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Ischemic stroke randomized

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https://www.readbyqxmd.com/read/29141857/contemporary-characteristics-and-outcomes-in-chagasic-heart-failure-compared-with-other-nonischemic-and-ischemic-cardiomyopathy
#1
Li Shen, Felix Ramires, Felipe Martinez, Luiz Carlos Bodanese, Luis Eduardo Echeverría, Efraín A Gómez, William T Abraham, Kenneth Dickstein, Lars Køber, Milton Packer, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Michael R Zile, Pardeep S Jhund, Claudio R Gimpelewicz, John J V McMurray
BACKGROUND: Chagas' disease is an important cause of cardiomyopathy in Latin America. We aimed to compare clinical characteristics and outcomes in patients with heart failure (HF) with reduced ejection fraction caused by Chagas' disease, with other etiologies, in the era of modern HF therapies. METHODS AND RESULTS: This study included 2552 Latin American patients randomized in the PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure) trials...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29137382/circulating-long-chain-n-3-polyunsaturated-fatty-acid-and-incidence-of-stroke-a-meta-analysis-of-prospective-cohort-studies
#2
Bo Yang, Xiao-Li Ren, Hong Huang, Xiao-Juan Guo, Ai-Guo Ma, Duo Li
Background: Circulating long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) can provide objective measures that reflect both dietary consumption and relevant biological processes. Nevertheless, prospective cohort studies on circulating LC n-3 PUFA in relation to incidence of stroke have yielded inconsistent results. We therefore conducted a meta-analysis to quantitatively evaluate the association. Results: A total of 2,836 stroke events occurred among 20,460 individuals aged 35-79 yr from 10 prospective cohort studies...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29134924/treatment-evaluation-of-acute-stroke-for-using-in-regenerative-cell-elements-treasure-trial-rationale-and-design
#3
Toshiya Osanai, Kiyohiro Houkin, Shinichiro Uchiyama, Kazuo Minematsu, Akihiko Taguchi, Shunsuke Terasaka
Rationale MultiStem® (HLM051) is one of the promising allogenic cell products for acute ischemic stroke with strong evidence. A previous phase 2 randomized, double-blind, placebo-controlled, multicenter dose-escalation trial showed the safety of MultiStem® for acute ischemic stroke, with a time window beyond that of rt-PA and endovascular thrombectomy. We aim to obtain stronger evidence and to show the efficacy of the MultiStem® for treatment of ischemic stroke. Sample size Estimated sample size is 220 (110 patients per group), which has 90% power at 5% significance level...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#4
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29130956/ischemic-stroke-histological-thrombus-composition-and-pre-interventional-ct-attenuation-are-associated-with-intervention-time-and-rate-of-secondary-embolism
#5
Peter B Sporns, Uta Hanning, Wolfram Schwindt, Aglae Velasco, Boris Buerke, Christian Cnyrim, Jens Minnerup, Walter Heindel, Astrid Jeibmann, Thomas Niederstadt
BACKGROUND AND PURPOSE: The introduction of stent retrievers has made the complete extraction and histological analysis of human thrombi possible. A number of large randomized trials have proven the efficacy of thrombectomy for ischemic stroke; however, thrombus composition could have an impact on the efficacy and risk of the intervention. We therefore investigated the impact of histologic thrombus features on interventional outcome and procedure-related embolisms. For a pre-interventional estimation of histologic features and outcome parameters, we assessed the pre-interventional CT attenuation of the thrombi...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29129157/thrombectomy-6-to-24-hours-after-stroke-with-a-mismatch-between-deficit-and-infarct
#6
Raul G Nogueira, Ashutosh P Jadhav, Diogo C Haussen, Alain Bonafe, Ronald F Budzik, Parita Bhuva, Dileep R Yavagal, Marc Ribo, Christophe Cognard, Ricardo A Hanel, Cathy A Sila, Ameer E Hassan, Monica Millan, Elad I Levy, Peter Mitchell, Michael Chen, Joey D English, Qaisar A Shah, Frank L Silver, Vitor M Pereira, Brijesh P Mehta, Blaise W Baxter, Michael G Abraham, Pedro Cardona, Erol Veznedaroglu, Frank R Hellinger, Lei Feng, Jawad F Kirmani, Demetrius K Lopes, Brian T Jankowitz, Michael R Frankel, Vincent Costalat, Nirav A Vora, Albert J Yoo, Amer M Malik, Anthony J Furlan, Marta Rubiera, Amin Aghaebrahim, Jean-Marc Olivot, Wondwossen G Tekle, Ryan Shields, Todd Graves, Roger J Lewis, Wade S Smith, David S Liebeskind, Jeffrey L Saver, Tudor G Jovin
Background The effect of endovascular thrombectomy that is performed more than 6 hours after the onset of ischemic stroke is uncertain. Patients with a clinical deficit that is disproportionately severe relative to the infarct volume may benefit from late thrombectomy. Methods We enrolled patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery who had last been known to be well 6 to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume, with mismatch criteria defined according to age (<80 years or ≥80 years)...
November 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29127417/the-positive-effects-of-xueshuan-xinmai-tablets-on-brain-functional-connectivity-in-acute-ischemic-stroke-a-placebo-controlled-randomized-trial
#7
Dongfeng Wei, Daojun Xie, He Li, Yaojing Chen, Di Qi, Yujiao Wang, Yangjun Zhang, Kewei Chen, Chuanfu Li, Zhanjun Zhang
Through a placebo controlled randomized study, the purpose of this report was to investigate the effects of Xueshuan Xinmai tablets (XXMT) on neurologic deficits, quality of life and brain functional connectivity in acute ischemic stroke patients and to explore the mechanism of action of XXMT. In total, 44 acute ischemic stroke patients were randomly divided to the XXMT treatment group (n = 22) or the placebo group (n = 22) in a 2-week trial. Before and after the treatment, the neurological assessment and functional magnetic resonance imaging examinations were carried out...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29127196/mechanical-thrombectomy-for-acute-ischemic-stroke-with-occlusion-of-the-m2-segment-of-the-middle-cerebral-artery-a-meta-analysis
#8
Hamidreza Saber, Sandra Narayanan, Mohan Palla, Jeffrey L Saver, Raul G Nogueira, Albert J Yoo, Sunil A Sheth
BACKGROUND: Endovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA). METHODS: We conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29124703/vitamin-d-cardiovascular-disease-and-risk-factors
#9
Tea Skaaby, Betina H Thuesen, Allan Linneberg
Observational studies have suggested a possible protective role of vitamin D on the cardiovascular system. The available evidence does not support either cardiovascular benefits or harms of vitamin D supplementation. This chapter provides an overview and discussion of the current knowledge of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29121222/neurological-effects-of-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-direct-comparisons
#10
Navkaranbir S Bajaj, Nirav Patel, Rajat Kalra, Amier Ahmad, Anand Venkatraman, Garima Arora, Pankaj Arora
Aims: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors considerably alter the lipid profile. We sought to examine rates of ischemic stroke, and neurocognitive deficits in patients treated with and without PCSK9 inhibitors. Methods and Results: Randomized controlled trials (RCTs) reporting rates of ischemic stroke, and neurocognitive deficits in patients using PCSK9 inhibitors were identified. Standard meta-analysis techniques were used to compare these outcomes among patients treated with and without PCSK9 inhibitors, and the two U...
October 6, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29120921/pregnancy-and-ischemic-stroke-a-practical-guide-to-management
#11
Mayte E van Alebeek, Roel de Heus, Anil M Tuladhar, Frank-Erik de Leeuw
PURPOSE OF REVIEW: Ischemic stroke during pregnancy or the puerperium is a devastating disease during a crucial period in life and warrants a specific approach. To date, current practice is mainly based on expert opinion because of a lack of randomized controlled trials and high-quality observational studies. The present review is intended as a practical guide to (acute) management of ischemic stroke during pregnancy and puerperium. RECENT FINDINGS: Recent findings showed that the incidence of stroke during pregnancy is rising...
November 7, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29119369/clinical-importance-of-temporal-bone-features-for-the-efficacy-of-contrast-enhanced-sonothrombolysis-a-retrospective-analysis-of-the-nor-sass-trial
#12
Vojtech Novotny, Aliona Nacu, Christopher E Kvistad, Annette Fromm, Gesche F Neckelmann, Andrej N Khanevski, Haakon Tobro, Ulrike Waje-Andreassen, Halvor Naess, Lars Thomassen, Nicola Logallo
Contrast-enhanced sonothrombolysis (CEST) seems to be a safe and promising treatment in acute ischemic stroke. It remains unknown if temporal bone features may influence the efficacy of CEST. We investigated the association between different temporal bone features on admission computed tomography (CT) scan and the outcome in acute ischemic stroke patients included in the randomized Norwegian Sonothrombolysis in Acute Stroke Study (NOR-SASS). Patients diagnosed as stroke mimics and those with infratentorial stroke or with incorrect insonation were excluded...
November 8, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29117953/brain-microbleeds-anticoagulation-and-hemorrhage-risk-meta-analysis-in-stroke-patients-with-af
#13
Andreas Charidimou, Christopher Karayiannis, Tae-Jin Song, Dilek Necioglu Orken, Vincent Thijs, Robin Lemmens, Jinkwon Kim, Su Mei Goh, Thanh G Phan, Cathy Soufan, Ronil V Chandra, Lee-Anne Slater, Shamir Haji, Vincent Mok, Solveig Horstmann, Kam Tat Leung, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe, Tsukasa Saito, Lawrence K S Wong, Yannie Soo, Roland Veltkamp, Kelly D Flemming, Toshio Imaizumi, Velandai Srikanth, Ji Hoe Heo
OBJECTIVES: To assess the association between cerebral microbleeds (CMBs) and future spontaneous intracerebral hemorrhage (ICH) risk in ischemic stroke patients with nonvalvular atrial fibrillation (AF) taking oral anticoagulants. METHODS: This was a meta-analysis of cohort studies with >50 patients with recent ischemic stroke and documented AF, brain MRI at baseline, long-term oral anticoagulation treatment, and ≥6 months of follow-up. Authors provided summary-level data on stroke outcomes stratified by CMB status...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29116691/hyperbaric-oxygen-in-patients-with-ischemic-stroke-following-cardiac-surgery-a-retrospective-observational-trial
#14
Viktoria Heide-Marie Weixler, Ameli Elisabeth Yates, Markus Puchinger, Birgit Zirngast, Prisca Pondorfer, Beatrice Ratzenhofer-Komenda, Andrea Amegah-Sakotnik, Freyja-Maria Smolle-Juettner, Otto Dapunt
BACKGROUND: Hyperbaric oxygenation (HBO₂) involves breathing 100% oxygen under elevated ambient pressure in a hyperbaric chamber, thereby dissolving oxygen in the plasma. This results in an increase of arterial partial pressure of oxygen (pO₂). Though well established in experimental studies, HBO₂ treatment for ischemic stroke is still under discussion. METHODS: From 2002-2014 HBO₂ (2.2 bar, 90 minutes one/day; average number per patient: 4.7) was applied in 49 consecutive patients (32 males, 17 females, mean age: 68...
2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29114975/real-world-evidence-for-off-label-intravenous-thrombolysis-in-acute-ischemic-stroke
#15
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas
The most feared complication of intravenous tissue-plasminogen-activator (tPA) delivery in patients with acute ischemic stroke (AIS) is symptomatic intracerebral hemorrhage (sICH) which has been the driver behind most of the exclusion criteria in all randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of intravenous thrombolysis (IVT) for AIS(1) . This article is protected by copyright. All rights reserved.
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29114094/association-of-osteopontin-neopterin-and-myeloperoxidase-with-stroke-risk-in-patients-with-prior-stroke-or-transient-ischemic-attacks-results-of-an-analysis-of-13-biomarkers-from-the-stroke-prevention-by-aggressive-reduction-in-cholesterol-levels-trial
#16
Peter Ganz, Pierre Amarenco, Larry B Goldstein, Henrik Sillesen, Weihang Bao, Gregory M Preston, K Michael A Welch
BACKGROUND AND PURPOSE: Established risk factors do not fully identify patients at risk for recurrent stroke. The SPARCL trial (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) evaluated the effect of atorvastatin on stroke risk in patients with a recent stroke or transient ischemic attack and no known coronary heart disease. This analysis explored the relationships between 13 plasma biomarkers assessed at trial enrollment and the occurrence of outcome strokes. METHODS: We conducted a case-cohort study of 2176 participants; 562 had outcome strokes and 1614 were selected randomly from those without outcome strokes...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29113375/efficacy-and-safety-of-triple-versus-dual-antithrombotic-therapy-in-atrial-fibrillation-and-ischemic-heart-disease-a-systematic-review-and-meta-analysis
#17
Wengen Zhu, Linjuan Guo, Fadi Liu, Rong Wan, Yang Shen, Gregory Y H Lip, Kui Hong
The optimal antithrombotic regimen for patients with atrial fibrillation and ischemic heart disease remains unclear. Therefore, we aimed to compare the efficacy and safety of triple therapy (TT [an anticoagulant and 2 antiplatelet drugs]) with dual therapy (DAPT [2 antiplatelet drugs] or DT [an anticoagulant and a single antiplatelet drug]) in patients with atrial fibrillation and ischemic heart disease. We systematically searched the Cochrane Library, PubMed and Embase databases for all relevant studies up to August 2017...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29108817/chronic-oral-methylene-blue-treatment-in-a-rat-model-of-focal-cerebral-ischemia-reperfusion
#18
Lei Huang, Jianfei Lu, Bianca Cerqueira, Yichu Liu, Zhao Jiang, Timothy Q Duong
A single acute low-dose methylene blue (MB), an FDA-grandfathered drug, has been shown to ameliorate behavioral deficits and reduces MRI-defined infarct volume in experimental ischemic stroke when administered intravenously or intraperitoneally. The efficacy of chronic MB treatment in ischemic stroke remains unknown. In a randomized, double-blinded and vehicle-controlled design, we investigated the efficacy of chronic oral MB administration in ischemic stroke longitudinally up to 60 days post injury using MRI and behavioral tests, with end-point histology...
November 3, 2017: Brain Research
https://www.readbyqxmd.com/read/29108804/statewide-trends-in-utilization-and-outcomes-of-endovascular-treatment-of-acute-ischemic-stroke-analysis-of-minnesota-hospital-association-data-2014-and-2015
#19
Haitham M Hussein, Muhammad A Saleem, Adnan I Qureshi
BACKGROUND: The study aims at examining the changes in endovascular procedures utilization after the publication of the clinical trials showing their benefit in patients with acute ischemic stroke (AIS). METHODS: Minnesota Hospital Association database from 137 member hospitals was used to calculate the statewide utilization rates for 2 periods: prior to (calendar year 2014) and after (calendar year 2015) the publication of multiple randomized clinical trials showing the efficacy of endovascular therapy...
November 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29105492/real-world-cardiovascular-disease-burden-in-patients-with-atherosclerotic-cardiovascular-disease-a-comprehensive-systematic-literature-review
#20
Dasha Cherepanov, Tanya Bentley, Wendy Hsiao, Pin Xiang, Frank O'Neill, Yi Qian, Nicole Yurgin, David Beenhouwer
OBJECTIVE: Based on randomized controlled trials (RCT), non-fatal myocardial infarction (MI) rates range between 9-15 events per 1,000 person-year, ischemic stroke between 4-6 per 1,000 person-year, CHD death rates between 5-7 events per 1,000 person-year, any major vascular event between 28-53 per 1,000 person-year in patients with atherosclerotic cardiovascular disease (ASCVD). We reviewed global literature on the topic to determine if the real-world burden of secondary major adverse cardiovascular events (MACEs) is higher among ASCVD patients...
November 5, 2017: Current Medical Research and Opinion
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