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Stroke clinical trials

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https://www.readbyqxmd.com/read/28088807/posterior-versus-anterior-circulation-stroke-in-young-adults-a-comparative-study-of-stroke-aetiologies-and-risk-factors-in-stroke-among-young-fabry-patients-sifap1
#1
Bettina von Sarnowski, Ulf Schminke, Ulrike Grittner, Christian Tanislav, Tobias Böttcher, Michael G Hennerici, Turgut Tatlisumak, Jukka Putaala, Manfred Kaps, Franz Fazekas, Christian Enzinger, Arndt Rolfs, Christof Kessler
BACKGROUND: Although 20-30% of all strokes occur in the posterior circulation, few studies have explored the characteristics of patients with strokes in the posterior compared to the anterior circulation so far. Especially data on young patients is missing. METHODS: In this secondary analysis of data of the prospective multi-centre European sifap1 study that investigated stroke and transient ischemic attack (TIA) patients aged 18-55 years, we compared vascular risk factors, stroke aetiology, presence of white matter hyperintensities (WMH) and cerebral microbleeds (CMB) between patients with ischaemic posterior circulation stroke (PCS) and those having suffered from anterior circulation stroke (ACS) based on cerebral MRI...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28088798/the-intracranial-b2leed3s-score-and-the-risk-of-intracranial-hemorrhage-in-ischemic-stroke-patients-under-antiplatelet-treatment
#2
Pierre Amarenco, Leila Sissani, Julien Labreuche, Eric Vicaut, Marie Germaine Bousser, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Heinrich Mattle, Peter M Rothwell, Philippe Gabriel Steg, Hans-Christoph Diener, Ralph L Sacco, Jacoba P Greving, Ale Algra
BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a non-cardioembolic ischemic stroke or transient ischemic attack, and externally validated this score in one contemporary trial of very similar size and inclusion criteria, the PRoFESS trial (n = 20,332 patients)...
January 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#3
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28076988/ischemic-stroke-risk-in-east-asian-patients-with-cha2ds2-vasc-score-of-1-systematic-review-and-meta-analysis
#4
Ying Bai, Alena Shantsila, Gregory Y H Lip
Background The use of anticoagulation for stroke prevention in patients with atrial fibrillation (AF) and CHA2DS2-VASc score of 1 has been debated, partially due to limited data on ischemic stroke risk and specific clinical trials in these patients. East Asian patients have a different stroke risk profile compared to non-East Asians. We performed a systematic review and meta-analysis of ischemic stroke risk in AF patients with a CHA2DS2-VASc score of 1 in East Asian countries. Methods A comprehensive literature search for studies evaluating ischemic stroke risk related with AF with CHA2DS2-VASc score of 1 was conducted by two reviewers...
January 11, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28072804/multidisciplinary-care-of-unruptured-brain-arteriovenous-malformations-to-improve-symptomatic-headache-and-the-onset-progression-and-outcomes-of-unruptured-brain-arteriovenous-malformations
#5
Ling-Feng Lai, Min Chen, Jia-Xiang Chen, Kuang Zheng, Xu-Ying He, Xi-Feng Li, Xin Zhang, Jian Yin, Qiu-Jing Wang, Tuan-Ming Zou, Chuan-Zhi Duan
BACKGROUND: Symptomatic headaches attributed to unruptured brain arteriovenous malformations (ubAVMs) are very common and affect patients' quality life, but multidisciplinary care of ubAVMs to improve symptomatic headache remains unclear. OBJECTIVE: The objective is to identify the features of symptomatic headaches, and to obtain headache outcomes following multidisciplinary care of ubAVMs, as well as provide background on the natural history of ubAVMs. STUDY DESIGN: The features of symptomatic headaches and headache outcomes were analyzed in a large cohort of cases after multidisciplinary care of ubAVMs...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072733/efficacy-and-safety-of-puerarin-injection-in-curing-acute-ischemic-stroke-a-meta-analysis-of-randomized-controlled-trials
#6
Qing-Hua Zheng, Xiao-Li Li, Zhi-Gang Mei, Li Xiong, Qing-Xian Mei, Jin-Feng Wang, Ling-Jing Tan, Song-Bai Yang, Zhi-Tao Feng
BACKGROUND: Previous studies indicated that the puerarin injection has been widely employed in China for the treatment of acute ischemic stroke. We aim to evaluate the efficacy and safety of the puerarin injection for the treatment of acute ischemic stroke. METHODS: A systematic literature search was performed in PUBMED, EMBASE, SPRINGER LINK, Scopus, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Journals Database, Wanfang database and the China Biological Medicine database before November 2016, randomized controlled clinical trials (RCTs) of puerarin injection treating acute ischemic stroke were included...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28071818/safety-profile-of-the-direct-oral-anticoagulants-an-analysis-of-the-who-database-of-adverse-drug-reactions
#7
Luca Monaco, Chiara Biagi, Valentino Conti, Mauro Melis, Monia Donati, Mauro Venegoni, Alberto Vaccheri, Domenico Motola
AIM: Direct oral anticoagulants (DOACs) have shown non-inferiority to warfarin for stroke prevention in non-valvular atrial fibrillation (AF) and a more promising safety profile. Unanswered safety aspects remain to addressed and available evidence on the risk associated with these drugs are conflicting. In order to contribute to the debate on their safety profile, we conducted a comparative analysis of the reports of suspected adverse drug reactions (ADRs) associated with DOACs in VigiBase...
January 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28067195/combined-erythropoietin-and-iron-therapy-for-anemic-patients-undergoing-transcatheter-aortic-valve-replacement-the-epicure-randomized-clinical-trial
#8
Marina Urena, Maria Del Trigo, Omar Abdul-Jawad Altisent, Francisco Campelo-Prada, Ander Regueiro, Robert DeLarochellière, Daniel Doyle, Siamak Mohammadi, Jean-Michel Paradis, François Dagenais, Eric Dumont, Rishi Puri, Vincent Laroche, Josep Rodés-Cabau
AIMS: The aim of this study was to evaluate, in anemic patients, the efficacy of erythropoietin (EPO) in reducing red-cell (RC) transfusion rates post-TAVI. METHODS AND RESULTS: This was a randomized double-blind trial. Patients with severe symptomatic aortic stenosis and concomitant anemia with an indication for TAVI were randomized (1:1) to receive 2 weight-based doses of EPO (darbepoetin alfa) + iron or placebo at days 10 (±4 days) and 1 (±1 day) pre- TAVI...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28066594/cough-frequency-monitors-can-they-discriminate-patient-from-environmental-coughs
#9
Stefan T Kulnik, Natalie M Williams, Lalit Kalra, John Moxham, Surinder S Birring
BACKGROUND: Objective cough frequency measurements are increasingly applied in clinical research. Technological advances enable automated detection and counting of cough events from sound recordings of many hours' duration. A possible limitation of sound-based cough frequency measurement is the contamination of recordings by environmental coughs (coughs from persons other than the patient). This study aimed to investigate the accuracy of a sound-based cough monitor for detecting and discriminating patient cough from environmental cough...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#10
REVIEW
Csaba András Dézsi, Balázs Bence Dézsi, Döme András Dézsi
: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28064388/stem-cell-recipes-of-bone-marrow-and-fish-just-what-the-stroke-doctors-ordered
#11
REVIEW
Eleonora Napoli, Cesar V Borlongan
Stem cell therapy for stroke has advanced from the laboratory to the clinic, but remains as an experimental treatment. Two lines of transplant regimens have emerged, namely the "early bird" peripheral injections in subacute stroke patients and the "late night" direct intracerebral treatments in chronic stroke patients. Autologous bone marrow-derived stem cells, which only required minimal manipulations during graft cell preparation, gained fast-track entry into the clinic, while gene modified stem cells necessitated overcoming more stringent regulatory criteria before they were approved for clinical use...
January 7, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28064150/a-novel-risk-prediction-score-in-atrial-fibrillation-for-a-net-clinical-outcome-from-the-engage-af-timi-48-randomized-clinical-trial
#12
Christina L Fanola, Robert P Giugliano, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
AIMS: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. METHODS AND RESULTS: ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28064029/improving-precision-by-adjusting-for-prognostic-baseline-variables-in-randomized-trials-with-binary-outcomes-without-regression-model-assumptions
#13
Jon Arni Steingrimsson, Daniel F Hanley, Michael Rosenblum
In randomized clinical trials with baseline variables that are prognostic for the primary outcome, there is potential to improve precision and reduce sample size by appropriately adjusting for these variables. A major challenge is that there are multiple statistical methods to adjust for baseline variables, but little guidance on which is best to use in a given context. The choice of method can have important consequences. For example, one commonly used method leads to uninterpretable estimates if there is any treatment effect heterogeneity, which would jeopardize the validity of trial conclusions...
January 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28062625/high-sensitivity-troponin-i-in-stable-patients-with-atherosclerotic-disease-in-the-tra-2%C3%A2-p-timi-50-trial
#14
Alon Eisen, Marc P Bonaca, Petr Jarolim, Benjamin M Scirica, Harvey D White, Michal Tendera, Mikael Dellborg, Jose C Nicolau, Joao Morais, Keith A A Fox, Erin A Bohula, Sabina A Murphy, Eugene Braunwald, David A Morrow
BACKGROUND: Cardiac troponin I, measured with a high-sensitivity assay (hs-TnI), is well-established for risk prediction in acute coronary syndromes. However, its prognostic role in stable atherosclerotic disease, particularly for future myocardial infarction (MI), is less well defined. METHODS: We measured hs-TnI (Abbott ARCHITECT) in 15833 patients with prior MI, ischemic stroke, or peripheral arterial disease from the placebo-controlled Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)-Thrombolysis in Myocardial Infarction (TIMI) 50 trial of the platelet inhibitor vorapaxar, excluding patients with recent MI (<30 days)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28060096/safety-of-extracranial-intracranial-arterial-bypass-in-the-treatment-of-moyamoya-disease
#15
Lian Liu, Song Wei Su, Hong Yan Sun
OBJECTIVE: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. METHODS: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28057693/assessing-the-safety-of-sitagliptin-in-older-participants-in-the-trial-evaluating-cardiovascular-outcomes-with-sitagliptin-tecos
#16
M Angelyn Bethel, Samuel S Engel, Jennifer B Green, Zhen Huang, Robert G Josse, Keith D Kaufman, Eberhard Standl, Shailaja Suryawanshi, Frans Van de Werf, Darren K McGuire, Eric D Peterson, Rury R Holman
OBJECTIVE: Limited data exist regarding safety and efficacy of antihyperglycemic drugs in older patients with type 2 diabetes. The Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) was a randomized, double-blind, placebo-controlled trial assessing the impact of sitagliptin on a primary composite outcome of cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, or unstable angina hospitalizations in patients with type 2 diabetes (HbA1c ≥6.5% [48 mmol/mol] and ≤8...
January 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28057651/efficacy-of-interventions-to-improve-physical-activity-levels-in-individuals-with-stroke-a-systematic-review-protocol
#17
Larissa Tavares Aguiar, Júlia Caetano Martins, Sylvie Nadeau, Raquel Rodrigues Britto, Luci F Teixeira-Salmela, Christina D C M Faria
INTRODUCTION: Stroke is a leading health problem worldwide and an important cause of disability. Stroke survivors show low levels of physical activity, and increases in physical activity levels may improve function and health status. Therefore, the aims are to identify which interventions that have been employed to increase physical activity levels with stroke survivors, to verify their efficacy and to identify the gaps in the literature. METHODS AND ANALYSIS: A systematic review of randomised controlled trials that investigated the efficacy of interventions aiming at increasing physical activity levels of stroke survivors will be conducted...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28057444/redefining-beta-blocker-use-in-hypertension-selecting-the-right-beta-blocker-and-the-right-patient
#18
REVIEW
Samuel J Mann
Randomized controlled trials have concluded that the cardiovascular outcome of first-step treatment of hypertension with traditional vasoconstricting beta-blockers is inferior to treatment with other antihypertensive drug classes. Beta-blocker use is also associated with undesirable side effects. Consequently, some recent guidelines consider beta-blockers an inferior option for first-step treatment of hypertension. Despite this, beta-blockers are still widely prescribed, and likely overused, in the management of hypertension...
December 5, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28055887/eeg-based-strategies-to-detect-motor-imagery-for-control-and-rehabilitation
#19
Kai Keng Ang, Cuntai Guan
Advances in Brain-Computer Interface (BCI) technology have facilitated the detection of Motor Imagery (MI) from electroencephalography (EEG). First, we present three strategies of using BCI to detect MI from EEG: operant conditioning that employed a fixed model, machine learning that employed a subject-specific model computed from calibration, and adaptive strategy that continuously compute the subjectspecific model. Second, we review prevailing works that employed the operant conditioning and machine learning strategies...
December 30, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28054364/patients-and-physicians-perceptions-regarding-the-benefits-of-atrial-fibrillation-ablation
#20
Auroa Badin, Alan R Parr, Sandeep Banga, Rebecca R Wigant, Timir S Baman
INTRODUCTION: It is unclear whether patients and physicians understand that atrial fibrillation ablation (AFA) has been shown to only improve symptomology and not reduce morbidity or mortality. METHODS: 177 of 445 (40%) consecutive patients referred to an electrophysiology clinic for atrial fibrillation (AF) management responded anonymously to our survey via mail. 105 of 656 (15%) physicians responded to our survey via email. Comparisons among groups were conducted using Chi- Square test for categorical variables...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
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