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Stroke clinical trials

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https://www.readbyqxmd.com/read/28330726/provision-of-physiological-data-and-reference-values-in-awake-and-anaesthetized-female-sheep-aged-6-12-months
#1
Tim Kampmeier, Philip Arnemann, Michael Heßler, Sebastian Rehberg, Andrea Morelli, Martin Westphal, Matthias Lange, Hugo Van Aken, Christian Ertmer
OBJECTIVE: To provide physiological data and reference values in awake and anaesthetized sheep aged 6-12 months. STUDY DESIGN: Descriptive study. ANIMALS: Data from 260 female sheep of the species Ovis orientalis aries aged 6-12 months were extracted from 10 experimental trials. METHODS: Data from pulmonary arterial thermodilution in awake (cohort 1; n = 109) and anaesthetized animals (cohort 2; n = 81), and transpulmonary thermodilution in anaesthetized animals (cohort 3; n = 70) were analysed...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28330015/contact-aspiration-versus-stent-retriever-front-line-for-recanalisation-in-acute-cerebral-infarction-the-aster-trial
#2
Bertrand Lapergue, Julien Labreuche, Michel Piotin
RATIONALE: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO). Favorable outcome is strongly associated with the successful reperfusion status. New techniques for MT such as contact aspiration (CA) seem promising to increase reperfusion status and clinical outcome in retrospective studies. We aim at ascertaining whether CA is more efficient than stent retriever as a front-line endovascular procedure...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28330012/mechanical-thrombectomy-for-minor-and-mild-stroke-patients-harboring-large-vessel-occlusion-in-the-anterior-circulation-a-multicenter-case-control-study
#3
Cyril Dargazanli, Caroline Arquizan, Arturo Consoli, Benjamin Gory, Omer Eker, Xavier Ayrignac, Jean-Pierre Decroix, Astrid Corlobé, Isabelle Mourand, Grégory Gascou, Mahmoud Charif, Julien Labreuche, Alain Duhamel, Paul-Emile Labeyrie, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Carlos Riquelme, Oguzhan Coskun, Jean-Philippe Desilles, Frédéric Bourdain, Roberto Riva, Mikael Obadia, Francis Turjman, Georges Rodesch, Pierre Labauge, Alain Bonafé, Mikael Mazighi, Vincent Costalat, Michel Piotin, Raphaël Blanc, Bertrand Lapergue
BACKGROUND AND PURPOSE: Proximal large vessel occlusion (LVO) is present in up to 30% of minor strokes. There is no proven effectiveness of MT in the subgroup of minor stroke with LVO in the anterior circulation and data about mechanical thrombectomy (MT) in this subgroup of patients are sparse, with optimal management of these patients being yet not definitely addressed. The purpose of this case-control study was to evaluate MT in patients suffering from acute ischemic stroke (AIS) and LVO in the anterior circulation, presenting with minor to mild stroke symptoms (NIHSS<8)...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#4
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329215/triple-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-a-viewpoint
#5
Jennifer C V Gwyn, Mark R Thomas, Paulus Kirchhof
Patients undergoing percutaneous coronary intervention (PCI) are treated with dual antiplatelet therapy to reduce the risk of subsequent myocardial infarction (MI) and stent thrombosis. Approximately 5-10% of patients undergoing PCI also have atrial fibrillation (AF). Patients with AF have an additional requirement for anticoagulation, as dual antiplatelet therapy alone is insufficient to adequately reduce the risk of stroke in patients with AF. However, it is now well established that combining anticoagulants with dual antiplatelet therapy also causes a significant increase in the risk of bleeding...
March 13, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28328002/endovascular-treatment-of-middle-cerebral-artery-m2-occlusion-strokes-clinical-and-procedural-predictors-of-outcomes
#6
Maxim Mokin, Christopher T Primiani, Zeguang Ren, Peter Kan, Edward Duckworth, Raymond D Turner, Aquilla S Turk, Kyle M Fargen, Guilherme Dabus, Italo Linfante, Travis M Dumont, Leonardo B C Brasiliense, Hussain Shallwani, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Patients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy. OBJECTIVE: To better understand the clinical, imaging, and procedural predictors of successful recanalization and clinical outcomes in this population of patients. METHODS: We performed a multicenter retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique approach)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327054/effects-of-low-frequency-repetitive-transcranial-magnetic-stimulation-and-neuromuscular-electrical-stimulation-on-upper-extremity-motor-recovery-in-the-early-period-after-stroke-a-preliminary-study
#7
Aliye Tosun, Sabiha Türe, Ayhan Askin, Engin Ugur Yardimci, Secil Umit Demirdal, Tülay Kurt Incesu, Ozgur Tosun, Hikmet Kocyigit, Galip Akhan, Fazıl Mustafa Gelal
OBJECTIVE: To assess the efficacy of inhibitory repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on upper extremity motor function in patients with acute/subacute ischemic stroke. METHODS: Twenty-five ischemic acute/subacute stroke subjects were enrolled in this randomized controlled trial. Experimental group 1 received low frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT) including activities to improve strength, flexibility, transfers, posture, balance, coordination, and activities of daily living, mainly focusing on upper limb movements; experimental group 2 received the same protocol combined with NMES to hand extensor muscles; and the control group received only PT...
March 22, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28325524/current-status-of-lipid-management-in-acute-coronary-syndrome
#8
REVIEW
Koichiro Fujisue, Kenichi Tsujita
The development of coronary revascularization has dramatically improved early cardiovascular outcomes in patients with acute coronary syndrome (ACS). However, patients who have experienced myocardial infarction (MI) are at high risk of recurrence of cardiovascular events compared with those who are healthy or have stable coronary artery disease. Acute coronary events induce further inflammatory responses and plaque vulnerability in either a coronary culprit or whole vessels. The majority of data have supported the importance of coronary risk management to prevent secondary events...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28322973/imidazoline-i2-receptors-an-update
#9
REVIEW
Jun-Xu Li
Since first introduced more than two decades ago, the research in imidazoline I2 receptors has been steadily increasing. This review provides an update on the current status of I2 receptor pharmacology. Imidazoline I2 receptors or I2 binding sites refer to several (at least four) different proteins that bind to [(3)H]-idazoxan and [(3)H]-2-BFI with high affinity. The molecular identities of the proteins remain elusive. One of the proteins (45 kD) seems to be consistent with the identity of brain creatine kinase...
March 16, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28322009/prognostic-importance-of-left-ventricular-mechanical-dyssynchrony-in-heart-failure-with-preserved-ejection-fraction
#10
Tor Biering-Sørensen, Sanjiv J Shah, Inder Anand, Nancy Sweitzer, Brian Claggett, Li Liu, Bertram Pitt, Marc A Pfeffer, Scott D Solomon, Amil M Shah
AIMS: Left ventricular mechanical dyssynchrony has been described in heart failure with preserved ejection fraction (HFpEF), but its prognostic significance is not known. METHODS AND RESULTS: Of 3445 patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, dyssynchrony analysis was performed on 424 patients (12%) by multiple speckle tracking echocardiography strain-based criteria. The primary dyssynchrony analysis was the standard deviation of the time to peak longitudinal strain (SD T2P LS)...
March 21, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28321003/midterm-outcomes-with-a-self-expandable-transcatheter-heart-valve-in-japanese-patients-with-symptomatic-severe-aortic-stenosis
#11
Yoshiki Sawa, Kei Torikai, Junjiro Kobayashi, Hiroshi Niinami, Toru Kuratani, Koichi Maeda, Hideaki Kanzaki, Nobuyuki Komiyama, Yutaka Tanaka, Angie Zhang, Shigeru Saito
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a viable alternative to surgical aortic valve replacement in high-risk or inoperable patients with aortic stenosis (AS). Here we report the midterm outcomes of high-risk Japanese patients with severe AS who underwent TAVI with a self-expandable TAV.Methods and Results:The CoreValve Japan Trial was a prospective, multicenter trial of the CoreValve System. A group of 55 patients (mean age 82.5±5.5 years, 30.9% male, 100% NYHA class III/IV, STS 8...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28321002/five-year-outcomes-of-the-first-pivotal-clinical-trial-of-balloon-expandable-transcatheter-aortic-valve-replacement-in-japan-prevail-japan
#12
Yoshiki Sawa, Morimasa Takayama, Tsuyoshi Goto, Shuichiro Takanashi, Tatsuhiko Komiya, Tetsuya Tobaru, Koichi Maeda, Toru Kuratani, Yasushi Sakata
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28321000/the-effects-of-hydrogen-gas-inhalation-on-adverse-left-ventricular-remodeling-after-percutaneous-coronary-intervention-for-st-elevated-myocardial-infarction%C3%A3-first-pilot-study-in-humans
#13
Yoshinori Katsumata, Fumiya Sano, Takayuki Abe, Tomoyoshi Tamura, Taishi Fujisawa, Yasuyuki Shiraishi, Shun Kohsaka, Ikuko Ueda, Koichiro Homma, Masaru Suzuki, Shigeo Okuda, Yuichiro Maekawa, Eiji Kobayashi, Shingo Hori, Junichi Sasaki, Keiichi Fukuda, Motoaki Sano
BACKGROUND: Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI).Methods and Results:The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320635/safety-and-efficacy-of-multipotent-adult-progenitor-cells-in-acute-ischaemic-stroke-masters-a-randomised-double-blind-placebo-controlled-phase-2-trial
#14
David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays
BACKGROUND: Multipotent adult progenitor cells are a bone marrow-derived, allogeneic, cell therapy product that modulates the immune system, and represents a promising therapy for acute stroke. We aimed to identify the highest, well-tolerated, and safest single dose of multipotent adult progenitor cells, and if they were efficacious as a treatment for stroke recovery. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, dose-escalation trial of intravenous multipotent adult progenitor cells in 33 centres in the UK and the USA...
March 17, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28319424/rivaroxaban-in-patients-with-atrial-fibrillation-from-rocket-af-to-everyday-practice
#15
Gonzalo Barón-Esquivias, Francisco Marín, Marcelo Sanmartín
Registries and non-interventional studies offer relevant and complementary information to clinical trials, since they have a high external validity. Areas covered: The information regarding the efficacy and safety of rivaroxaban compared with warfarin, or rivaroxaban alone in clinical practice was reviewed in this manuscript. For this purpose, a search on MEDLINE and EMBASE databases was performed. The MEDLINE and EMBASE search included both medical subject headings (MeSH) and keywords including: atrial fibrillation (AF) OR warfarin OR clinical practice OR ROCKET AF AND rivaroxaban...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28318984/safety-and-efficacy-of-thrombectomy-in-acute-ischaemic-stroke-revascat-1-year-follow-up-of-a-randomised-open-label-trial
#16
Antoni Dávalos, Erik Cobo, Carlos A Molina, Angel Chamorro, M Angeles de Miquel, Luis San Román, Joaquín Serena, Elena López-Cancio, Marc Ribó, Mónica Millán, Xabier Urra, Pere Cardona, Alejandro Tomasello, Carlos Castaño, Jordi Blasco, Lucía Aja, Marta Rubiera, Meritxell Gomis, Arturo Renú, Blanca Lara, Joan Martí-Fàbregas, Brian Jankowitz, Neus Cerdà, Tudor G Jovin
BACKGROUND: The REVASCAT trial and other studies have shown that the neurovascular thrombectomy improves outcomes at 90 days post stroke. However, whether the observed benefit is sustained in the long term remains unknown. We report the results of the prespecified 12-month analysis of the REVASCAT trial. METHODS: Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone...
March 16, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28318816/use-of-electromyography-to-optimize-lokomat-%C3%A2-settings-for-subject-specific-gait-rehabilitation-in-post-stroke-hemiparetic-patients-a-proof-of-concept-study
#17
Yosra Cherni, Mickael Begon, Hicham Chababe, Florent Moissenet
OBJECTIVES: While generic protocols exist for gait rehabilitation using robotic orthotics such as the Lokomat(®), several settings - guidance, body-weight support (BWS) and velocity - may be adjusted to individualize patient training. However, no systematic approach has yet emerged. Our objective was to assess the feasibility and effects of a systematic approach based on electromyography to determine subject-specific settings with application to the strengthening of the gluteus maximus muscle in post-stroke hemiparetic patients...
March 16, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28318138/safety-and-efficacy-of-6-month-versus-12-month-dual-antiplatelet-therapy-in-patients-after-implantation-of-multiple-biodegradable-polymer-coated-sirolimus-eluting-coronary-stents-insight-from-the-i-love-it-2-trial
#18
Jing Qi, Yi Li, Jing Li, Quanmin Jing, Kai Xu, Chuanyu Gao, Likun Ma, Zhi Zhang, Bo Xu, Yaling Han
OBJECTIVE: This study sought to compare the clinical outcomes of 6-month versus 12-month dual antiplatelet therapy (DAPT) in patients receiving multiple biodegradable polymer-coated sirolimus-eluting stents (BP-SES) implants. BACKGROUND: The clinical outcomes for patients who undergo multiple BP-SES implantation with different DAPT durations are uncertain. METHODS: In the I-LOVE-IT 2 trial, 907 patients treated with multiple BP-SES (total stent number ≥2) were assigned to receive 6-month (n = 440) or 12-month (n = 467) DAPT...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28318092/lycopene-and-risk-of-cardiovascular-diseases-a-meta-analysis-of-observational-studies
#19
Bo Song, Kai Liu, Yuan Gao, Lu Zhao, Hui Fang, Yusheng Li, Lulu Pei, Yuming Xu
SCOPE: The aim of current meta-analysis was to investigate the relation between lycopene and risk of cardiovascular diseases (CVD). METHODS AND RESULTS: Studies concerning about the association between lycopene and risk of CVD were searched on Pubmed, Embase, and Web of Science from inception to October 2016. A total of 14 eligible studies were identified. A significantly inverse association with a pooled risk ratio (RR) of 0.83 (95% CI: 0.76-0.90) was shown between lycopene exposure and risk of CVD...
March 20, 2017: Molecular Nutrition & Food Research
https://www.readbyqxmd.com/read/28317947/parietal-operculum-and-motor-cortex-activities-predict-motor-recovery-in-moderate-to-severe-stroke
#20
Firdaus Fabrice Hannanu, Thomas A Zeffiro, Laurent Lamalle, Olivier Heck, Félix Renard, Antoine Thuriot, Alexandre Krainik, Marc Hommel, Olivier Detante, Assia Jaillard
While motor recovery following mild stroke has been extensively studied with neuroimaging, mechanisms of recovery after moderate to severe strokes of the types that are often the focus for novel restorative therapies remain obscure. We used fMRI to: 1) characterize reorganization occurring after moderate to severe subacute stroke, 2) identify brain regions associated with motor recovery and 3) to test whether brain activity associated with passive movement measured in the subacute period could predict motor outcome six months later...
2017: NeuroImage: Clinical
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