Wei-Liang Xia
AIMS: Sirt3 is one member of the NAD+ -dependent protein deacetylase family and plays crucial roles in diverse aspects of mammalian biological function. Then the role of Sirt3 on ischemia stroke is unknown. METHODS: To examine the effect of Sirt3 on ischemic stroke, we performed transient middle cerebral artery occlusion (tMCAO) in adult male Sirt3 knockout (KO) and wild-type (WT) mice. RESULTS: The level of Sirt3 in infarct region is decreased after ischemic stroke...
May 18, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#6
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776764/-transient-monocular-blindness-vascular-causes-and-differential-diagnoses
#7
REVIEW
S Bidot, D Biotti
Transient monocular blindness is an acute episode of ischemic origin in which one eye has profound visual loss, followed by full recovery within one hour. Transient monocular blindness most often occurs in the setting of retinal ischemia secondary to carotid embolism, but other mechanisms have been reported, including thrombosis (most often in the setting of giant cell arteritis), hemodynamic disorders (secondary to severe carotid stenosis) or vasospasm. Transient monocular blindness is considered a transient ischemic attack originating in the carotid arteries and must benefit from the same management as transient ischemic attack involving the brain, in order to prevent a subsequent stroke...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29776406/the-effect-of-dpp-4-inhibition-to-improve-functional-outcome-after-stroke-is-mediated-by-the-sdf-1%C3%AE-cxcr4-pathway
#8
Fausto Chiazza, Harald Tammen, Hiranya Pintana, Grazyna Lietzau, Massimo Collino, Thomas Nyström, Thomas Klein, Vladimer Darsalia, Cesare Patrone
BACKGROUND: Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) are approved drugs for the treatment of hyperglycemia in patients with type 2 diabetes. These effects are mainly mediated by inhibiting endogenous glucagon-like peptide-1 (GLP-1) cleavage. Interestingly, gliptins can also improve stroke outcome in rodents independently from GLP1. However, the underlying mechanisms are unknown. Stromal cell-derived factor-1α (SDF-1α) is a DPP-4 substrate and CXCR4 agonist promoting beneficial effects in injured brains...
May 19, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29774054/beta-adrenoceptor-blockade-ameliorates-impaired-glucose-tolerance-and-alterations-of-the-cerebral-ceramide-metabolism-in-an-experimental-model-of-ischemic-stroke
#9
Sebastian Luger, Annette Schwebler, Rajkumar Vutukuri, Nerea Ferreiros Bouzas, Sandra Labocha, Yannick Schreiber, Robert Brunkhorst, Helmuth Steinmetz, Josef Pfeilschifter, Waltraud Pfeilschifter
Background: Sphingolipids are versatile signaling molecules derived from membrane lipids of eukaryotic cells. Ceramides regulate cellular processes such as proliferation, differentiation and apoptosis and are involved in cellular stress responses. Experimental evidence suggests a pivotal role of sphingolipids in the pathogenesis of cardiovascular diseases, including ischemic stroke. A neuroprotective effect has been shown for beta-adrenergic antagonists in rodent stroke models and supported by observational clinical data...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29773949/effect-of-dual-antiplatelet-on-recurrent-stroke-in-minor-stroke-or-tia-depends-on-bodyweight
#10
Yan Ma, Ying Liu, Jie Xu, Yilong Wang, Yongjun Wang, Fenghe Du
Objective: To assess whether bodyweight influences the efficacy and safety of dual antiplatelet therapy (DAT) in male patients with minor stroke or transient ischemic attack patients. Materials and methods: All 3,420 male participants coming from the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial were divided into 3 groups based on bodyweight (<65 kg, 65-75 kg, and ≥75 kg). The stroke outcomes included stroke recurrence, combined vascular events, and bleeding events during 90 days of follow-up...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29769288/targeted-complement-inhibition-salvages-stressed-neurons-and-inhibits-neuroinflammation-after-stroke-in-mice
#11
Ali Alawieh, E Farris Langley, Stephen Tomlinson
Ischemic stroke results from the interruption of blood flow to the brain resulting in long-term motor and cognitive neurological deficits, and it is a leading cause of death and disability. Current interventions focus on the restoration of blood flow to limit neuronal death, but these treatments have a therapeutic window of only a few hours and do not address post-stroke cerebral inflammation. The complement system, a component of the innate immune system, is activated by natural immunoglobulin M (IgM) antibodies that recognize neoepitopes expressed in the brain after ischemic stroke...
May 16, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29766771/five-year-risk-of-stroke-after-tia-or-minor-ischemic-stroke
#12
Pierre Amarenco, Philippa C Lavallée, Linsay Monteiro Tavares, Julien Labreuche, Gregory W Albers, Halim Abboud, Sabrina Anticoli, Heinrich Audebert, Natan M Bornstein, Louis R Caplan, Manuel Correia, Geoffrey A Donnan, José M Ferro, Fernando Gongora-Rivera, Wolfgang Heide, Michael G Hennerici, Peter J Kelly, Michal Král, Hsiu-Fen Lin, Carlos Molina, Jong Moo Park, Francisco Purroy, Peter M Rothwell, Tomas Segura, David Školoudík, P Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Éric Vicaut, Yongjun Wang, Lawrence K S Wong
Background After a transient ischemic attack (TIA) or minor stroke, the long-term risk of stroke and other vascular events is not well known. In this follow-up to a report on 1-year outcomes from a registry of TIA clinics in 21 countries that enrolled 4789 patients with a TIA or minor ischemic stroke from 2009 through 2011, we examined the 5-year risk of stroke and vascular events. Methods We evaluated patients who had had a TIA or minor stroke within 7 days before enrollment in the registry. Among 61 sites that participated in the 1-year outcome study, we selected 42 sites that had follow-up data on more than 50% of their enrolled patients at 5 years...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29766750/clopidogrel-and-aspirin-in-acute-ischemic-stroke-and-high-risk-tia
#13
S Claiborne Johnston, J Donald Easton, Mary Farrant, William Barsan, Robin A Conwit, Jordan J Elm, Anthony S Kim, Anne S Lindblad, Yuko Y Palesch
Background Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population. Methods In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29765392/carotid-stenting-for-treatment-of-symptomatic-carotid-webs-a-single-center-case-series
#14
Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764964/cardiovascular-cv-risk-after-initiation-of-abatacept-versus-tnf-inhibitors-in-rheumatoid-arthritis-patients-with-and-without-baseline-cv-disease
#15
Yinzhu Jin, Eun Ha Kang, Gregory Brill, Rishi J Desai, Seoyoung C Kim
OBJECTIVE: To evaluate the cardiovascular safety of abatacept (ABA) versus tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients with and without underlying cardiovascular disease (CVD). METHODS: We identified RA patients with and without baseline CVD who initiated ABA or TNFi by using data from 2 large US insurance claims databases: Medicare (2008-2013) and Truven MarketScan (2006-2015). After stratifying by baseline CVD, ABA initiators were 1:1 propensity score (PS) matched to TNFi initiators to control for > 60 baseline covariates...
May 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29762050/dl-3-n-butylphthalide-attenuates-ischemic-reperfusion-injury-by-improving-the-function-of-cerebral-artery-and-circulation
#16
Chuan Qin, Panting Zhou, Liping Wang, Muyassar Mamtilahun, Wanlu Li, Zhijun Zhang, Guo-Yuan Yang, Yongting Wang
Dl-3-N-butylphthalide (NBP) is approved in China for the treatment of ischemic stroke. Previous studies have shown that NBP promotes recovery after stroke via multiple mechanisms. However, the effect of NBP on vascular function and thrombosis remains unclear. Here, we aim to study the effect of NBP on vascular function using a rat model of transient middle cerebral artery occlusion (MCAO) and a state-of-the-art high-resolution synchrotron radiation angiography. Eighty SD rats underwent MCAO surgery. NBP (90 mg/kg) was administrated daily by gavage...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29760293/-safety-of-dual-antiplatelet-therapy-with-argatroban-in-patients-with-acute-ischemic-stroke
#17
Yoshinari Nagakane, Eijirou Tanaka, Shinji Ashida, Yuta Kojima, Shiori Ogura, Keiko Maezono, Yasumasa Yamamoto
To prevent early neurological worsening or recurrence in stroke patients with intracranial arterial stenosis or branch atheromatous disease, aggressive antithrombotic therapy, such as dual antiplatelet therapy (DAPT) with or without anticoagulant therapy, is warranted. Such an aggressive antithrombotic therapy, however, may increase the bleeding risk. We studied the risks of DAPT with the anticoagulant argatroban in patients with acute ischemic stroke or transient ischemic attack (TIA). Between October 2011 and September 2015, 341 patients with stroke or TIA, who received DAPT with argatroban within 48 hours after onset, were retrospectively studied...
May 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29760276/early-blood-brain-barrier-disruption-in-ischemic-stroke-initiates-multifocally-around-capillaries-venules
#18
Angelika Hoffmann, Tassilo Dege, Reiner Kunze, Anne-Sophie Ernst, Holger Lorenz, Laura-Inés Böhler, Thomas Korff, Hugo H Marti, Sabine Heiland, Martin Bendszus, Xavier Helluy, Mirko Pham
BACKGROUND AND PURPOSE: Detection and localization of the early phase of blood-brain barrier disruption (BBBD) in vivo during cerebral ischemia/reperfusion injury remain a major challenge but may be a relevant outcome parameter in stroke. METHODS: We studied early BBBD in mice after transient middle cerebral artery occlusion by multimodal, high-field (9.4T) in vivo magnetic resonance imaging, including the contrast agent gadofluorineM as an albumin-binding tracer...
May 14, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29759854/a-meta-analysis-of-reduced-leaflet-motion-for-surgical-and-transcatheter-aortic-valves-relationship-to-cerebrovascular-events-and-valve-degeneration
#19
Nader Makki, Satya Shreenivas, Dean Kereiakes, Scott Lilly
BACKGROUND: Reduced leaflet motion (RLM) of transcatheter aortic valves (TAV) is observed in up to 4% of cases with similar frequency in surgical valves, with an overall incidence that differs based on prosthesis type and size. This phenomenon likely represents subclinical leaflet thrombosis. Herein we sought to analyze the existing reported literature to assess whether or not RLM is associated with subsequent valve degeneration or cerebrovascular events. METHODS AND RESULTS: We searched PubMed, and EMBASE (2008-2017) to identify relevant studies...
April 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29758555/secondary-prevention-three-and-six-years-after-stroke-using-the-french-national-insurance-healthcare-system-database
#20
Laura Mechtouff, Julie Haesebaert, Marie Viprey, Valérie Tainturier, Anne Termoz, Sylvie Porthault-Chatard, Jean-Stéphane David, Laurent Derex, Norbert Nighoghossian, Anne-Marie Schott
BACKGROUND: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS). METHODS: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period)...
May 14, 2018: European Neurology
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