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Specialty: General Medicine
Source: LANCET
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Total 186 results found since Jan 2013.
Articles Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Endovascular thrombectomy is of benefit to most patients with acute ischaemic stroke caused by occlusion of the proximal anterior circulation, irrespective of patient characteristics or geographical location. These findings will have global implications on structuring systems of care to provide timely treatment to patients with acute ischaemic stroke due to large vessel occlusion.
Source: LANCET - February 17, 2016 Category: Journals (General) Authors: Mayank Goyal, Bijoy K Menon, Wim H van Zwam, Diederik W J Dippel, Peter J Mitchell, Andrew M Demchuk, Antoni Dávalos, Charles B L M Majoie, Aad van der Lugt, Maria A de Miquel, Geoffrey A Donnan, Yvo B W E M Roos, Alain Bonafe, Reza Jahan, Hans-Christoph Tags: Articles Source Type: research
Correspondence IST-3 stroke trial data available
The third International Stroke Trial1 was the largest ever randomised controlled trial of intravenous thrombolysis treatment for patients with acute ischaemic stroke. In accordance with our published protocol and statistical analysis plan, we made the patient data available for an individual patient data meta-analysis.2 We now wish to announce that the IST-3 collaborative group has lodged an anonymised version of the dataset with University of Edinburgh DataShare,3 to enable bona fide researchers to obtain access to the data.
Source: LANCET - May 6, 2016 Category: Journals (General) Authors: Peter Sandercock, Joanna Wardlaw, Richard Lindley, William Whiteley, Geoff Cohen Tags: Correspondence Source Type: research
Comment Can biomarkers balance stroke and bleeding risk?
Age and previous stroke, together with other clinical risk factors (often summarised in the CHA2DS2VASc score), identify patients with atrial fibrillation at high risk for stroke. Dose-adjusted warfarin prevents ischaemic strokes, prolongs life, and maintains autonomy in such patients.1,2 Hence, oral anticoagulation is currently recommended for all patients with atrial fibrillation with two of the CHA2DS2VASc risk factors, and should be considered in those with one of them.1,2 Although even reinitiation of anticoagulation after an intracerebral bleed seems to be associated with improved outcomes,3,4 bleeding is a major rea...
Source: LANCET - April 3, 2016 Category: Journals (General) Authors: Paulus Kirchhof, Larissa Fabritz Tags: Comment Source Type: research
Correspondence The INTERSTROKE study on risk factors for stroke
In a large case-control study in 32 countries, O'Donnell and colleagues (Aug 20, p 761) 1 sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world. They found that ten potentially modifiable risk factors are collectively associated with about 90% of the population attributable risks of stroke in each major region of the world.
Source: LANCET - January 6, 2017 Category: Journals (General) Authors: Xianwei Zeng, Aijun Deng, Yi Ding Tags: Correspondence Source Type: research
Correspondence Risk of mortality and stroke after atrial fibrillation
Jeff Healey and colleagues (Sept 17, p 1161)1 should take credit for their study about mortality and stroke 1 year after a diagnosis of atrial fibrillation. The main findings of the study were the almost two-times higher mortality in South America (17%) and Africa (20%) compared with North America, western Europe, and Australia (10%), and the higher stroke frequency in Africa (8%) and China (7%) compared with the aforementioned regions (3%).
Source: LANCET - March 3, 2017 Category: Journals (General) Authors: Constantinos Mihas, Anargiros Mariolis, Konstantinos P Letsas, Maria Kantzanou Tags: Correspondence Source Type: research
Comment Learning from TARDIS: time for more focused trials in stroke prevention
Antithrombotic therapy immediately following stroke is important to minimise the risk of recurrence, but the optimum choice and number of drugs to use are unclear, and efficacy in preventing thrombosis needs to be weighed against bleeding risk. In The Lancet, the TARDIS investigators report findings from a randomised trial1 that tested intensive antiplatelet therapy with three agents (aspirin, clopidogrel, and dipyridamole) against therapy based on current UK guidelines2 (either clopidogrel, or aspirin plus dipyridamole) for 30 days in patients with transient ischaemic attack (TIA) or ischaemic stroke.
Source: LANCET - December 20, 2017 Category: General Medicine Authors: Pierre Amarenco Tags: Comment Source Type: research
World Report India unveils plans to improve stroke research and care
India has begun a nationwide effort to collect stroke data in a bid to improve epidemiological research and care for the disorder. Tamoghna Biswas reports from Kolkata.
Source: LANCET - January 18, 2013 Category: Journals (General) Authors: Tamoghna Biswas Tags: World Report Source Type: research
Comment Intermittent pneumatic compression in patients with stroke
A patient with acute stroke has just been admitted who is immobile, and cannot walk to the bathroom without help. Looking at the patient's unmoving legs the risk of thrombosis is clear, but a low molecular weight heparin (LMWH) might lead to bleeding, and elastic compression stockings cause skin problems. So you settle on intermittent pneumatic compression devices (IPCs)—but do they actually prevent blood clots?
Source: LANCET - August 10, 2013 Category: Journals (General) Authors: Scott M Stevens, Scott C Woller Tags: Comment Source Type: research
Correspondence Intermittent pneumatic compression in patients with stroke – Authors' reply
Johann Auer and colleagues question whether intermittent pneumatic compression (IPC) would be as effective if used with prophylactic anticoagulants. The CLOTS 3 trial was done in the UK, where the evidence-based national guidelines do not recommend routine use of anticoagulants for deep vein thrombosis (DVT) prophylaxis after stroke. David Barer highlights that although anticoagulants reduce (mainly asymptomatic) DVT, effects on pulmonary embolism are unclear and the increase in bleeds offsets any benefits, so there is no significant effect on survival or functional outcomes.
Source: LANCET - November 2, 2013 Category: Journals (General) Authors: Martin Dennis, Peter Sandercock, Gordon Murray, John Forbes Tags: Correspondence Source Type: research
Articles A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis
In a large scale, robust evaluation, results from this study have shown no differences between the LSCTC and usual care on any of the assessed outcomes. The immediate period after stroke might not be the ideal time to deliver structured caregiver training.
Source: LANCET - December 20, 2013 Category: Journals (General) Authors: Anne Forster, Josie Dickerson, John Young, Anita Patel, Lalit Kalra, Jane Nixon, David Smithard, Martin Knapp, Ivana Holloway, Shamaila Anwar, Amanda Farrin, on behalf of the TRACS Trial Collaboration Tags: Articles Source Type: research
Articles Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants
Interventions that reduce high blood pressure, cholesterol, and glucose might address about half of excess risk of coronary heart disease and three-quarters of excess risk of stroke associated with high BMI. Maintenance of optimum bodyweight is needed for the full benefits.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects) Tags: Articles Source Type: research
Editorial Transient ischaemic attack: more than a stroke of bad luck
Transient ischaemic attack (TIA), in which clots temporarily disrupt blood supply to the brain, affects 46 000 people for the first time in the UK every year. Patients often dismiss the symptoms of TIA as a funny turn, caused by another disorder or old age. However, up to 10% of people with a TIA go on to have a stroke in the next 7 days.
Source: LANCET - May 9, 2014 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Articles Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775 385 individuals and 12 539 strokes
The excess risk of stroke associated with diabetes is significantly higher in women than men, independent of sex differences in other major cardiovascular risk factors. These data add to the existing evidence that men and women experience diabetes-related diseases differently and suggest the need for further work to clarify the biological, behavioural, or social mechanisms involved.
Source: LANCET - June 6, 2014 Category: Journals (General) Authors: Sanne A E Peters, Rachel R Huxley, Mark Woodward Tags: Articles Source Type: research
Correspondence Alteplase for ischaemic stroke
Roger Shinton's Correspondence (Aug 23, p 659) called into question the evidence supporting the safe use of alteplase in patients with acute ischaemic stroke. Ian Hudson, of the Medicines and Healthcare Products Regulatory Agency (MHRA), responded to this Correspondence by convening an expert working group to review the benefits and risks of this drug. A review of reports of spontaneous adverse drug reactions (ADR) should inform this query, but a substantial level of under-reporting might restrict its use.
Source: LANCET - October 25, 2014 Category: Journals (General) Authors: Daniel Burrage Tags: Correspondence Source Type: research
