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Source: JAMA
Condition: Ischemic Stroke

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Total 108 results found since Jan 2013.

Blood Pressure Management After Successful Thrombectomy
Despite the success of endovascular therapy (EVT) in acute ischemic stroke due to large vessel occlusion, opportunities to further optimize clinical outcomes remain. One such avenue is to reduce hemorrhagic transformation in the infarcted tissue bed after successful reperfusion, which has been shown to be associated with worsened clinical outcomes. Because higher cerebral perfusion pressures may foster hemorrhagic transformation, it has been hypothesized that lowering systemic blood pressure (BP) after successful reperfusion could decrease cerebral hemorrhagic complications. Reducing systemic BP may also lead to a decrease...
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research

Blood Pressure Management After Endovascular Therapy for Stroke
This randomized clinical trial evaluates whether moderately lowering systolic blood pressure, compared with a higher target, in the first 24 hours after successful endovascular treatment for acute ischemic stroke is futile.
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research

Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke
This randomized trial assesses the effect of intensive blood pressure management vs conventional management on functional independence at 3 months among patients with large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy.
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research

Extracranial-Intracranial Bypass and Risk of Stroke and Death in Patients With Symptomatic Artery Occlusion
This clinical trial compares the efficacy of extracranial-intracranial bypass surgery plus medical therapy vs medical therapy alone in symptomatic patients with internal carotid artery or middle cerebral artery occlusion and hemodynamic insufficiency on a composite of stroke or death within 30 days or ipsilateral ischemic stroke beyond 30 days through 2 years after randomization.
Source: JAMA - August 22, 2023 Category: General Medicine Source Type: research

Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke
This randomized trial examines whether dual antiplatelet therapy is noninferior to intravenous thrombolysis among patients with minor nondisabling acute ischemic stroke.
Source: JAMA - June 27, 2023 Category: General Medicine Source Type: research

Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy
This retrospective cohort study assesses the association between recent use of oral vitamin K antagonists and symptomatic intracranial hemorrhage among patients with acute ischemic stroke undergoing endovascular thrombectomy.
Source: JAMA - June 20, 2023 Category: General Medicine Source Type: research

Vaccination, Acute Myocardial Infarction, and Ischemic Stroke After COVID-19 Infection
To the Editor We would like to highlight some key points about the recent article that reported that patients who received full vaccination against COVID-19 had a reduced risk of acute myocardial infarction (AMI) and ischemic stroke after COVID-19 diagnosis.
Source: JAMA - February 7, 2023 Category: General Medicine Source Type: research

Vaccination, Acute Myocardial Infarction, and Ischemic Stroke After COVID-19 Infection —Reply
In Reply We thank Dr Chu and colleagues for their comments about our Research Letter. Our analysis found that 2 doses of COVID-19 vaccine were associated with a reduced risk of AMI and ischemic stroke after COVID-19, using inverse probability treatment weighting to mitigate the imbalance in patient characteristics by vaccination status.
Source: JAMA - February 7, 2023 Category: General Medicine Source Type: research

COVID-19 vs Influenza for Risk of Thrombotic Events in Hospitalized Patients —Reply
In Reply We appreciate the interest in our recent study and the opportunity to share our responses to the comments by Dr Yii and colleagues. We sought to assess whether the risk of arterial and venous thromboembolism among patients hospitalized with COVID-19 differed from those hospitalized with another respiratory viral infection. Patients with influenza in 2018-2019 were selected as the comparator because this pathogen also causes pandemics, results in hospitalization when severe, and is associated with increased risk of acute myocardial infarction, ischemic stroke, and venous thromboembolism. Evaluating outcomes of COVI...
Source: JAMA - December 27, 2022 Category: General Medicine Source Type: research

Remote Ischemic Conditioning vs Usual Care and Neurologic Function in Acute Moderate Ischemic Stroke
To the Editor The Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS) randomized clinical trial shed new light on remote ischemic conditioning (RIC) as a potential treatment in acute ischemic stroke, although there was a 5.4% absolute risk improvement in excellent outcome with a power of 66%. To reproduce these findings with the same protocol using a power of 80%, a sample size of 2458 patients would be required. Previous trials in acute brain infarction and myocardial infarction have delivered 1 cycle of RIC in the first 6 hours of ischemia with the underlying hypothesis of enhanced penumbra salvage....
Source: JAMA - December 20, 2022 Category: General Medicine Source Type: research

Remote Ischemic Conditioning vs Usual Care and Neurologic Function in Acute Moderate Ischemic Stroke —Reply
In Reply We appreciate the interest shown by Dr Pico and colleagues about our trial that investigated the effect of RIC on neurologic function in patients with acute moderate ischemic stroke. A dose-response relationship between the number of days of RIC (or the number of RICs delivered) and excellent outcomes is important information to determine the best protocol for in-hospital RIC. These data will be investigated in our secondary analysis of the RICAMIS study.
Source: JAMA - December 20, 2022 Category: General Medicine Source Type: research

Ischemic Stroke in Patients With Asymptomatic Severe Carotid Stenosis Without Surgical Intervention
To the Editor In a recent study, the authors reported 133 ipsilateral ischemic strokes among patients with medically treated asymptomatic severe carotid stenosis who did not undergo surgical intervention after a mean follow-up of 4.1 years. During this follow-up period, 55.6% of the 3737 patients died; however, cause of death was not reported in this study. Could some of these deaths have been caused by major strokes, and is it possible that these events were missed?
Source: JAMA - September 27, 2022 Category: General Medicine Source Type: research

Ischemic Stroke in Patients With Asymptomatic Severe Carotid Stenosis Without Surgical Intervention —Reply
In Reply In their Letter about our recent study of patients with asymptomatic severe carotid stenosis, Dr Sterpetti and colleagues highlight the short life expectancy of the cohort and state that only 43 patients were alive at the end of the study. We would like to clarify that this number applies only to the small subgroup of patients who experienced an ipsilateral stroke and survived through the observation period. Overall mortality of the cohort was 51.4% during the study period. We agree with Sterpetti and colleagues that surgically and medically treated patients were likely not comparable; indeed, we specifically avoi...
Source: JAMA - September 27, 2022 Category: General Medicine Source Type: research