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Efficacy and safety of ticagrelor versus aspirin and clopidogrel for stroke prevention in patients with vascular disease: a systematic review and meta-analysis
Introduction: Currently, it is still controversial to treat stroke with ticagrelor alone. The purpose of our study was to systematically review and analyze the efficacy and safety of ticagrelor on cerebrovascular outcomes in patients with vascular risk factors. Methods: The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords stroke, ticagrelor, clopidogrel, and aspirin to identify randomized controlled trials (RCT). Primary outcomes included reported stroke, ischemic stroke and complex events; the secondary outcome was hemorrhagic stroke. The safety outcomes included major bleedi...
Source: European Neurology - April 17, 2023 Category: Neurology Source Type: research

Advances in Futile Reperfusion following Endovascular Treatment in Acute Ischemic Stroke due to Large Vessel Occlusion
Background: Futile reperfusion (FR) is becoming an urgent issue for acute ischemic stroke patients who underwent endovascular treatment (EVT). Although the recanalization rate has improved after EVT, it is far from translating to increased tissue reperfusion and functional independence.Summary: Many underlying mechanisms including the “no-reflow” phenomenon, poor collateral flow, venous dysfunction, and inflammation were proposed, but the pathophysiology of FR is still unclear. Clinically, reliable predictors are still yet to be identified, and ongoing trials on shortening the time delay and cytoprotection may provide ...
Source: European Neurology - February 8, 2023 Category: Neurology Source Type: research

Microcirculation No-Reflow Phenomenon after Acute Ischemic Stroke
Conclusion: Here, we review the occurrence of the no-reflow phenomenon after ischemic stroke and discuss its impact, detection method, and therapeutic strategies on the course of ischemic stroke, from basic science to clinical findings.Eur Neurol
Source: European Neurology - January 6, 2023 Category: Neurology Source Type: research

Effects of Direct Oral Anticoagulants ’ Nonrecommended Dose in Atrial Fibrillation: A Meta-Analysis
Background: The efficacy and safety profiles of nonrecommended direct oral anticoagulant (DOAC) doses in patients with nonvalvular atrial fibrillation (NVAF) are still undefined.Summary: We searched for randomized controlled trials and observational studies that compared nonrecommended versus recommended doses of DOACs, published up to December 2021. Primary study outcomes were ischemic stroke/transient ischemic attack/systemic embolism (IS/TIA/SE) and major bleeding (MB). All-cause mortality was a secondary outcome. We determined pooled odds ratios (ORs) between groups of patients with a random-effect model. Twenty-three ...
Source: European Neurology - September 13, 2022 Category: Neurology Source Type: research

Treatments in Ischemic Stroke: Current and Future
Background and Aim: Despite progress made over the last 30 years, stroke is still a leading cause of disability and mortality; likewise, its burden is expected to increase over the next decades, due to population growth and aging. The development of drugs with better safety-efficacy profiles as well as strategies able to improve ischemic stroke management from the pre-hospital setting is needed.Summary: The pathophysiology of ischemic stroke involves multiple pathways resulting in cerebral artery obstruction and brain tissue ischemia. To date, the only approved drug for acute ischemic stroke is intravenous thrombolytic alt...
Source: European Neurology - August 2, 2022 Category: Neurology Source Type: research

Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke When Multiple Passes Are Required and Associated Risk Factors
Conclusion: Needing more than 2 passes during mechanical thrombectomy is associated with poorer outcomes. Higher preprocedural NIHSS scores and internal carotid artery thrombi are associated with more than 2 passes.Eur Neurol
Source: European Neurology - May 3, 2022 Category: Neurology Source Type: research

The Novel microRNA Rno-miR-686-3p Is Associated with the Ischaemic Penumbra
Conclusion: rno-miR-686-3p is a novel miRNA associated with the ischaemic penumbra that is implicated in transcriptional regulation and modulation of the Wnt and cAMP signalling pathways. Furthermore, it may serve as a possible new biomarker with potential value for detecting the existence of the penumbra.Eur Neurol
Source: European Neurology - January 31, 2022 Category: Neurology Source Type: research

Mechanical Thrombectomy with or without Intravenous Thrombolysis in Acute Ischemic Stroke: A Meta-Analysis for Randomized Controlled Trials
Conclusion: In this meta-analysis including 7 RCTs, MT had comparable consequences to bridging treatment in efficacy and safety outcomes for patients with ischemic stroke caused by the occlusion of proximal anterior circulation, irrespective of geographical location. These findings support the adoption of dMT in acute ischemic stroke treatments and have higher cost-effectiveness in global applications.Eur Neurol
Source: European Neurology - November 24, 2021 Category: Neurology Source Type: research

Ten Years of Improving Acute Stroke Management in a Metropolitan Area: A Population-Based Quantification of Quality Indicators
Conclusions: Collaborative stroke care quality projects are suitable and effective to improve acute stroke care.Eur Neurol
Source: European Neurology - October 14, 2021 Category: Neurology Source Type: research

A pilot study of the ticagrelor role in ischemic stroke secondary prevention
Conclusion: Ticagrelor was noninferior to aspirin regarding safety profile. Compared with aspirin, ticagrelor had a better clinical outcome based on NIHSS and mRS in first-ever acute ischemic stroke patients who received it within 9 h from symptom onset, leading to a shorter hospital stay.Eur Neurol
Source: European Neurology - August 30, 2021 Category: Neurology Source Type: research

Function of Astrocytes in Neuroprotection and Repair after Ischemic Stroke
Background: Astrocytes are the most numerous cell types within the central nervous system, and many efforts have been put into determining the exact role of astrocytes in neuroprotection and repair after ischemic stroke. Although numerous studies have been done in recent years, there is still no thorough understanding of the exact function of astrocytes in the whole course of the stroke.Summary: According to the recent literature, there are many structures and factors that play important roles in the process of ischemic stroke, among which blood-brain barrier, various growth factors, gap junctions, AQP4, and glial scars ha...
Source: European Neurology - August 27, 2021 Category: Neurology Source Type: research

Does Chronic Kidney Disease Have an Impact on the Use of Oral Anticoagulants after Stroke? An Observational Follow-Up Study
Conclusion: Our results show that chronic kidney disease was not the main factor in the decision to withhold oral anticoagulation in patients with recent stroke/TIA and AF.Eur Neurol
Source: European Neurology - June 24, 2021 Category: Neurology Source Type: research

Plasma C-Reactive Protein Level and Outcome of Acute Ischemic Stroke Patients Treated by Intravenous Thrombolysis: A Systematic Review and Meta-Analysis
Conclusion: A high plasma CRP level was associated with a 3-month poor outcome of AIS patients treated with IVT. CRP may be used as a biomarker for the risk stratification of AIS patients as candidates receiving IVT or other alternative therapy such as mechanical thrombectomy.Eur Neurol
Source: European Neurology - April 9, 2021 Category: Neurology Source Type: research

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