دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
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In Memoriam: Dr Teruo Omae
Takenori Yamaguchi, Kazuo Minematsu, Takanari Kitazono, Kazunori Toyoda
doi : 10.1161/STROKEAHA.121.037068
Stroke. 2021;52:3415–3417
November 2021 Stroke Highlights
José Rafael Romero
doi : 10.1161/STROKEAHA.121.037116
Stroke. 2021;52:3418
Patent Foramen Ovale Closure Decreases the Incidence but Not the Size of New Brain Infarction on Magnetic Resonance Imaging: An Analysis of the REDUCE Trial
Steven R. Messé, Guray Erus, Michel Bilello, Christos Davatzikos, Grethe Andersen, Helle K. Iversen, Risto O. Roine, Christina Sjöstrand, John F. Rhodes, Lars Søndergaard, Scott E. Kasner, and on behalf of the Gore REDUCE Study Investigators
doi : 10.1161/STROKEAHA.121.034451
Stroke. 2021;52:3419–3426
Randomized patent foramen ovale closure trials have used open-label end point ascertainment which increases the risk of bias and undermines confidence in the conclusions. The Gore REDUCE trial prospectively performed baseline and follow-up magnetic resonance imaging (MRIs) for all subjects providing an objective measure of the effectiveness of closure.
Prevention of Patent Foramen Ovale-Related Stroke: An Evolving Concept
Marco R. Di Tullio
doi : 10.1161/STROKEAHA.121.035735
Stroke. 2021;52:3427–3429
Dual Antiplatelet Therapy Using Cilostazol With Aspirin or Clopidogrel: Subanalysis of the CSPS.com Trial
Haruhiko Hoshino, Kazunori Toyoda, Katsuhiro Omae, Noriyuki Ishida, Shinichiro Uchiyama, Kazumi Kimura, Nobuyuki Sakai, Yasushi Okada, Kortaro Tanaka, Hideki Origasa, Hiroaki Naritomi, Kiyohiro Houkin, Keiji Yamaguchi, Masanori Isobe, Kazuo Minematsu, Masayasu Matsumoto, Teiji Tominaga, Hidekazu Tomimoto, Yasuo Terayama, Satoshi Yasuda, Takenori Yamaguchi, and on behalf of the CSPS.com Trial Investigators
doi : 10.1161/STROKEAHA.121.034378
Stroke. 2021;52:3430–3439
Although dual antiplatelet therapy (DAPT) with aspirin and clopidogrel reduces the recurrence of ischemic stroke while significantly increasing the bleeding events compared with monotherapy, the CSPS.com trial (Cilostazol Stroke Prevention Study combination) showed that DAPT using cilostazol was more effective without the bleeding risk. In the CSPS.com trial, aspirin or clopidogrel was used as the underlying antiplatelet drug. The effectiveness and safety of each combination were examined and clarified.
Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial
Jose Jimenez-Torres, Juan F. Alcalá-Diaz, Jose D. Torres-Peña, Francisco M. Gutierrez-Mariscal, Ana Leon-Acuña, Purificación Gómez-Luna, Carolina Fernández-Gandara, Gracia M. Quintana-Navarro, Jose C. Fernandez-Garcia, Pablo Perez-Martinez, Jose M. Ordovas, Javier Delgado-Lista, Elena M. Yubero-Serrano, Jose Lopez-Miranda
doi : 10.1161/STROKEAHA.120.033214
Stroke. 2021;52:3440–3449
Lifestyle and diet affect cardiovascular risk, although there is currently no consensus about the best dietary model for the secondary prevention of cardiovascular disease. The CORDIOPREV study (Coronary Diet Intervention With Olive Oil and Cardiovascular Prevention) is an ongoing prospective, randomized, single-blind, controlled trial in 1002 coronary heart disease patients, whose primary objective is to compare the effect of 2 healthy dietary patterns (low-fat rich in complex carbohydrates versus Mediterranean diet rich in extra virgin olive oil) on the incidence of cardiovascular events. Here, we report the results of one secondary outcome of the CORDIOPREV study. Thus, to evaluate the efficacy of these diets in reducing cardiovascular disease risk. Intima-media thickness of both common carotid arteries (IMT-CC) was ultrasonically assessed bilaterally. IMT-CC is a validated surrogate for the status and future cardiovascular disease risk.
Cerebral Edema in Patients With Large Hemispheric Infarct Undergoing Reperfusion Treatment: A HERMES Meta-Analysis
Felix C. Ng, Nawaf Yassi, Gagan Sharma, Scott B. Brown, Mayank Goyal, Charles B.L.M. Majoie, Tudor G. Jovin, Michael D. Hill, Keith W. Muir, Jeffrey L. Saver, Francis Guillemin, Andrew M. Demchuk, Bijoy K. Menon, Luis San Roman, David S. Liebeskind, Philip White, Diederik W.J. Dippel, Antoni Davalos, Serge Bracard, Peter J. Mitchell, Michael J. Wald, Stephen M. Davis, Kevin N. Sheth, W. Taylor Kimberly, Bruce C.V. Campbell, and for the HERMES Collaborators
doi : 10.1161/STROKEAHA.120.033246
Stroke. 2021;52:3450–3458
Whether reperfusion into infarcted tissue exacerbates cerebral edema has treatment implications in patients presenting with extensive irreversible injury. We investigated the effects of endovascular thrombectomy and reperfusion on cerebral edema in patients presenting with radiological evidence of large hemispheric infarction at baseline.
Comparing Warfarin and 4 Direct Oral Anticoagulants for the Risk of Dementia in Patients With Atrial Fibrillation
So-Ryoung Lee, Eue-Keun Choi, Sang-Hyun Park, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y.H. Lip
doi : 10.1161/STROKEAHA.120.033338
Stroke. 2021;52:3459–3468
Atrial fibrillation is a risk factor for dementia, and oral anticoagulant use is associated with a decreased risk of dementia in patients with atrial fibrillation. We aimed to investigate whether the risk of dementia would be different between patients treated with direct oral anticoagulants (DOACs) compared with those with warfarin.
Direct Oral Anticoagulants and Prevention of Dementia in Nonvalvular Atrial Fibrillation
Sarah T. Pendlebury
doi : 10.1161/STROKEAHA.121.035664
Stroke. 2021;52:3469–3471
Oral Anticoagulants in Atrial Fibrillation Patients With Recent Stroke Who Are Dependent on the Daily Help of Others
Louisa Meya, Alexandros A. Polymeris, Sabine Schaedelin, Fabian Schaub, Valerian L. Altersberger, Christopher Traenka, Sebastian Thilemann, Benjamin Wagner, Joachim Fladt, Lisa Hert, Sohei Yoshimura, Masatoshi Koga, Annaelle Zietz, Tolga Dittrich, Urs Fisch, Kazunori Toyoda, David J. Seiffge, Nils Peters, Gian Marco De Marchis, Henrik Gensicke, Leo H. Bonati, Philippe A. Lyrer, Stefan T. Engelter
doi : 10.1161/STROKEAHA.120.033862
Stroke. 2021;52:3472–3481
Data on the effectiveness and safety of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in patients with stroke attributable to atrial fibrillation (AF) who were dependent on the daily help of others at hospital discharge are scarce.
Ischemic Benefit and Hemorrhage Risk of Ticagrelor-Aspirin Versus Aspirin in Patients With Acute Ischemic Stroke or Transient Ischemic Attack
S. Claiborne Johnston, Pierre Amarenco, Maria Aunes, Hans Denison, Scott R. Evans, Anders Himmelmann, Marianne Jahreskog, Stefan James, Mikael Knutsson, Per Ladenvall, Carlos A. Molina, Sven Nylander, Joachim Röther, Yongjun Wang, and for the THALES Investigators
doi : 10.1161/STROKEAHA.121.035555
Stroke. 2021;52:3482–3489
In patients with acute mild-moderate ischemic stroke or high-risk transient ischemic attack, the THALES trial (Acute Stroke or Transient Ischemic Attack Treated With Ticagrelor and Aspirin for Prevention of Stroke and Death) demonstrated that when added to aspirin, ticagrelor reduced stroke or death but increased risk of severe hemorrhage compared with placebo. The primary efficacy outcome of THALES included hemorrhagic stroke and death, events also counted in the primary safety outcome. We sought to disentangle risk and benefit, assess their relative impact, and attempt to identify subgroups with disproportionate risk or benefit.
Middle Cerebral Artery M2 Thrombectomy in the STRATIS Registry
Mouhammad A. Jumaa, Alicia C. Castonguay, Hisham Salahuddin, Ashutosh P. Jadhav, Kaustubh Limaye, Mudassir Farooqui, Syed F. Zaidi, Nils Mueller-Kronast, David S. Liebeskind, Osama O. Zaidat, Santiago Ortega-Gutierrez
doi : 10.1161/STROKEAHA.120.033951
Stroke. 2021;52:3490–3496
The safety and benefit of mechanical thrombectomy in the treatment of acute ischemic stroke patients with M2 segment middle cerebral artery occlusions remain uncertain. Here, we compare clinical and angiographic outcomes in M2 versus M1 occlusions in the STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) Registry.
Deep Learning–Based Automated Thrombolysis in Cerebral Infarction Scoring: A Timely Proof-of-Principle Study
Maximilian Nielsen, Moritz Waldmann, Andreas M. Frölich, Fabian Flottmann, Evelin Hristova, Martin Bendszus, Fatih Seker, Jens Fiehler, Thilo Sentker, Rene Werner
doi : 10.1161/STROKEAHA.120.033807
Stroke. 2021;52:3497–3504
Mechanical thrombectomy is an established procedure for treatment of acute ischemic stroke. Mechanical thrombectomy success is commonly assessed by the Thrombolysis in Cerebral Infarction (TICI) score, assigned by visual inspection of X-ray digital subtraction angiography data. However, expert-based TICI scoring is highly observer-dependent. This represents a major obstacle for mechanical thrombectomy outcome comparison in, for instance, multicentric clinical studies. Focusing on occlusions of the M1 segment of the middle cerebral artery, the present study aimed to develop a deep learning (DL) solution to automated and, therefore, objective TICI scoring, to evaluate the agreement of DL- and expert-based scoring, and to compare corresponding numbers to published scoring variability of clinical experts.
Making the Right Call: Human Biases and Still Learning Machines
Yasmin N. Aziz, Joseph P. Broderick
doi : 10.1161/STROKEAHA.121.036758
Stroke. 2021;52:3505–3506
Core Outcome Measures for Palliative and End-of-Life Research After Severe Stroke: Mixed-Method Delphi Study
Bruce Mason, Kirsty Boyd, Fergus Doubal, Mark Barber, Marian Brady, Eileen Cowey, Akila Visvanathan, Steff Lewis, Katie Gallacher, Sarah Morton, Gillian E. Mead
doi : 10.1161/STROKEAHA.120.032650
Stroke. 2021;52:3507–3513
Stroke is the second commonest cause of death worldwide and a leading cause of severe disability, yet there are no published trials of palliative care in stroke. To design and evaluate palliative care interventions for people with stroke, researchers need to know what measurable outcomes matter most to patients and families, stroke professionals, and other service providers.
Blood Pressure in the First 6 Hours Following Endovascular Treatment for Ischemic Stroke Is Associated With Outcome
Noor Samuels, Rob A. van de Graaf, Carlijn A.L. van den Berg, Simone M. Uniken Venema, Kujtesa Bala, Pieter Jan van Doormaal, Wouter van der Steen, Elbert Witvoet, Jelis Boiten, Heleen den Hertog, Wouter J. Schonewille, Jeannette Hofmeijer, Floris Schreuder, Tobien A.H.C.M.L. Schreuder, H. Bart van der Worp, Yvo B.W.E.M. Roos, Charles B.L.M. Majoie, James F. Burke, Adriaan C.G.M. van Es, Aad van der Lugt, Bob Roozenbeek, Hester F. Lingsma, Diederik W.J. Dippel, and on behalf of the MR CLEAN Registry Investigators
doi : 10.1161/STROKEAHA.120.033657
Stroke. 2021;52:3514–3522
Optimal blood pressure (BP) management in the acute phase of ischemic stroke remains an unresolved issue. It is uncertain whether guidelines for BP management during and after intravenous alteplase can be extrapolated to endovascular treatment (EVT) for stroke due to large artery occlusion in the anterior circulation. We evaluated the associations between systolic BP (SBP) in the first 6 hours following EVT and functional outcome as well as symptomatic intracranial hemorrhage.
Posttreatment Ischemic Lesion Evolution Is Associated With Reduced Favorable Functional Outcome in Patients With Stroke
Praneeta Konduri, Henk van Voorst, Amber Bucker, Katinka van Kranendonk, Anna Boers, Kilian Treurniet, Olvert Berkhemer, Albert J. Yoo, Wim van Zwam, Robert van Oostenbrugge, Aad van der Lugt, Diederik Dippel, Yvo Roos, Joost Bot, Charles Majoie, Henk Marquering, on behalf of the MR CLEAN Trial Investigators
doi : 10.1161/STROKEAHA.120.032331
Stroke. 2021;52:3523–3531
Ischemic lesion volume can increase even 24 hours after onset of an acute ischemic stroke. In this study, we investigated the association of lesion evolution with functional outcome and the influence of successful recanalization on this association.
Pediatric Ischemic Stroke and Epilepsy: A Nationwide Cohort Study
Heléne E.K. Sundelin, Torbjörn Tomson, Johan Zelano, Jonas Söderling, Peter Bang, Jonas F. Ludvigsson
doi : 10.1161/STROKEAHA.121.034796
Stroke. 2021;52:3532–3540
The risk of epilepsy after stroke has not been thoroughly explored in pediatric ischemic stroke. We examined the risk of epilepsy in children with ischemic stroke as well as in their first-degree relatives.
Long-Term Risk of Epilepsy After Pediatric Stroke and Potential Genetic Vulnerabilities
Lauren A. Beslow, Ingo Helbig, Christine K. Fox
doi : 10.1161/STROKEAHA.121.036376
Stroke. 2021;52:3541–3542
Peanut Consumption and Risk of Stroke and Ischemic Heart Disease in Japanese Men and Women: The JPHC Study
Satoyo Ikehara, Hiroyasu Iso, Yoshihiro Kokubo, Kazumasa Yamagishi, Isao Saito, Hiroshi Yatsuya, Takashi Kimura, Norie Sawada, Motoki Iwasaki, Shoichiro Tsugane, and the JPHC Study Group
doi : 10.1161/STROKEAHA.120.031212
Stroke. 2021;52:3543–3550
Several prospective cohort studies and a randomized clinical trial have shown the beneficial effects of peanut consumption on cardiovascular disease and its risk factors. We examined the association between peanut consumption and risk of cardiovascular disease in Japanese men and women.
Eating Well to Prevent Stroke: Peanuts Are on the Plate
Walter N. Kernan
doi : 10.1161/STROKEAHA.121.036172
Stroke. 2021;52:3551–3554
Obesity and Risk for First Ischemic Stroke Depends on Metabolic Syndrome: The HUNT Study
Jens W. Horn, Tingting Feng, Bjørn Mørkedal, Linn Beate Strand, Julie Horn, Kenneth Mukamal, Imre Janszky
doi : 10.1161/STROKEAHA.120.033016
Stroke. 2021;52:3555–3561
Obesity is one of the most prevalent modifiable risk factors of ischemic stroke. However, it is still unclear whether obesity itself or the metabolic abnormalities due to obesity increase the risk of ischemic stroke. We therefore investigated the association between metabolic health, weight, and risk of ischemic stroke in a large prospective cohort study.
Association Between Excess Leisure Sedentary Time and Risk of Stroke in Young Individuals
Raed A. Joundi, Scott B. Patten, Jeanne V.A. Williams, Eric E. Smith
doi : 10.1161/STROKEAHA.121.034985
Stroke. 2021;52:3562–3568
The association between physical activity (PA) and lower risk of stroke is well established, but the relationship between leisure sedentary time and stroke is less well studied.
Greater Adherence to Secondary Prevention Medications Improves Survival After Stroke or Transient Ischemic Attack: A Linked Registry Study
Lachlan L. Dalli, Joosup Kim, Dominique A. Cadilhac, Melanie Greenland, Frank M. Sanfilippo, Nadine E. Andrew, Amanda G. Thrift, Rohan Grimley, Richard I. Lindley, Vijaya Sundararajan, Douglas E. Crompton, Natasha A. Lannin, Craig S. Anderson, Leanne Whiley, Monique F. Kilkenny
doi : 10.1161/STROKEAHA.120.033133
Stroke. 2021;52:3569–3577
Although a target of 80% medication adherence is commonly cited, it is unclear whether greater adherence improves survival after stroke or transient ischemic attack (TIA). We investigated associations between medication adherence during the first year postdischarge, and mortality up to 3 years, to provide evidence-based targets for medication adherence.
Incidence Rates and Case-Fatality Rates of Cerebral Vein Thrombosis: A Population-Based Study
Emanuele Rezoagli, Aldo Bonaventura, Jonathan M. Coutinho, Alessandra Vecchié, Vera Gessi, Roberta Re, Alessandro Squizzato, Fulvio Pomero, Matteo Bonzini, Walter Ageno, Francesco Dentali
doi : 10.1161/STROKEAHA.121.034202
Stroke. 2021;52:3578–3585
Cerebral vein thrombosis (CVT) incidence is estimated to be >10 per 1?000?000 per year. Few population-based studies investigating case-fatality rates (CFRs) and pyogenic/nonpyogenic CVT incidence are available. We assessed trends in CVT incidence between 2002 and 2012, as well as adjusted in-hospital CFRs and incidence of hospital admissions for pyogenic/nonpyogenic CVT in a large Northwestern Italian epidemiological study.
Stroke Hospitalizations Before and During COVID-19 Pandemic Among Medicare Beneficiaries in the United States
Quanhe Yang, Xin Tong, Sallyann Coleman King, Benjamin S. Olivari, Robert K. Merritt
doi : 10.1161/STROKEAHA.121.034562
Stroke. 2021;52:3586–3601
Emergency department visits and hospitalizations for stroke declined significantly following declaration of coronavirus disease 2019 (COVID-19) as a national emergency on March 13, 2020, in the United States. This study examined trends in hospitalizations for stroke among Medicare fee-for-service beneficiaries aged ?65 years and compared characteristics of stroke patients during COVID-19 pandemic to comparable weeks in the preceding year (2019).
Prevalence, Characteristics, and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis
Konark Malhotra, Christina Zompola, Aikaterini Theodorou, Aristeidis H. Katsanos, Ashkan Shoamanesh, Himanshu Gupta, Simon Beshara, Nitin Goyal, Jason Chang, Ashis H. Tayal, Efstathios Boviatsis, Konstantinos Voumvourakis, Charlotte Cordonnier, David J. Werring, Andrei V. Alexandrov, Georgios Tsivgoulis
doi : 10.1161/STROKEAHA.120.031471
Stroke. 2021;52:3602–3612
There are scarce data regarding the prevalence, characteristics and outcomes of intracerebral hemorrhage (ICH) of undetermined (unknown or cryptogenic) etiology. We sought to determine the prevalence, radiological characteristics, and clinical outcomes of undetermined ICH.
Innate Immune Anti-Inflammatory Response in Human Spontaneous Intracerebral Hemorrhage
Anan Shtaya, Leslie R. Bridges, Rebecca Williams, Sarah Trippier, Liqun Zhang, Anthony C. Pereira, James A.R. Nicoll, Delphine Boche, Atticus H. Hainsworth
doi : 10.1161/STROKEAHA.121.034673
Stroke. 2021;52:3613–3623
Spontaneous intracerebral hemorrhage (sICH) is a common form of hemorrhagic stroke, with high mortality and morbidity. Pathophysiological mechanisms in sICH are poorly understood and treatments limited. Neuroinflammation driven by microglial-macrophage activation contributes to brain damage post-sICH. We aim to test the hypothesis that an anti-inflammatory (repair) process occurs in parallel with neuroinflammation in clinical sICH.
Invasive Multimodal Neuromonitoring in Aneurysmal Subarachnoid Hemorrhage: A Systematic Review
Michael Veldeman, Walid Albanna, Miriam Weiss, Soojin Park, Anke Hoellig, Hans Clusmann, Raimund Helbok, Yasin Temel, Gerrit Alexander Schubert
doi : 10.1161/STROKEAHA.121.034633
Stroke. 2021;52:3624–3632
Aneurysmal subarachnoid hemorrhage is a devastating disease leaving surviving patients often severely disabled. Delayed cerebral ischemia (DCI) has been identified as one of the main contributors to poor clinical outcome after subarachnoid hemorrhage. The objective of this review is to summarize existing clinical evidence assessing the diagnostic value of invasive neuromonitoring (INM) in detecting DCI and provide an update of evidence since the 2014 consensus statement on multimodality monitoring in neurocritical care.
Endovascular Treatment Effect Diminishes With Increasing Thrombus Perviousness: Pooled Data From 7 Trials on Acute Ischemic Stroke
Manon Kappelhof, Manon L. Tolhuisen, Kilian M. Treurniet, Bruna G. Dutra, Heitor Alves, Guang Zhang, Scott Brown, Keith W. Muir, Antoni Dávalos, Yvo B.W.E.M. Roos, Jeffrey L. Saver, Andrew M. Demchuk, Tudor G. Jovin, Serge Bracard, Bruce C.V. Campbell, Aad van der Lugt, Francis Guillemin, Philip White, Michael D. Hill, Diederik W.J. Dippel, Peter J. Mitchell, Mayank Goyal, Henk A. Marquering, Charles B.L.M. Majoie, and on behalf of the HERMES Collaborators
doi : 10.1161/STROKEAHA.120.033124
Stroke. 2021;52:3633–3641
Thrombus perviousness estimates residual flow along a thrombus in acute ischemic stroke, based on radiological images, and may influence the benefit of endovascular treatment for acute ischemic stroke. We aimed to investigate potential endovascular treatment (EVT) effect modification by thrombus perviousness.
Optic Tract Shrinkage Limits Visual Restoration After Occipital Stroke
Berkeley K. Fahrenthold, Matthew R. Cavanaugh, Subin Jang, Allison J. Murphy, Sara Ajina, Holly Bridge, Krystel R. Huxlin
doi : 10.1161/STROKEAHA.121.034738
Stroke. 2021;52:3642–3650
Damage to the adult primary visual cortex (V1) causes vision loss in the contralateral visual hemifield, initiating a process of trans-synaptic retrograde degeneration. The present study examined functional implications of this process, asking if degeneration impacted the amount of visual recovery attainable from visual restoration training in chronic patients, and if restoration training impacted optic tract (OT) shrinkage.
Changes in Stroke Hospital Care During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Aristeidis H. Katsanos, Lina Palaiodimou, Ramin Zand, Shadi Yaghi, Hooman Kamel, Babak B. Navi, Guillaume Turc, Vassiliki Benetou, Vijay K. Sharma, Dimitris Mavridis, Shima Shahjouei, Luciana Catanese, Ashkan Shoamanesh, Konstantinos Vadikolias, Konstantinos Tsioufis, Pagona Lagiou, Petros P. Sfikakis, Andrei V. Alexandrov, Sotirios Tsiodras, Georgios Tsivgoulis
doi : 10.1161/STROKEAHA.121.034601
Stroke. 2021;52:3651–3660
We systematically evaluated the impact of the coronavirus 2019 (COVID-19) pandemic on stroke care across the world.
Large-Scale Multivariate Analysis to Interrogate an Animal Model of Stroke: Novel Insights Into Poststroke Pathology
Shenpeng R. Zhang, Hyun Ah Kim, Hannah X. Chu, Seyoung Lee, Megan A. Evans, Xia Li, Henry Ma, Grant R. Drummond, Christopher G. Sobey, Thanh G. Phan
doi : 10.1161/STROKEAHA.121.036500
Stroke. 2021;52:3661–3669
Preclinical stroke studies endeavor to model the pathophysiology of clinical stroke, assessing a range of parameters of injury and impairment. However, poststroke pathology is complex and variable, and associations between diverse parameters may be difficult to identify within the usual small study designs that focus on infarct size.
CCL2 (C-C Motif Chemokine Ligand 2) Biomarker Responses in Central Versus Peripheral Compartments After Focal Cerebral Ischemia
Jingfei Shi, Wenlu Li, Fang Zhang, Ji Hyun Park, Hong An, Shuzhen Guo, Yunxia Duan, Di Wu, Kazuhide Hayakawa, Eng H. Lo, Xunming Ji
doi : 10.1161/STROKEAHA.120.032782
Stroke. 2021;52:3670–3679
Inflammatory mediators in blood have been proposed as potential biomarkers in stroke. However, a direct relationship between these circulating factors and brain-specific ischemic injury remains to be fully defined.
GATA3 (GATA-Binding Protein 3)/KMT2A (Lysine-Methyltransferase-2A) Complex by Increasing H3K4-3me (Trimethylated Lysine-4 of Histone-3) Upregulates NCX3 (Na+-Ca2+ Exchanger 3) Transcription and Contributes to Ischemic Preconditioning Neuroprotection
Natascia Guida, Luigi Mascolo, Angelo Serani, Ornella Cuomo, Serenella Anzilotti, Paola Brancaccio, Giuseppe Pignataro, Pasquale Molinaro, Lucio Annunziato, Luigi Formisano
doi : 10.1161/STROKEAHA.121.034637
Stroke. 2021;52:3680–3691
NCX3 (Na+-Ca2+ exchanger 3) plays a relevant role in stroke; indeed its pharmacological blockade or its genetic ablation exacerbates brain ischemic damage, whereas its upregulation takes part in the neuroprotection elicited by ischemic preconditioning. To identify an effective strategy to induce an overexpression of NCX3, we examined transcription factors and epigenetic mechanisms potentially involved in NCX3 gene regulation.
Reporting of Results by Sex in Randomized Controlled Trials of Acute Stroke Therapies (2010–2020)
Julia Pudar, Brent Strong, Virginia J. Howard, Mathew J. Reeves
doi : 10.1161/STROKEAHA.120.034099
Stroke. 2021;52:e702–e705
When reporting primary results from randomized controlled trials, recommendations include reporting results by sex. We reviewed the reporting of results by sex in contemporary acute stroke randomized controlled trials.
Biomarkers of Coagulation and Inflammation in COVID-19–Associated Ischemic Stroke
Charles Esenwa, Natalie T. Cheng, Jorge Luna, Joshua Willey, Amelia K. Boehme, Kathryn Kirchoff-Torres, Daniel Labovitz, Ava L. Liberman, Peter Mabie, Khadean Moncrieffe, Ainie Soetanto, Andrea Lendaris, Johanna Seiden, Inessa Goldman, David Altschul, Ryan Holland, Joshua Benton, Joseph Dardick, Jenelys Fernandez-Torres, David Flomenbaum, Jenny Lu, Avinash Malaviya, Nikunj Patel, Aureliana Toma, Aaron Lord, Koto Ishida, Jose Torres, Thomas Snyder, Jennifer Frontera, Shadi Yaghi
doi : 10.1161/STROKEAHA.121.035045
Stroke. 2021;52:e706–e709
We sought to determine if biomarkers of inflammation and coagulation can help define coronavirus disease 2019 (COVID-19)–associated ischemic stroke as a novel acute ischemic stroke (AIS) subtype.
Treatment-Associated Stroke in Patients Undergoing Endovascular Therapy in the ARUBA Trial
Joshua D. Burks, Evan M. Luther, Vaidya Govindarajan, Stephanie H. Chen, Robert M. Starke
doi : 10.1161/STROKEAHA.120.033743
Stroke. 2021;52:e710–e714
Since the publication of ARUBA trial (A Randomized Trial of Unruptured Brain Arteriovenous Malformations), outcomes in treated and untreated patients with unruptured arteriovenous malformation have been thoroughly compared. However, no prior analysis of ARUBA patients has sought to identify risk factors for perioperative stroke. Improved understanding of risks within the ARUBA cohort will help clinicians apply the study’s findings in a broader context.
Effect of Hispanic Status in Mechanical Thrombectomy Outcomes After Ischemic Stroke: Insights From STAR
Joshua D. Burks, Stephanie H. Chen, Evan M. Luther, Eyad Almallouhi, Sami Al Kasab, Pascal M. Jabbour, Stacey Q. Wolfe, Kyle M. Fargen, Adam S. Arthur, Nitin Goyal, Isabel Fragata, Ilko Maier, Charles Matouk, Jonathan Grossberg, Peter Kan, Clemens Schirmer, R. Webster Crowley, William Ares, Christopher S. Ogilvy, Ansaar T. Rai, Michael R. Levitt, Maxim Mokin, Waldo Guerrero, Min S. Park, Justin Mascitelli, Albert Yoo, Richard W. Williamson, Andrew Grande, Roberto Crosa, Sharon Webb, Marios Psychogios, Eric C. Peterson, Dileep R. Yavagal, Alejandro M. Spiotta, Robert M. Starke
doi : 10.1161/STROKEAHA.120.033326
Stroke. 2021;52:e715–e719
Epidemiological studies have shown racial and ethnic minorities to have higher stroke risk and worse outcomes than non-Hispanic Whites. In this cohort study, we analyzed the STAR (Stroke Thrombectomy and Aneurysm Registry) database, a multi-institutional database of patients who underwent mechanical thrombectomy for acute large vessel occlusion stroke to determine the relationship between mechanical thrombectomy outcomes and race.
Incidence, Risk Factors, and Outcomes of Stroke Following Cardiac Transplantation
Hilmi Alnsasra, Rabea Asleh, Neeraj Kumar, Camden Lopez, Takumi Toya, Walter K. Kremers, Brooks Edwards, Richard C. Daly, Sudhir S. Kushwaha
doi : 10.1161/STROKEAHA.121.034874
Stroke. 2021;52:e720–e724
Less is known about the risk factors and outcomes associated with stroke in the current era of increasing heart transplantation (HT) being performed in older patients. The impact of immunosuppression on risk of stroke has not yet been previously studied. We aimed to determine the incidence, risk factors and outcomes of stroke after HT.
Outcomes of Endovascular Therapy in Patients With Prestroke Mobility Impairment
Rachel Beekman, Jie-Lena Sun, Brooke Alhanti, Lee H. Schwamm, Eric E. Smith, Deepak L. Bhatt, Ying Xian, Shreyansh Shah, Barbara L. Lytle, Gregg C. Fonarow, Kevin N. Sheth
doi : 10.1161/STROKEAHA.121.034464
Stroke. 2021;52:e725–e728
Patients with prestroke mobility impairment (PSMI) were excluded from endovascular clinical trials. There are limited data regarding safety and outcomes of endovascular thrombectomy in this population. We used a large, national data set (Get With The Guidelines–Stroke) to evaluate the safety and outcomes of endovascular thrombectomy in patients with PSMI.
Objectively Measured Physical Activity and Sedentary Time Among Adults With and Without Stroke: A National Cohort Study
Andrea T. Duran, Christian B. Pascual, Jeff Goldsmith, Virginia J. Howard, Brent Hutto, Natalie Colabianchi, John E. Vena, Michelle N. McDonnell, Steven N. Blair, Steven P. Hooker, Keith M. Diaz
doi : 10.1161/STROKEAHA.121.034194
Stroke. 2021;52:e729–e732
We examined differences in the volume and pattern of physical activity (PA) and sedentary behavior between adults with and without stroke.
Factors Associated With Decreased Accuracy of Modified Thrombolysis in Cerebral Infarct Scoring Among Neurointerventionalists During Thrombectomy
Elliot Pressman, Muhammad Waqas, Victoria Sands, Adnan Siddiqui, Kenneth Snyder, Jason Davies, Elad Levy, Ciprian Ionita, Waldo Guerrero, Zeguang Ren, Maxim Mokin
doi : 10.1161/STROKEAHA.120.033372
Stroke. 2021;52:e733–e738
The modified Thrombolysis in Cerebral Infarct (mTICI) score is used to grade angiographic outcome after endovascular thrombectomy. We sought to identify factors that decrease the accuracy of intraprocedural mTICI.
Effect of Adjusting for Baseline Stroke Severity in the National Inpatient Sample
Adam de Havenon, Kevin N. Sheth, Karen C. Johnston, Mohammad Anadani, Shadi Yaghi, David Tirschwell, John Ney
doi : 10.1161/STROKEAHA.121.035112
Stroke. 2021;52:e739–e741
Neuroticism Increases the Risk of Stroke: Mendelian Randomization Study
Yaozhong Liu, Peng Cheng, Na Liu, Biao Li, Yingxu Ma, Wanyun Zuo, Qiming Liu
doi : 10.1161/STROKEAHA.121.036131
Stroke. 2021;52:e742–e743
Association Between Enlarged Perivascular Spaces and White Matter Microstructure
Zi-Yue Liu, Si-Yu Chen, Mei-Jun Shu, Fei-Fei Zhai, Fei Han, Li-Xin Zhou, Jun Ni, Ming Yao, Shu-Yang Zhang, Zheng-Yu Jin, Li-Ying Cui, Yi-Cheng Zhu
doi : 10.1161/STROKEAHA.121.036077
Stroke. 2021;52:e744–e745
Translational Interdisciplinary Science—Immune Cell Niches: Possible Targets for Stroke Therapy?
Louise D. McCullough, María A. Moro
doi : 10.1161/STROKEAHA.121.033969
Stroke. 2021;52:3692–3695
Advances in Neurocardiology: Focus on Atrial Fibrillation
Luciano A. Sposato, Mahmut Edip Gurol
doi : 10.1161/STROKEAHA.121.033970
Stroke. 2021;52:3696–3699
Vascular Brain Health
Christopher L.H. Chen, Tatjana Rundek
doi : 10.1161/STROKEAHA.121.033450
Stroke. 2021;52:3700–3705
Timing and Dose of Upper Limb Motor Intervention After Stroke: A Systematic Review
Kathryn S. Hayward, Sharon F. Kramer, Emily J. Dalton, Gemma R. Hughes, Amy Brodtmann, Leonid Churilov, Geoffrey Cloud, Dale Corbett, Laura Jolliffe, Tina Kaffenberger, Venesha Rethnam, Vincent Thijs, Nick Ward, Natasha Lannin, Julie Bernhardt
doi : 10.1161/STROKEAHA.121.034348
Stroke. 2021;52:3706–3717
This systematic review aimed to investigate timing, dose, and efficacy of upper limb intervention during the first 6 months poststroke. Three online databases were searched up to July 2020. Titles/abstracts/full-text were reviewed independently by 2 authors. Randomized and nonrandomized studies that enrolled people within the first 6 months poststroke, aimed to improve upper limb recovery, and completed preintervention and postintervention assessments were included. Risk of bias was assessed using Cochrane reporting tools. Studies were examined by timing (recovery epoch), dose, and intervention type. Two hundred and sixty-one studies were included, representing 228 (n=9704 participants) unique data sets. The number of studies completed increased from one (n=37 participants) between 1980 and 1984 to 91 (n=4417 participants) between 2015 and 2019. Timing of intervention start has not changed (median 38 days, interquartile range [IQR], 22–66) and study sample size remains small (median n=30, IQR 20–48). Most studies were rated high risk of bias (62%). Study participants were enrolled at different recovery epochs: 1 hyperacute (<24 hours), 13 acute (1–7 days), 176 early subacute (8–90 days), 34 late subacute (91–180 days), and 4 were unable to be classified to an epoch. For both the intervention and control groups, the median dose was 45 (IQR, 600–1430) min/session, 1 (IQR, 1–1) session/d, 5 (IQR, 5–5) d/wk for 4 (IQR, 3–5) weeks. The most common interventions tested were electromechanical (n=55 studies), electrical stimulation (n=38 studies), and constraint-induced movement (n=28 studies) therapies. Despite a large and growing body of research, intervention dose and sample size of included studies were often too small to detect clinically important effects. Furthermore, interventions remain focused on subacute stroke recovery with little change in recent decades. A united research agenda that establishes a clear biological understanding of timing, dose, and intervention type is needed to progress stroke recovery research. Prospective Register of Systematic Reviews ID: CRD42018019367/CRD42018111629.
Studying Stroke Thrombus Composition After Thrombectomy: What Can We Learn?
Senna Staessens, Olivier François, Waleed Brinjikji, Karen M. Doyle, Peter Vanacker, Tommy Andersson, Simon F. De Meyer
doi : 10.1161/STROKEAHA.121.034289
Stroke. 2021;52:3718–3727
The composition of ischemic stroke thrombi has gained an increasing amount of interest in recent years. The implementation of endovascular procedures in standard stroke care has granted researchers the unique opportunity to examine patient thrombus material. Increasing evidence indicates that stroke thrombi are complex and heterogenous, consisting of various biochemical (eg, fibrin, von Willebrand Factor, and neutrophil extracellular traps) and cellular (eg, red blood cells, platelets, leukocytes, and bacteria) components. This complex composition may explain therapeutic limitations and also offer novel insights in several aspects of stroke management. Better understanding of thrombus characteristics could, therefore, potentially lead to improvements in the management of patients with stroke. In this review, we provide a comprehensive overview of the lessons learned by examining stroke thrombus composition after endovascular thrombectomy and its potential relevance for thrombectomy success rates, thrombolysis, clinical outcomes, stroke etiology, and radiological imaging.
Automated Brain Perfusion Imaging in Acute Ischemic Stroke: Interpretation Pearls and Pitfalls
Manal Nicolas-Jilwan, Max Wintermark
doi : 10.1161/STROKEAHA.121.035049
Stroke. 2021;52:3728–3738
Recent advancements in computed tomography technology, including improved brain coverage and automated processing of the perfusion data, have reinforced the use of perfusion computed tomography imaging in the routine evaluation of patients with acute ischemic stroke. The DAWN (Diffusion Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention) and DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trials have established the benefit of endovascular thrombectomy in patients with acute ischemic stroke with anterior circulation large vessel occlusion up to 24 hours of last seen normal, using perfusion imaging-based patient selection. The compelling data has prompted stroke centers to increasingly introduce automated perfusion computed tomography imaging in the routine evaluation of patients with acute ischemic stroke. We present a comprehensive overview of the acquisition and interpretation of automated perfusion imaging in patients with acute ischemic stroke with a special emphasis on the interpretation pearls, pitfalls, and stroke mimicking conditions.
Use of the Estimand Framework to Manage the Disruptive Effects of COVID-19 on Stroke Clinical Trials
Nawaf Yassi, Kathryn S. Hayward, Bruce C.V. Campbell, Leonid Churilov
doi : 10.1161/STROKEAHA.121.036537
Stroke. 2021;52:3739–3747
The coronavirus disease 2019 (COVID-19) pandemic has presented unique challenges to stroke care and research internationally. In particular, clinical trials in stroke are vulnerable to the impacts of the pandemic at multiple stages, including design, recruitment, intervention, follow-up, and interpretation of outcomes. A carefully considered approach is required to ensure the appropriate conduct of stroke trials during the pandemic and to maintain patient and participant safety. This has been recently addressed by the International Council for Harmonisation which, in November 2019, released an addendum to the Statistical Principles for Clinical Trials guidelines entitled Estimands and Sensitivity Analysis in Clinical Trials. In this article, we present the International Council for Harmonisation estimand framework for the design and conduct of clinical trials, with a specific focus on its application to stroke clinical trials. This framework aims to align the clinical and scientific objectives of a trial with its design and end points. It also encourages the prospective consideration of potential postrandomization intercurrent events which may occur during a trial and either impact the ability to measure an end point or its interpretation. We describe the different categories of such events and the proposed strategies for dealing with them, specifically focusing on the COVID-19 pandemic as a source of intercurrent events. We also describe potential practical impacts posed by the COVID-19 pandemic on trials, health systems, study groups, and participants, all of which should be carefully reviewed by investigators to ensure an adequate practical and statistical strategy is in place to protect trial integrity. We provide examples of the implementation of the estimand framework within hypothetical stroke trials in intracerebral hemorrhage and stroke recovery. While the focus of this article is on COVID-19 impacts, the strategies and principles proposed are well suited for other potential events or issues, which may impact clinical trials in the field of stroke.
Keeping Up With the Medical Literature: Why, How, and When?
Joseph Kamtchum-Tatuene, Joseline Guetsop Zafack
doi : 10.1161/STROKEAHA.121.036141
Stroke. 2021;52:e746–e748
Minor Ischemic Stroke and a Smoldering Case of Giant-Cell Arteritis: A Case Report
Alexandru Dimancea, Celine Guidoux, Pierre Amarenco
doi : 10.1161/STROKEAHA.121.035432
Stroke. 2021;52:e749–e752
Correction to: Mendelian Randomization Studies in Stroke: Exploration of Risk Factors and Drug Targets With Human Genetic Data
doi : 10.1161/STR.0000000000000392
Stroke. 2021;52:e753
Correction to: Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial
doi : 10.1161/STR.0000000000000393
Stroke. 2021;52:e754
