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Pulse pressure and in-hospital outcome of acute ischemic stroke
We aimed to evaluate the association between pulse pressure, a readily available marker of arterial stiffness, and the in-hospital outcome of patients with acute ischemic stroke. We prospectively studied 790 consecutive patients who were admitted with acute ischemic stroke (41.0% males, age 79.4±6.8 years). The severity of stroke was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). The outcome was assessed with dependency rates at discharge (modified Rankin scale between 2 and 5) and with in-hospital mortality.
Source: Journal of the American Society of Hypertension - March 31, 2016 Category: Cardiology Authors: Konstantinos Tziomalos, Stella Bouziana, Marianna Spanou, Stavroula Kostaki, Stella-Maria Angelopoulou, Maria Papadopoulou, Vasilios Giampatzis, Maria Tsopozidi, Christos Savopoulos, Apostolos I. Hatzitolios Tags: Stroke Source Type: research

The Evolution of Mechanical Thrombectomy for Acute Stroke
Opinion statement The natural history of an acute ischemic stroke from a large vessel occlusion (LVO) is poor and has long challenged stroke therapy. Recently, endovascular therapy has demonstrated superiority to medical management in appropriately selected patients. This advance has revolutionized acute care for LVO and mandates a reevaluation of the entire chain of stroke care delivery, including patient selection, intervention, and post-procedural care. Since endovascular therapy is a therapy specifically targeting LVO, its application should be restricted to those patients only. Clinical and radiologic parame...
Source: Current Treatment Options in Cardiovascular Medicine - March 1, 2016 Category: Cardiology Source Type: research

Changing Cholesterol Levels and Coronary Heart Disease Risk.
Abstract A report by Colantonio and colleagues in this issue of Circulation describes the relations between serum lipoprotein cholesterol levels and triglycerides with coronary heart disease (CHD) incidence.(1) Their analyses draw upon the experience of three American population samples of adults with 8.9 years of follow up. The first study group is the Reasons for Geographic and Racial Differences in Stroke (REGARDS, National Institutes of Health observational cohort, baseline 2003-2007), the second investigation is the Atherosclerosis Risk in Communities (ARIC, National Heart, Lung and Blood observational cohort...
Source: Circulation - December 9, 2015 Category: Cardiology Authors: Wilson PW Tags: Circulation Source Type: research

Effects of Different Classes of Antihypertensive Agents on the Outcome of Acute Ischemic Stroke
It is unclear whether antihypertensive treatment before stroke affects acute ischemic stroke severity and outcome. To evaluate this association, the authors studied 482 consecutive patients (age 78.8±6.7 years) admitted with acute ischemic stroke. Stroke severity was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). The outcome was assessed with rates of adverse outcome (modified Rankin scale at discharge ≥2). Independent predictors of severe stroke (NIHSS ≥16) were female sex and atrial fibrillation. Treatment with diuretics before stroke was associated with nonsevere stroke. At disc...
Source: The Journal of Clinical Hypertension - March 1, 2015 Category: Cardiology Authors: Konstantinos Tziomalos, Vasilios Giampatzis, Stella D. Bouziana, Marianna Spanou, Maria Papadopoulou, Pavlina Kazantzidou, Stavroula Kostaki, Antonios Kouparanis, Christos Savopoulos, Apostolos I. Hatzitolios Tags: Original Paper Source Type: research

Progress toward the prevention and treatment of atrial fibrillation: A summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9–10, 2013
The Heart Rhythm Society convened a research symposium on December 9–10, 2013, in Washington, DC, that focused on the prevention of atrial fibrillation (AF) as well as AF-related stroke and morbidity. Attendees sought to summarize advances in understanding AF since a 2008 National Institutes of Health (NIH) conference on this topic1 and to identify continued knowledge gaps and current research priorities. The research symposium also sought to identify key deficiencies and opportunities in research infrastructure, operations, and methodologies.
Source: Heart Rhythm - November 17, 2014 Category: Cardiology Authors: David R. Van Wagoner, Jonathan P. Piccini, Christine M. Albert, Mark E. Anderson, Emelia J. Benjamin, Bianca Brundel, Robert M. Califf, Hugh Calkins, Peng-Sheng Chen, Nipavan Chiamvimonvat, Dawood Darbar, Lee Eckhardt, Patrick T. Ellinor, Derek V. Exner, Source Type: research

Chelation therapy after the Trial to Assess Chelation Therapy: results of a unique trial
Purpose of reviewEDTA chelation therapy has been in off-label use for the treatment of atherosclerosis. We review the results of the first large-scale randomized trial of this treatment. Recent findingsThe trial to assess chelation therapy was a $30 million National Institutes of Health-funded study of the safety and efficacy of EDTA-based chelation infusions in 1708 post-myocardial infarction (MI) patients. The trial to assess chelation therapy demonstrated a significant (P = 0.035) 18% reduction in a combined primary endpoint of death, MI, stroke, coronary revascularization, or hospitalization for angina. In diabetic...
Source: Current Opinion in Cardiology - August 7, 2014 Category: Cardiology Tags: PREVENTION: Edited by Andrew Pipe Source Type: research

Interventional Management of Acute Ischemic Stroke: A Systematic Review
Opinion statement Historically, acute ischemic stroke (AIS) trials defined syndromes according to acute clinical presentation and post-ictus parenchymal imaging. With improvements in real-time arterial imaging, modern AIS treatment demands a structural approach based upon the level of cerebrovascular occlusion. The poor concordance of presenting National Institute of Health Stroke Scale (NIHSS) with vessel occlusion in recent trials bespeaks the need for an anatomic perspective. Specifically, patients with large-vessel occlusion (LVO) represent a distinct entity with a poorer prognosis than general AIS patients. ...
Source: Current Treatment Options in Cardiovascular Medicine - June 13, 2014 Category: Cardiology Source Type: research

Resistant hypertension: resistance to treatment or resistance to taking treatment?
The treatment of hypertension has been a therapeutic success. A generation or more of effective drugs deserves considerable credit for their contribution to the substantial decline in age-related incidence of stroke, ischaemic heart disease and heart failure. And because almost all the drugs are long-since off patent, the cost of success comes cheaply. Indeed, National Institute of Health and Care Excellence (NICE) has branded treatment of hypertension as not only cost effective but cost saving.1 Yet not all patients achieve their blood pressure target and are labelled as ‘resistant hypertension’. A contentious...
Source: Heart - May 8, 2014 Category: Cardiology Authors: Brown, M. J. Tags: Drugs: cardiovascular system, Hypertension, Interventional cardiology, Epidemiology Editorials Source Type: research

Effects of Batroxobin with Continuous Transcranial Doppler Monitoring in Patients with Acute Cerebral Stroke: A Randomized Controlled Trial
Our objective was to determine whether continuous transcranial Doppler (TCD) monitoring could safely enhance the efficacy of batroxobin, a thrombin‐like enzyme extracted from Bothrops atrox moojeni venom, in the treatment for acute cerebral stroke beyond the thrombolytic time window. Ninety patients suffering an acute cerebral stroke were recruited into the study within 12 hours after the onset of symptoms. Patients were randomized to receive batroxobin with (target group) or without 1 hour of continuous TCD monitoring (control group). Clinical evaluation of stroke was based on the National Institutes of Health Stroke ...
Source: Echocardiography - March 1, 2014 Category: Cardiology Authors: He Yitao, Ma Kefu, Tang Bingshan, Fu Xuejun, Zhan Ying, Cai Zhili, Jiang Xin, Yi Guo Tags: Original Investigation Source Type: research

Low levels of high-density lipoprotein cholesterol in patients with atherosclerotic stroke: A prospective cohort study
Abstract: Objective: The purpose of this study was to evaluate the influence of baseline high-density lipoprotein cholesterol (HDL-C) on initial stroke severity and clinical outcomes in acute ischemic stroke.Methods: From August 2006 through December 2011, patients with acute atherosclerotic ischemic stroke were included. Total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and HDL-C were checked and National Institutes of Health Stroke Scale (NIHSS) scores were obtained at admission. The primary outcomes were a composite end point of all-cause mortality, recurrent stroke, or occurrence of ischemic...
Source: Atherosclerosis - April 25, 2013 Category: Cardiology Authors: Poh-Shiow Yeh, Chun-Ming Yang, Sheng-Hsiang Lin, Wei-Ming Wang, Po-Sheng Chen, Ting-Hsing Chao, Huey-Juan Lin, Kao-Chang Lin, Chia-Yu Chang, Tain-Junn Cheng, Yi-Heng Li Tags: Epidemiology, Biomarkers, Nutrition Source Type: research

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