Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States.

Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States. Ethn Dis. 2020;30(1):91-96 Authors: Esenwa C, Lekoubou A, Bishu KG, Small K, Liberman A, Ovbiagele B Abstract Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, mechanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circulation large vessel occlusion (LVO). Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differences. Methods: We performed a retrospective cohort study using nationally representative data of a non-institutionalized population sample from 2006 to 2014 obtained from the Nationwide Inpatient Sample (NIS). We identified a total of 889,309 observations of AIS, of which there were 5,256 MT observations. Results: In the fully adjusted model, rate of thrombectomy utilization was significantly lower in African Americans (AA) (OR .67, CI .58-.76, P
Source: Ethnicity and Disease - Category: International Medicine & Public Health Tags: Ethn Dis Source Type: research

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Discussion IAB is a rather frequent finding in the general population. IAB is a risk factor for AF and is associated with an increased risk of stroke or TIA independently of associated AF. Key messagesBoth partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population.Advanced interatrial block is an independent risk factor for stroke and transient ischemic attack.The clinical significance of interatrial block is dependent on the subtype classification. PMID: 32077319 [PubMed - as supplied by publisher]
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
Conclusion: Higher serum sortilin level was associated with carotid calcification and severe carotid plaque score. PMID: 32077308 [PubMed - as supplied by publisher]
Source: Future Medicine: Biomarkers in Medicine - Category: Internal Medicine Tags: Biomark Med Source Type: research
Publication date: Available online 21 February 2020Source: Journal of Clinical NeuroscienceAuthor(s): Abhinav Raina, Madhukar Trivedi, Mahesh Kate, Laisa Kumar, Sapna Erat Sreedharan, PN SylajaAbstractBackgroundDoor to needle (DTN) time provides valuable insight into stroke care workflow and is a performance indicator of an acute stroke unit. The aim of the current study was to ascertain whether a door to needle time of less than 60 min can be achieved for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) and maintained long term in a comprehensive stroke unit.MethodsPatients with AIS treated with IVT in t...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Authors: Heo GS, Sultan D, Liu Y Abstract Cardiovascular disease (CVD) remains the leading cause of death worldwide despite advances in diagnostic technologies and treatment strategies. The underlying cause of most CVD is atherosclerosis, a chronic disease driven by inflammatory reactions. Atherosclerotic plaque rupture could cause arterial occlusion leading to ischemic tissue injuries such as myocardial infarction (MI) and stroke. Clinically, most imaging modalities are based on anatomy and provide limited information about the on-going molecular activities affecting the vulnerability of atherosclerotic lesion for...
Source: Quarterly Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Tags: Q J Nucl Med Mol Imaging Source Type: research
Elevated blood pressure is common in patients with acute ischemic stroke. While this may occur secondary to the body's own response to preserve cerebral blood flow, elevated blood pressure may also increase the risk of hemorrhagic transformation. Current guidelines recommend various blood pressure goals based upon multiple factors, including thresholds specific to certain treatment interventions. Despite these guidelines, there is limited evidence to support specific blood pressure targets, and variability in clinical practice is common. The purpose of this review was to discuss blood pressure management in adult patients ...
Source: Critical Care Nursing Quarterly - Category: Nursing Tags: Original Articles Source Type: research
The antiplatelet landscape for the secondary prevention of ischemic stroke has changed significantly over the past decade. Poststroke dual antiplatelet regimens are becoming increasingly routine as supported by recent literature and guideline recommendations. Dual antiplatelet therapy after stroke generally consists of aspirin and clopidogrel and is considered in the short term after stroke in select populations including those with mild stroke or transient ischemic attack and in patients with severe intracranial atherosclerosis. When initiating dual antiplatelet therapy, factors that may increase a patient's risk of bleed...
Source: Critical Care Nursing Quarterly - Category: Nursing Tags: Original Articles Source Type: research
Publication date: Available online 20 February 2020Source: The LancetAuthor(s): Michael D Hill, Mayank Goyal, Bijoy K Menon, Raul G Nogueira, Ryan A McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Brian H Buck, Thalia S Field, Dar Dowlatshahi, Brian A van Adel, Richard H Swartz, Ruchir A Shah, Eric Sauvageau, Charlotte Zerna, Johanna M Ospel, Manish Joshi, Mohammed A Almekhlafi, Karla J Ryckborst, Mark W LowerisonSummaryBackgroundNerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, is a neuroprotectant that is effective in preclinical stroke models of ischaemia-reperfusion. In this trial, we ...
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: Available online 20 February 2020Source: The LancetAuthor(s): Graeme J Hankey
Source: The Lancet - Category: General Medicine Source Type: research
The addition of endovascular therapy to thrombolysis for acute ischemic stroke with basilar artery occlusion improved functional outcomes in a new registry study.Medscape Medical News
Source: Medscape Cardiology Headlines - Category: Cardiology Tags: Neurology & Neurosurgery News Source Type: news
This study aimed to investigate the potential roles of Nogo-A/Nogo-66 receptor 1 (NgR1) in autophagic activation in the ipsilateral thalamus after cerebral infarction. Focal neocortical infarction was established using the middle cerebral artery occlusion (MCAO) method. Secondary damage in the ipsilateral thalamus was assessed by Nissl staining and immunostaining. The expression of Nogo-A, NgR1, Rho-A and Rho-associated coiled-coil containing protein kinase 1 (ROCK1) as well as autophagic flux were evaluated by immunofluorescence and immunoblotting. The roles of Nogo-A–NgR1 signaling in autophagic activation were det...
Source: Neuroscience - Category: Neuroscience Source Type: research
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