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Ischemic stroke randomized

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https://www.readbyqxmd.com/read/28076988/ischemic-stroke-risk-in-east-asian-patients-with-cha2ds2-vasc-score-of-1-systematic-review-and-meta-analysis
#1
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/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#2
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28072733/efficacy-and-safety-of-puerarin-injection-in-curing-acute-ischemic-stroke-a-meta-analysis-of-randomized-controlled-trials
#3
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/28072691/the-effectiveness-and-safety-of-dual-antiplatelet-therapy-in-ischemic-cerebrovascular-disease-with-intracranial-and-extracranial-arteriostenosis-in-chinese-patients-a-randomized-and-controlled-trail
#4
Feng-Tong Zuo, Hui Liu, Hui-Jun Wu, Na Su, Jie-Qiong Liu, Ai-Qin Dong
BACKGROUND: There are limited data on the effect of dual antiplatelet treatment with clopidogrel plus aspirin in patients with ischemic cerebrovascular disease and intracranial and extracranial arteriostenosis. The aim of our study was to evaluate the efficacy and safety of aspirin plus clopidogrel in the treatment of ischemic cerebrovascular disease with intracranial and extracranial arteriostenosis. METHODS: Patients with clinically evident acute cerebral infarction or transient ischemic attack combined with intracranial and extracranial arteriostenosis (greater than 50%) who were unsuitable or reluctance to perform stent implantation were enrolled in this study...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070000/anesthesia-technique-and-outcomes-of-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke
#5
Kimon Bekelis, Symeon Missios, Todd A MacKenzie, Stavropoula Tjoumakaris, Pascal Jabbour
BACKGROUND AND PURPOSE: The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS: We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
January 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#6
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/28056920/huatuo-zaizao-pill-promotes-functional-recovery-and-neurogenesis-after-cerebral-ischemia-reperfusion-in-rats
#7
Sijin Duan, Tian Wang, Jianqiao Zhang, Minmin Li, Chengwen Lu, Lijie Wang, Yan Zou, Fenghua Fu
BACKGROUND: Ischemic stroke is the third leading cause of death in adults worldwide and is the first leading cause of long-term disability. Neurogenesis plays an important role in promoting behavioral recovery after stroke. Huatuo Zaizao pill (HT), a traditional Chinese medicine, has been used clinically in China to promote the rehabilitation after stroke, but the underlying mechanism of action was still unclear. This study is to investigate the effects of HT on the functional recovery in a rat model of cerebral ischemia-reperfusion (I/R) injury, and the potential molecular mechanisms...
January 5, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#8
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28043669/long-term-clinical-outcomes-of-remote-ischemic-preconditioning-and-postconditioning-outcome-rispo-trial-in-patients-undergoing-cardiac-surgery
#9
Youn Joung Cho, Eun-Ho Lee, Kanghee Lee, Tae Kyong Kim, Deok Man Hong, Ji-Hyun Chin, Dae-Kee Choi, Jae-Hyon Bahk, Ji-Yeon Sim, In-Cheol Choi, Yunseok Jeon
BACKGROUND: Remote ischemic conditioning has been shown to confer myocardial protection. However, there is still no sufficient data on its long-term clinical outcomes. We analyzed the long-term results of the Remote Ischemic Preconditioning and Postconditioning Outcome (RISPO) trial in cardiac surgery patients. METHODS: In the RISPO trial, 1280 patients were randomized to receive remote ischemic preconditioning (RIPC) with postconditioning (RIPostC, upper arm ischemia by four cycles of 5-min inflation followed by 5-min deflation of a pneumatic cuff, N=644) or sham (N=636) during cardiac surgery...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28038899/mechanical-thrombectomy-in-acute-ischemic-stroke-initial-single-center-experience-and-comparison-with-randomized-controlled-trials
#10
Andreia Carvalho, André Cunha, Marta Rodrigues, Sofia Figueiredo, Ludovina Paredes, Tiago Gregório, Hugo Morais, Joaquim Pinheiro, Vítor Tedim Cruz, José Mário Roriz, João Pinho, Carla Ferreira, Edgar Torre, Joana Nunes, Sérgio Castro, Manuel Ribeiro, Miguel Veloso, Pedro Barros
BACKGROUND: Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion. After 1 year of performing thrombectomy with stent retrievers in our tertiary hospital, we intended to answer the question: is it possible to achieve similar results in a "real-world" setting? METHODS: We analyzed data from our prospective observational registry, compared it with the trials aforementioned, and concluded that the answer is affirmative...
December 27, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28033306/outcomes-of-%C3%A2-6-month-versus-12-month-dual-antiplatelet-therapy-after-drug-eluting-stent-implantation-a-meta-analysis-and-meta-regression
#11
Pedro A Villablanca, Daniele Massera, Verghese Mathew, Sripal Bangalore, Panagiota Christia, Irving Perez, Ningxin Wan, Stefanie Schulz-Schüpke, David F Briceno, Anna E Bortnick, Mario J Garcia, Richard Lucariello, Mark Menegus, Robert Pyo, Jose Wiley, Harish Ramakrishna
BACKGROUND: The benefit of ≤6-month compared with 12-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) placement remains controversial. We performed a meta-analysis and meta-regression of ≤6-month versus 12-month DAPT in patients undergoing PCI with DES placement. METHODS: We conducted electronic database searches of randomized controlled trials (RCTs) comparing DAPT durations after DES placement...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029216/safety-and-efficacy-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-diabetic-patients-with-atrial-fibrillation-a-study-level-meta-analysis-of-phase-iii-randomized-trials
#12
REVIEW
Giuseppe Patti, Giuseppe Di Gioia, Ilaria Cavallari, Antonio Nenna
BACKGROUND: In patients with atrial fibrillation (AF) the safety and efficacy of non-vitamin K antagonist oral anticoagulants (NOACs) vs warfarin according to diabetes mellitus (DM) status is not completely characterized; we performed a meta-analysis to clarify whether in these patients the strategy of oral anticoagulation should be tailored on diabetes status METHODS: In this study-level meta-analysis we included four randomized phase III trials comparing NOACs and warfarin in patients with non-valvular AF; a total of 18,134 patients with DM and 40,454 without DM were overall considered...
December 28, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28028149/sex-and-stroke-in-thrombolyzed-patients-and-controls
#13
Christian Hametner, Rachael L MacIsaac, Lars Kellert, Azmil H Abdul-Rahim, Peter A Ringleb, Kennedy R Lees
BACKGROUND AND PURPOSE: We hypothesized that any sex-related difference in outcome poststroke is explained by other prognostic factors and that the response to intravenous recombinant tissue-type plasminogen activator (r-tPA) is equal in males and females after adjustment for such factors. METHODS: We accessed an independent collection of randomized clinical trials-the VISTA (Virtual International Stroke Trials Archive). Data were preprocessed by selecting complete cases (n=8028) and matching females to males (coarsened exact matching, n=4575, 24...
December 27, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28026740/comparative-hemodynamic-effects-of-contemporary-percutaneous-mechanical-circulatory-support-devices-in-a-porcine-model-of-acute-myocardial-infarction
#14
Brian R Weil, Filip Konecny, Gen Suzuki, Vijay Iyer, John M Canty
OBJECTIVES: The aim of this study was to directly compare the hemodynamic effects of 2 contemporary percutaneous mechanical circulatory support devices in a porcine model of acute myocardial infarction. BACKGROUND: Percutaneous support devices offer the ability to unload the ischemic left ventricle, but the comparative hemodynamic effects of contemporary platforms are unclear. METHODS: Yorkshire swine (mean weight 76 ± 2 kg; n = 7) were instrumented with a left ventricular (LV) pressure-volume (PV) catheter and subjected to a 2-h coronary occlusion...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28024656/validation-of-bleeding-classifications-in-coronary-artery-bypass-grafting
#15
Debora Brascia, Daniel Reichart, Francesco Onorati, Andrea Perrotti, Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Ciro Bancone, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Giuseppe Faggian, Tuomas Tauriainen, Eeva-Maija Kinnunen, Francesco Nicolini, Tiziano Gherli, Stefano Rosato, Fausto Biancari
Perioperative bleeding is a determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but there is a lack of adequate stratification of its severity. The ability of the European registry of Coronary Artery Bypass Grafting (E-CABG), Universal Definition of Perioperative Bleeding (UDPB), Study of Platelet Inhibition and Patient Outcomes (PLATO), Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes (CURRENT-OASIS 7), Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q Wave Coronary Events (ESSENCE), and SafeTy and Efficacy of Enoxaparin in Percutaneous coronary intervention patients, an internationaL randomized Evaluation (STEEPLE) bleeding classifications to predict early mortality, stroke, acute kidney injury (AKI) stage 3, and deep sternal wound infection/mediastinitis was investigated in 3,730 patients from the prospective, multicentre E-CABG registry...
December 3, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28019027/robustness-of-spatio-temporal-regularization-in-perfusion-mri-deconvolution-an-application-to-acute-ischemic-stroke
#16
Mathilde Giacalone, Carole Frindel, Marc Robini, Frédéric Cervenansky, Emmanuel Grenier, David Rousseau
PURPOSE: The robustness of a recently introduced globally convergent deconvolution algorithm with temporal and edge-preserving spatial regularization for the deconvolution of dynamic susceptibility contrast perfusion magnetic resonance imaging is assessed in the context of ischemic stroke. THEORY AND METHODS: Ischemic tissues are not randomly distributed in the brain but form a spatially organized entity. The addition of a spatial regularization term allows to take into account this spatial organization contrarily to the sole temporal regularization approach which processes each voxel independently...
December 26, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28017749/general-anesthesia-during-endovascular-stroke-therapy-does-not-negatively-impact-outcome
#17
Arthur Wang, Madison Stellfox, Fred Moy, Apolonia E Abramowicz, Rachel Lehrer, Rivkah Epstein, Nicole Eiden, Amy Aquilina, Noorie Pednekar, Glenn Brady, Matthew Wecksell, John Cooley, Justin Santarelli, Michael F Stiefel
OBJECTIVE: Recent randomized trials, have demonstrated that endovascular therapy improves outcomes in patients with an acute ischemic stroke from a large vessel occlusion (LVO). Sub-group analysis of the MR CLEAN study found that patients undergoing general anesthesia (GA) for the procedure did worse than those with non-general anesthesia (non-GA). Current guidelines now suggest that we consider non-GA over GA, without large, randomized trials specifically designed to address this issue...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017746/outcome-evaluation-of-acute-ischemic-stroke-patients-treated-with-endovascular-thrombectomy-a-single-institution-experience-in-the-era-of-randomized-controlled-trials
#18
Francesca Sarzetto, Shaurya Gupta, Naif M Alotaibi, Peter Howard, Leodante da Costa, Chris Heyn, Pejman Jabehdar Maralani, Daipayan Guha, Rick Swartz, Karl Boyle, Victor X D Yang
BACKGROUND: Endovascular thrombectomy is an effective procedure to treat selected ischemic strokes as shown in recent randomized controlled trials (RCTs). However, the generalizability of these trial data to real-world setting is unknown. The aim of this study was to examine our single center experience with endovascular thrombectomy for acute ischemic strokes and perform a comparative outcome analysis to the most recent RCTs. METHODS: We performed a 5-year retrospective analysis, from April 2011 to March 2016, on 66 consecutive patients with acute ischemic stroke who received endovascular thrombectomy at our institution...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017631/nonalcoholic-fatty-liver-disease-and-the-risk-of-clinical-cardiovascular-events-a-systematic-review-and-meta-analysis
#19
REVIEW
Toufik Mahfood Haddad, Shadi Hamdeh, Arun Kanmanthareddy, Venkata M Alla
OBJECTIVE: Numerous studies have assessed the association between Nonalcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). However, results have been conflicting due to variability in definitions of NAFLD and ascertainment of CVD, often combining clinical and surrogate endpoints. We therefore systematically reviewed published literature to assess the association between NAFLD and clinical cardiovascular events (CVE) and performed a meta-analysis. METHODS: We searched PubMed, Medline, Cochrane, CINAHL, and Web of Science databases using terms "nonalcoholic fatty liver disease", "nonalcoholic steatohepatitis", "cardiovascular disease", and their combinations to identify prospective studies published from inception through March 2016...
December 15, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28012846/neuroprotection-of-agomelatine-against-cerebral-ischemia-reperfusion-injury-through-an-antiapoptotic-pathway-in-rat
#20
Wijitra Chumboatong, Sarinthorn Thummayot, Piyarat Govitrapong, Chainarong Tocharus, Jinatta Jittiwat, Jiraporn Tocharus
Agomelatine is an agonist of the melatonergic MT1/MT2 receptors and an antagonist of the serotonergic 5-HT receptors. Its actions mimic melatonin in antioxidative and anti-inflammation. However, the protective mechanism of agomelatine in ischemic/reperfusion (I/R) injury has not been investigated. In this study, cerebral I/R injury rats were induced by middle cerebral artery occlusion (MCAO) for 2 h followed by reperfusion. The rats were randomly divided into 6 groups (12 rats per group): sham-operated; vehicle-treated I/R; 20 mg/kg, 40 mg/kg, and 80 mg/kg agomelatine-treated I/R; and 10 mg/kg melatonin-treated I/R...
January 2017: Neurochemistry International
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