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Changes in European Label and Guideline Adherence After Updated Recommendations for Stroke Thrombolysis: Results From the Safe Implementation of Treatments in Stroke Registry Original Articles
Conclusions— After the European guideline update, new recommendations were promptly adopted and nonadherence to the unchanged label increased. Label contraindications should be updated.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Anani, N., Mazya, M. V., Bill, O., Chen, R., Koch, S., Ahmed, N., Wahlgren, N., Prazeres Moreira, T. Tags: Treatment, Cerebrovascular Disease/Stroke, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Articles Source Type: research

Abstract 7: Risk of Intracranial Hemorrhage Among Acute Ischemic Stroke Patients Receiving Prior Antiplatelet Therapy and Treated with Intravenous Tissue Plasminogen Activator Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusion: This study represents the largest clinical experience of the safety of thrombolysis in patients on prior antiplatelet therapy. Despite a higher incidence of sICH, the absolute excess risk appears small (0.67%). These findings support current guideline recommendations regarding use of intravenous tPA in patients on antiplatelet therapy with careful weighing of potential risk and benefit.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Xian, Y., Grau-Spulveda, M., Schwamm, L. H., Bhatt, D. L., Smith, E. E., Reeves, M. J., Federspiel, J., Thomas, L., Bettger, J. P., Laskowitz, D. T., Hernandez, A. F., Fonarow, G. C., Peterson, E. D. Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 106: Defining an International Standard Set of Patient-centered Outcome Measures After Stroke Session Title: Poster Session I
Conclusions: The stroke measure Standard Set is proposed for implementation to permit meaningful comparisons and increase value of stroke care worldwide using a simple, pragmatic strategy.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Salinas, J., ICHOM Stroke Measure Group Tags: Session Title: Poster Session I Source Type: research

Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals Original Articles
Conclusions— Documentation of NIHSS is higher in patients who are thrombolysis candidates. Evidence of modest bias in NIHSS scores was observed but this has lessened as the documentation of NIHSS has improved in recent years.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Reeves, M. J., Smith, E. E., Fonarow, G. C., Zhao, X., Thompson, M., Peterson, E. D., Schwamm, L. H., Olson, D. Tags: Cerebrovascular Disease/Stroke Original Articles Source Type: research

Care Trajectories of Veterans in the 12 Months After Hospitalization for Acute Ischemic Stroke Original Articles
Conclusions— Care trajectories after stroke were associated with stroke severity and functional dependency and they had a dramatic impact on subsequent costs.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Arling, G., Ofner, S., Reeves, M. J., Myers, L. J., Williams, L. S., Daggy, J. K., Phipps, M. S., Chumbler, N., Bravata, D. M. Tags: Ethics and Policy, Cerebrovascular Disease/Stroke Original Articles Source Type: research

Chronic Stroke Outcome Measures for Motor Function Intervention Trials: Expert Panel Recommendations Original Articles
Conclusions— The panel recommends that the Fugl-Meyer Upper and Lower Extremity scales be used as primary outcomes in intervention trials targeting motor function in populations with chronic stroke. The other 6 measures are recommended as secondary outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - October 29, 2015 Category: Cardiology Authors: Bushnell, C., Bettger, J. P., Cockroft, K. M., Cramer, S. C., Edelen, M. O., Hanley, D., Katzan, I. L., Mattke, S., Nilsen, D. M., Piquado, T., Skidmore, E. R., Wing, K., Yenokyan, G. Tags: Behavioral/Psychosocial Treatment, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Quantifying Selection Bias in National Institute of Health Stroke Scale Data Documented in an Acute Stroke Registry Original Articles
Conclusions— We demonstrate modest, but important, selection bias in documented NIHSS data, which are missing more often in patients with less severe stroke. The population mean NIHSS score was overestimated by >2 points, which could significantly alter the risk profile of hospitals treating patients with ischemic stroke and subsequent hospital risk–adjusted outcomes.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Thompson, M. P., Luo, Z., Gardiner, J., Burke, J. F., Nickles, A., Reeves, M. J. Tags: Ischemic Stroke Original Articles Source Type: research

Regional Learning Collaboratives Produce Rapid and Sustainable Improvements in Stroke Thrombolysis Times Original Articles
Conclusions— Using a learning collaborative model at Chicago’s 15 primary stroke centers, we observed major reductions in DTN times within 1 quarter of implementation. Regional collaboration and best practices sharing should be a model for rapid and sustainable system-wide quality improvement.
Source: Circulation: Cardiovascular Quality and Outcomes - September 19, 2016 Category: Cardiology Authors: Prabhakaran, S., Lee, J., ONeill, K. Tags: Health Services, Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Abstract 7: Reduced Hospitalization For Transient Ischemic Attack In The United States Over The Past Decade Concurrent I Session B: Oral Abstract Presentations on Stroke Topics
CONCLUSION: TIA hospitalizations in the United States decreased from 2000 to 2010 as the number of ischemic stroke hospitalizations increased. This may be a result of increased imaging utilization and use of tissue-based diagnosis of TIA. Cases of cerebral ischemia with resolved symptoms coded as TIA in the past may be coded as ischemic stroke with MRI imaging evidence of brain injury, yet further study is needed to confirm this finding.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Sanossian, N., Ramirez, L., Kim-Tenser, M. A., Cen, S., Wen, G., Towfighi, A., Ne, S., Adamczyk, P., Mack, W. J. Tags: Concurrent I Session B: Oral Abstract Presentations on Stroke Topics Source Type: research

Association of Body Mass Index and Mortality After Acute Ischemic Stroke Original Articles
Conclusions— Severe obesity is associated with increased poststroke mortality in middle-aged and older adults. Stroke patients with class 2 obesity had the lowest mortality risk. More research is needed to determine weight management goals among stroke survivors.
Source: Circulation: Cardiovascular Quality and Outcomes - January 21, 2014 Category: Cardiology Authors: Skolarus, L. E., Sanchez, B. N., Levine, D. A., Baek, J., Kerber, K. A., Morgenstern, L. B., Smith, M. A., Lisabeth, L. D. Tags: Obesity, Cerebrovascular disease/stroke Original Articles Source Type: research

Abstract 10: Predictors of Poor Outcome in Acute Ischemic Stroke Patients after Successful Recanalization Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics
Conclusions: Age, occlusion site, high NIHSS, diabetes, not receiving IV t-PA, use of rescue therapy and three or more passes, were associated with poor 90-day outcome despite successful recanalization.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Starosciak, A. K., Linfante, I., Walker, G., Zaidat, O. O., Castonguay, A. C., Lin, E., Dabus, G., NASA Investigators Tags: Session Title: Concurrent I Session B: Oral Abstracts on Stroke Topics Source Type: research

Abstract 18: Determinants of Adequate Blood Pressure Control in Stroke Patients Post-Discharge Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusions: Contrary to our hypothesis, once daily dosed BP medications did not improve the effectiveness of BP control at follow-up. Elevated SBP at the time of hospital discharge was associated with poor blood pressure control. Those patients receiving outpatient home health and therapy visits after hospital discharge had better blood pressure control. Further studies need to be done to assess medication adherence to determine whether the poor control was related to choice of medication or patient medication-taking behavior.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Bishop, L., Arnan, M., Petryna, E., Bushnell, C. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Abstract 19: Using the Heckman Selection Model to Assess Selection Bias in Ischemic Stroke Patients with Documented NIHSS Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusions: We found statistically significant albeit weak selection bias in the documentation of NIHSS in stroke patients. The Heckman Selection Model is a novel method that can be used to assess the presence and magnitude of selection bias when missing data is common.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Thompson, M. P., Luo, Z., Gardiner, J., Burke, J. F., Reeves, M. J. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Abstract 20: Patient Characteristics and Outcomes among Early-Arriving Acute Stroke Patients for Whom Alteplase Was Dispensed but Not Administered Session Title: Concurrent Session IIC: Oral Abstracts - Stroke
Conclusion: Delays in tPA initiation are common, and reduce health outcomes after thrombolysis. In our study, early dispensing of tPA prior to the final eligibility assessment produced an overall rate of tPA treatment of >60%. This conversion rate suggests that early tPA dispensing in high likelihood candidates is appropriate and supports the use of this strategy. Reasons for non-treatment were similar to those in unselected patients.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Siddiqui, K. A., Ali, S. F., Anderson, C. D., Rost, N., Schwamm, L. H. Tags: Session Title: Concurrent Session IIC: Oral Abstracts - Stroke Source Type: research

Novel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack Original Articles
Conclusions— NOACs have had modest but growing uptake over time among atrial fibrillation patients hospitalized with stroke or transient ischemic attack and are prescribed to patients with lower stroke risk compared with warfarin.
Source: Circulation: Cardiovascular Quality and Outcomes - July 21, 2015 Category: Cardiology Authors: Patel, P. A., Zhao, X., Fonarow, G. C., Lytle, B. L., Smith, E. E., Xian, Y., Bhatt, D. L., Peterson, E. D., Schwamm, L. H., Hernandez, A. F. Tags: Other anticoagulants, Embolic stroke, Anticoagulants Original Articles Source Type: research

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