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A cardiovascular polypill for secondary stroke prevention in a tertiary centre in Ghana (SMAART): a phase 2 randomised clinical trial
Lancet Glob Health. 2023 Oct;11(10):e1619-e1628. doi: 10.1016/S2214-109X(23)00347-9.ABSTRACTBACKGROUND: A cardiovascular polypill containing generic drugs might facilitate sustained implementation of and adherence to evidence-based treatments, especially in resource-limited settings. However, the impact of a cardiovascular polypill in mitigating atherosclerotic risk among stroke survivors has not been assessed. We aimed to compare a polypill regimen with usual care on carotid intima-media thickness (CIMT) regression after ischaemic stroke.METHODS: In SMAART, a phase 2 parallel, open-label, assessor-masked, randomised clini...
Source: Atherosclerosis - September 21, 2023 Category: Cardiology Authors: Fred Stephen Sarfo Jenifer Voeks Sheila Adamu Benedict Apaw Agyei Manolo Agbenorku Nyantakyi Adu-Darko Mercy Adomah Oteng Vida Obese Rexford Adu Gyamfi Nathaniel Adusei Mensah Raelle Tagge Michael Ampofo Samuel Amoabeng Kontoh Samuel Blay Nguah Bruce Ovbi Source Type: research

Single-center experience of endovascular treatment for patients with progressive posterior circulation cerebral infarction exceeding 24 h
CONCLUSION: In patients with progressive posterior circulation cerebral infarction caused by vertebral basilar artery occlusion, ET is effective and safe even if the time from onset to puncture exceeds 24 h.PMID:37719319 | PMC:PMC10505061 | DOI:10.2478/abm-2023-0046
Source: Biomed Res - September 18, 2023 Category: Research Authors: Guangfeng Zhao Xiongjun He Yajie Liu Liang Zhang Kaifeng Li Source Type: research

Risk factors and a prediction model for unruptured intracranial aneurysms in patients with ischemic stroke using carotid intima-media thickness and systemic atherosclerosis
CONCLUSION: The findings revealed that the risk factors for UIA in patients with IS included aspirin use, elevated CRP level, and smaller carotid IMT, and the predictive value of the prediction model was relatively better.PMID:37706007 | PMC:PMC10495834 | DOI:10.3389/fneur.2023.1227673
Source: Atherosclerosis - September 14, 2023 Category: Cardiology Authors: Gaiming Gao Dezhi Kang Jinning Zhang Zhixian Jiang Xueyang He Yanyu Wu Source Type: research

CYP2C19 Loss-of-Function Variants Associated with Long-term Ischemic Stroke Events During Clopidogrel Treatment in the Chinese Population
This study aims to determine whether CYP2C19 loss-of-function (LoF) variants were associated with long-term ischemic stroke risk in Chinese primary care patients treated with clopidogrel. Patients treated with clopidogrel were ascertained from a Chinese Electronic Medical Record linked with biobank for a retrospective cohort study. Their medical information was examined for the period from January 2018 to December 2021. Two CYP2C19 major loss of function variants (*2:rs4244285, *3: rs4986893) were genotyped. The clinical outcome was ischemic stroke event. Cox regression analysis was used to evaluate the association between...
Source: Clinical Pharmacology and Therapeutics - August 22, 2023 Category: Drugs & Pharmacology Authors: Peng Wu Ziqing Liu Zijian Tian Benrui Wu Jian Shao Qian Li Zhaoxu Geng Ying Pan Ke Lu Qiang Wang Tao Xu Kaixin Zhou Source Type: research

Preferred monotherapy after short-term dual antiplatelet therapy: Systematic review and network meta-analysis of randomized trials
CONCLUSIONS: Compared with aspirin monotherapy following short-term DAPT, ticagrelor following 3-month DAPT was associated with a reduced risk of primary bleeding outcomes without increasing any ischemic outcomes.PMID:37562542 | DOI:10.1016/j.jjcc.2023.08.001
Source: Journal of Cardiology - August 10, 2023 Category: Cardiology Authors: Satoshi Shoji Toshiki Kuno Hiroki Ueyama Hisato Takagi Alexandros Briasoulis Hyo-Soo Kim Bon-Kwon Koo Jeehoon Kang Hirotoshi Watanabe Takeshi Kimura Shun Kohsaka Source Type: research

Preferred monotherapy after short-term dual antiplatelet therapy: Systematic review and network Meta-analysis of randomized trials
CONCLUSIONS: Compared with aspirin monotherapy following short-term DAPT, ticagrelor following 3-month DAPT was associated with a reduced risk of primary bleeding outcomes without increasing any ischemic outcomes.PMID:37562542 | DOI:10.1016/j.jjcc.2023.08.001
Source: Journal of Cardiology - August 10, 2023 Category: Cardiology Authors: Satoshi Shoji Toshiki Kuno Hiroki Ueyama Hisato Takagi Alexandros Briasoulis Hyo-Soo Kim Bon-Kwon Koo Jeehoon Kang Hirotoshi Watanabe Takeshi Kimura Shun Kohsaka Source Type: research

Dual Antiplatelet Therapies and Causes in Minor Stroke or Transient Ischemic Attack: A Prespecified Analysis in the CHANCE-2 Trial
CONCLUSIONS: In this prespecified analysis of the CHANCE-2 trial, the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing new stroke were consistent in patients with different causes. The influence of stroke cause on benefit of gene-guided antiplatelet therapy should be explored by further trials.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT04078737.PMID:37548009 | DOI:10.1161/STROKEAHA.122.042233
Source: Atherosclerosis - August 7, 2023 Category: Cardiology Authors: Xuewei Xie Jing Jing Xia Meng S Claiborne Johnston Philip M Bath Zixiao Li Xingquan Zhao Liping Liu Yilong Wang Qin Xu Anxin Wang Yong Jiang Hao Li Yongjun Wang CHANCE-2 Investigators Source Type: research

Ischemic Stroke Management: Posthospitalization and Transition of Care
Am Fam Physician. 2023 Jul;108(1):70-77.ABSTRACTIschemic stroke is a major cause of morbidity and mortality worldwide. Ischemic stroke and transient ischemic attack exist on a continuum of the same disease process. Ischemic stroke is common, and more than 85% of stroke risk is attributed to modifiable risk factors. The initial management of acute stroke is usually performed in the emergency department and hospital settings. Family physicians have a key role in follow-up, ensuring that a complete diagnostic evaluation has been performed, addressing modifiable risk factors, facilitating rehabilitation, and managing chronic s...
Source: Pain Physician - July 13, 2023 Category: Anesthesiology Authors: Scott T Larson Brigit E Ray Jason Wilbur Source Type: research

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