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Bridging the Evidence-to-Practice Gap in Stroke Care
Stroke is particularly devastating globally. Although much progress on stroke has been made, stroke is the second leading cause of death worldwide and the leading cause of death in China, a country with a population greater than 1.5 billion. Indeed, the burden of stroke is substantial in Asian countries because of a higher stroke incidence and evolving access to modern stroke care. Stroke care may be one area of medicine that has a particularly large evidence-to-practice gap. Modern stroke treatment requires technology including imaging equipment, as well as stroke units and rehabilitation units, all of which can be prohib...
Source: JAMA - Journal of the American Medical Association - June 29, 2018 Category: General Medicine Source Type: research

Folate Supplements for Stroke Prevention Targeted Trial Trumps the Rest
The effect of folate supplementation on cardiovascular disease has been studied in many observational studies and randomized trials and has been a topic of debate for a number of years. In this issue of JAMA, Huo and colleagues provide results from their important clinical trial of folic acid therapy for primary prevention of stroke. In a carefully designed and executed randomized trial, 20 702 adults with hypertension were randomized to receive enalapril alone (n = 10 354) or enalapril combined with 0.8 mg folic acid (n = 10 348). As recommended by the data and safety monitoring board, the trial was terminat...
Source: JAMA - Journal of the American Medical Association - March 15, 2015 Category: Journals (General) Source Type: research

Association Between Stroke and Mortality in Young Adults
This cohort study uses Dutch registry and population data to estimate associations between incident stroke occurring between ages 18 and 49 years and short- and long-term all-cause mortality stratified by age, sex, and stroke subtype.
Source: JAMA - Journal of the American Medical Association - May 23, 2019 Category: General Medicine Source Type: research

Management of Patients With Acute Ischemic Stroke
This JAMA Clinical Guidelines Synopsis describes the 2018 American Heart Association/American Stroke Association guidelines for management of patients with acute ischemic stroke.
Source: JAMA - Journal of the American Medical Association - July 18, 2019 Category: General Medicine Source Type: research

Working Late, Courting Stroke
This Medical News & Perspectives article describes the stroke risk associated with working too many hours and efforts to protect workers’ health as well as promote wellness.
Source: JAMA - Journal of the American Medical Association - October 9, 2015 Category: Journals (General) Source Type: research

CYP2C19 Status and Stroke Risk Reduction With Clopidogrel in Patients With TIA
This study uses data from a trial comparing clopidogrel and aspirin vs aspirin alone for preventing stroke in patients with TIA to investigate associations between CYP2C19 status and effects of the drugs.
Source: JAMA - Journal of the American Medical Association - June 27, 2016 Category: Journals (General) Source Type: research

Effect of a Multifaceted Intervention on Adherence to Performance Measures in Acute Ischemic Stroke Patients
This cluster randomized clinical trial determines whether a multifaceted quality improvement intervention can improve adherence to evidence-based performance measures in patients with acute ischemic stroke in China.
Source: JAMA - Journal of the American Medical Association - June 29, 2018 Category: General Medicine Source Type: research

The Acute Stroke Care Revolution
This Viewpoint reviews evidence of the benefits of thrombectomy for patients with ischemic stroke due to large vessel occlusion, and details the systems of care that need to be developed to ensure that all patients who might benefit from the procedure can be rapidly identified, transported, imaged, and treated under the care of qualified specialists.
Source: JAMA - Journal of the American Medical Association - September 10, 2018 Category: General Medicine Source Type: research

Effect of Catheter Ablation vs Antiarrhythmic Drugs on Mortality, Stroke, Bleeding, and Cardiac Arrest in AF
This randomized trial compares the effect of pulmonary vein isolation via catheter ablation vs rate and rhythm control using medical therapy on a composite outcome of death, disabling stroke, serious bleeding, or cardiac arrest in patients with atrial fibrillation (AF).
Source: JAMA - Journal of the American Medical Association - March 15, 2019 Category: General Medicine Source Type: research

Cardiovascular Corner: Prescription Omega-3s, Stroke Rehab, and Statins After Age 75
This Medical News article is an update on important clinical research in the world of heart disease and stroke.
Source: JAMA - Journal of the American Medical Association - September 11, 2019 Category: General Medicine Source Type: research

Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Ischemic Stroke
This randomized clinical trial compares the effects of 2 tenecteplase doses (0.40 vs 0.25 mg/kg) prior to endovascular thrombectomy on blood flow restoration to brain ischemic territory in patients with large vessel occlusion ischemic stroke.
Source: JAMA - Journal of the American Medical Association - February 20, 2020 Category: General Medicine Source Type: research

Changes in Patterns of Acute MI or Ischemic Stroke Hospitalization During COVID-19 Surges
This study evaluates changes in rates of patients hospitalized for acute myocardial infarction (AMI) or suspected stroke during COVID-19 surges in the US as a measure of willingness to seek care during the pandemic.
Source: JAMA - Journal of the American Medical Association - June 2, 2021 Category: General Medicine Source Type: research

Intensive Medical Management to Prevent Large and Small Artery Atherothrombotic Stroke
This Viewpoint examines the potential of using newer strategies to prevent ischemic stroke due to large and small artery atherothrombosis, including agents to lower LDL cholesterol, as well as increase eicosapentaenoic acid levels, insulin sensitivity and synthesis, and folic acid levels.
Source: JAMA - Journal of the American Medical Association - July 1, 2021 Category: General Medicine Source Type: research

Temporal Trends in Stroke Thrombolysis in the US by Race and Ethnicity, 2009-2018
This study investigates the temporal trend in racial and ethnic differences in use of intravenous thrombolysis for stroke treatment between 2009 and 2018 in a representative sample of US adults.
Source: JAMA - Journal of the American Medical Association - October 11, 2021 Category: General Medicine Source Type: research

Acute Myocardial Infarction and Ischemic Stroke After COVID-19 by Vaccination Status
This retrospective cohort study examines the incidence of acute myocardial infarction and ischemic stroke after COVID-19 infection among vaccinated vs unvaccinated adults in Korea.
Source: JAMA - Journal of the American Medical Association - July 22, 2022 Category: General Medicine Source Type: research

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