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Source: JAMA
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Total 276 results found since Jan 2013.
Highlights From the International Stroke Conference 2022 —Thrombectomy and Alteplase, Access to Stroke Centers, and Warfarin vs Direct Oral Anticoagulants
Timely topics discussed at the AHA/ASA ’s International Stroke Conference included giving stroke patients intra-arterial alteplase following successful thrombectomy.
Source: JAMA - March 15, 2022 Category: General Medicine Source Type: research
Hemiplegia
There is tenderness implied in the word stroke as a verb, but as a noun the blood that fisted in the vessel dammed the flow to his brain, slammed shut every door
Source: JAMA - March 8, 2022 Category: General Medicine Source Type: research
Group Collaborator Supplement Added
The Original Investigation titled “Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial,” published February 20, 2020, has been corrected to include the nonauthor collaborator names in a supp lement.
Source: JAMA - March 8, 2022 Category: General Medicine Source Type: research
Patient Information: Acute Ischemic Stroke
This JAMA Patient Page describes acute ischemic stroke and its risk factors, diagnosis, and treatment.
Source: JAMA - March 1, 2022 Category: General Medicine Source Type: research
Intra-arterial Thrombolysis to Target Occlusions in Distal Arteries and the Microcirculation
Acute ischemic stroke remains a leading cause of disability in the United States and worldwide despite substantially improved treatments for the most severe strokes over the last 5 years. Treatment of severe ischemic strokes, specifically those due to occlusion of large intracranial arteries, has been transformed by endovascular removal of the thrombus using stent retrievers or aspiration catheters. Treatment with mechanical thrombectomy is associated with a 20% to 27% absolute increase in the rate of functional independence compared with patients not treated with thrombectomy. Despite highly efficacious treatment, approxi...
Source: JAMA - March 1, 2022 Category: General Medicine Source Type: research
Intra-arterial Alteplase After Successful Thrombectomy and Functional Outcomes in Large Vessel Occlusion Stroke
This randomized clinical trial assesses the effect of intra-arterial alteplase infusion vs placebo on functional outcomes (modified Rankin Scale scores) among patients with large vessel occlusion acute ischemic stroke and successful reperfusion following thrombectomy.
Source: JAMA - March 1, 2022 Category: General Medicine Source Type: research
Intravenous Thrombolytic Therapy for Treatment of Acute Ischemic Stroke in Patients Taking NOACs
Intravenous thrombolytic therapy with recombinant tissue plasminogen activator (alteplase) is the cornerstone of acute ischemic stroke reperfusion therapy and is associated with significant improvements in outcomes. Historically, a number of exclusion criteria for use of alteplase had been in place, but over the past 20 years, some of these have been eliminated (eg, age>80 years, seizures at stroke onset) or have become less stringent (eg, exclusion criteria may not strictly apply to recent vitamin K antagonist treatment if the patient has an international normalized ratio<1.7, and treatment may be administered in an...
Source: JAMA - February 22, 2022 Category: General Medicine Source Type: research
Recent Use of NOACs and Intracranial Hemorrhage in Patients With Stroke Treated With Alteplase
This retrospective cohort study uses data from hospitals participating in the Get With The Guidelines –Stroke registry on patients with acute ischemic stroke and compares the safety and functional outcomes of intravenous alteplase among patients who were taking non–vitamin K antagonist oral anticoagulants (NOACs) prior to stroke vs patients who were not taking long-term anticoagulants.
Source: JAMA - February 22, 2022 Category: General Medicine Source Type: research
Strokes Occur Later and Are Less Severe Than 2 Decades Ago
A registry study of patients in Japan suggests that all stroke types have become less severe over the past 2 decades and are occurring later in life. Short-term functional outcomes also improved for patients with ischemic strokes. The findings appeared in JAMA Neurology.
Source: JAMA - February 1, 2022 Category: General Medicine Source Type: research
Data Plotted Incorrectly in Figure 2
This article was corrected online.
Source: JAMA - January 25, 2022 Category: General Medicine Source Type: research
USPSTF Review: Screening for Atrial Fibrillation
This systematic review to support the 2022 US Preventive Services Task Force Recommendation Statement on screening for atrial fibrillation (AF) summarizes published evidence on the benefits and harms of screening and anticoagulant therapy among asymptomatic persons without known AF or prior stroke.
Source: JAMA - January 25, 2022 Category: General Medicine Source Type: research
Informing the Choice of Direct Oral Anticoagulant Therapy in Patients With Atrial Fibrillation
Anticoagulation is the fundamental priority for the prevention of stroke in patients with atrial fibrillation, yet enthusiasm for use among patients at highest thromboembolic risk is often tempered by concern for increased bleeding. In one of the earliest studies evaluating vitamin K antagonists (VKA) in atrial fibrillation, Askey and Cherry noted in 1950 that anticoagulant use for thromboembolic prophylaxis requires “a reasonable assurance that the benefit will justify the bother and expense of control and the dangers of the drug,” and predicted that “safer anticoagulant drugs will be available eventually.” It wou...
Source: JAMA - December 21, 2021 Category: General Medicine Source Type: research
Patent Foramen Ovale Closure —Harnessing Clinical Trial Evidence to Inform Individualized Treatment Decisions
According to some estimates, approximately one-quarter of the general US population has a patent foramen ovale (PFO). With such a high prevalence, clinicians frequently attempt to determine whether a PFO has had a causal role among patients who experience an unexplained stroke, and whether closing the PFO might reduce the risk of recurrent stroke. Several randomized clinical trials have compared the outcomes of PFO closure vs treatment with antiplatelet or anticoagulation agents. In 2016, the American Academy of Neurology conducted a systematic review of 3 trials and concluded that clinicians “should not routinely offer ...
Source: JAMA - December 14, 2021 Category: General Medicine Source Type: research
Heterogeneity of Treatment Effect
This Guide to Statistics and Methods discusses the various approaches to estimating variability in treatment effects, including heterogeneity of treatment effect, which was used to assess the association between surgery to close patent foramen ovale and risk of recurrent stroke in patients who presented with a stroke in a related JAMA article.
Source: JAMA - December 14, 2021 Category: General Medicine Source Type: research
Analysis of Pooled Individual Patient Data From RCTs of Device Closure of PFO After Stroke
This study evaluates heterogeneity of treatment effect (HTE) of patent foramen ovale (PFO) closure on stroke recurrence based on the Risk of Paradoxical Embolism and PFO-Associated Stroke Causal Likelihood scoring systems using individual patient data pooled from 6 randomized clinical trials (RCTs) that compared PFO closure plus medical therapy vs medical therapy alone in patients with PFO-associated stroke.
Source: JAMA - December 14, 2021 Category: General Medicine Source Type: research
