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Impact of age on mechanical thrombectomy and clinical outcome in patients with acute ischemic stroke
Mechanical thrombectomy (MT) has proven to be an effective and safe treatment for patients with acute ischemic stroke due to large vessel occlusion and its use has therefore rapidly increased over the past decade.1 –3 Although MT has been demonstrated to be effective independent of age, age seems to strongly affect clinical outcome after MT.1. The reasons are manifold. Besides the natural process of aging, elderly patients tend to have more significant comorbidities, such as atherosclerosis, arterial hyperte nsion and diabetes mellitus, all influencing brain plasticity, arterial collateral network and the ability to recover in general.
Source: Journal of Stroke and Cerebrovascular Diseases - July 11, 2023 Category: Neurology Authors: Nadine Rhiner, Mara Z. Thut, Patrick Thurner, Jawid Madjidyar, Tilman Schubert, Christoph Globas, Susanne Wegener, Andreas R. Luft, Lars Michels, Zsolt Kulcsar Source Type: research

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes diagnosed after metformin-triggered stroke-like episodes
A 40-year-old man with sensorineural hearing loss and diabetes mellitus was hospitalized with acute-onset impaired consciousness and clumsiness in his left hand. He had been taking metformin (750 mg/day) for 4 months. He had no febrile illness, energy failure, or use of mitochondria-toxic drugs other than metformin. The patient had a family history of diabetes mellitus (maternal uncle and aunt). His weight and height were 35 kg and 1.58 m, respectively. A neurological examination revealed confusion and weakness in the left upper limb.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2023 Category: Neurology Authors: Keishu Murakami, Ken Sakamoto, Hiroshi Ishiguchi, Hidefumi Ito Tags: Case Report Source Type: research

Differential associations between pre-diabetes, diabetes and stroke occurrence among West Africans
There are limited data from Africa on the burden and associations between pre-diabetes (pre-DM), diabetes mellitus (DM) and stroke occurrence in a region experiencing a profound rise in stroke burden.
Source: Journal of Stroke and Cerebrovascular Diseases - October 1, 2022 Category: Neurology Authors: Fred Stephen Sarfo, Bruce Ovbiagele, Joshua Akinyemi, Onoja Akpa, Albert Akpalu, Kolawole Wahab, Godwin Ogbole, Reginald Obiako, Morenikeji Komolafe, Lukman Owolabi, Godwin Osaigbovo, Carolyn Jenkins, Adekunle Fakunle, Abiodun Adeoye, Dan Lackland, Donna Source Type: research

Effect of metformin on outcome after acute ischemic stroke in patients with type 2 diabetes mellitus
Diabetes mellitus is a well-known risk factor for ischemic stroke and is associated with unfavorable outcome after stroke. Metformin is recommended as first-line treatment in these patients. Pre-stroke metformin use might have neuroprotective properties resulting in reduced stroke severity. However, results of the effects of pre-stroke metformin use on functional outcome are conflicting and has not been previously described in patients with type 2 diabetes mellitus regardless of stroke severity or revascularization treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - August 1, 2022 Category: Neurology Authors: C.J.B.A. Kersten, I.L.H. Knottnerus, E. Heijmans, M. Haalboom, A.A.M. Zandbergen, H.M. den Hertog Source Type: research

Taking the Obesity Paradox to New Heights in Cerebral Atherosclerosis
Obesity typically worsens many of the major cardiovascular disease (CVD) risk factors, such as elevating blood pressure, worsening dyslipidemia, increasing impaired plasma glucose metabolism (leading to metabolic syndrome and diabetes mellitus), and increasing systemic inflammation, increasing the risk of most CVD, including hypertension, coronary heart disease (CHD), heart failure, atrial fibrillation and cerebrovascular diseases.1 –3 However, in patients with established CVD, many studies published by my colleagues and I and others have demonstrated a consistent paradox, where obese patients with established CVD seem t...
Source: Journal of Stroke and Cerebrovascular Diseases - February 1, 2022 Category: Neurology Authors: Carl J. Lavie, Salvatore Carbone, Ian J. Neeland Tags: Editorial Source Type: research

Sodium-Glucose Co-Transporter-2 Inhibitors Decrease the Odds for Atrial Fibrillation in Subjects with Heart Failure
Ong et al. have shown in their very informative, recently published meta-analysis that sodium-glucose co-transporter-2 (SGLT-2) inhibitors result in a significant decrease in the odds for atrial fibrillation (AF) regardless of status of diabetes mellitus or cardiovascular disease at baseline.1 However, the authors failed to show that this effect is sustained in subjects with heart failure (HF).1
Source: Journal of Stroke and Cerebrovascular Diseases - December 22, 2021 Category: Neurology Authors: Dimitrios Patoulias, Christodoulos Papadopoulos, Michael Doumas Tags: Letter to the Editor Source Type: research

Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis
Globally, the number of people estimated to have diabetes mellitus (DM) in 2019 was 463 million, and the estimated number is expected to rise to 578 million people by 2030.1 DM is also associated with an increased risk of atrial fibrillation (AF), 2 and has shown to be an independent risk factor for stroke in patients with AF.3 A meta-analysis of 102 studies further showed that patients with diabetes have a higher risk of all subtypes of stroke (ischemic, hemorrhagic and unclassified stroke).4 This has generated great interest in anti-hyperglycemic agents and their ability to reduce the cardiovascular complications of diabetes.
Source: Journal of Stroke and Cerebrovascular Diseases - October 22, 2021 Category: Neurology Authors: How Ting Ong, Yao Hao Teo, Yao Neng Teo, Nicholas LX Syn, Caitlin Fern Wee, Shariel Leong, Alicia Swee Yan Yip, Ray Meng See, Adriel Zhi Hen Ting, Alys ZQ Chia, Alex Jia Yang Cheong, Benjamin Yong-Qiang Tan, Jamie Sin-Ying Ho, Leonard Leong-Litt Yeo, Aloy Source Type: research

Skin Autofluorescence is an Independent Predictor of Post Stroke Infection in Diabetes
Post stroke infection occurs in 15 –20% of acute stroke patients and is associated with a poor longterm outcome. In a prospective study on 113 acute ischemic stroke patients with diabetes mellitus 15.9% suffered nosocomial infection. We found chronic hyperglycemia measured by skin autofluorescence in arbitrary units to be an indepe ndent predictor of a nosocomial infection post stroke (OR = 3.24 [CI 95%: 1.13; 9.26], p = 0.029). Skin autofluorescence represents the glycemic memory beyond HbA1c. Potential mechanisms leading from increased skin autofluorescence to vulnerability for infectious complications include ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 26, 2021 Category: Neurology Authors: Alexandra Filipov, Heike Fuchshuber, Josephine Kraus, Anne D. Ebert, Vesile Sandikci, Angelika Alonso Source Type: research

Authors ’ Reply to: Do All Gliflozins Reduce Stroke in Patients with Type 2 Diabetes Mellitus and Impaired Renal Function?
Zhao LM et al. kindly comment on the design and the results of our recently published meta-analysis.1,2
Source: Journal of Stroke and Cerebrovascular Diseases - April 19, 2021 Category: Neurology Authors: Fotios Barkas, Evangelos Liberopoulos, Haralampos Milionis Source Type: research

Do all gliflozins reduce stroke in patients with type 2 diabetes mellitus and impaired renal function?
We have read with great interest a study of meta-analysis1 recently published in Journal of Stroke and Cerebrovascular Diseases. In that study1 Barkas and colleagues drew their main conclusion that sodium-glucose transporter 2 (SGLT2) inhibitors reduce the risk of total stroke in patients with type 2 diabetes mellitus (T2DM) and impaired renal function (IRF), which was based on the result of meta-analysis on the outcome of total stroke (including ischemic and hemorrhagic stroke) in the subgroup of patients with T2DM and IRF (Fig.
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2021 Category: Neurology Authors: Li-Min Zhao, Liang-Liang Ding, Ze-Lin Zhan, Mei Qiu Tags: Letter to the Editor Source Type: research

Detection of Early Vascular Atherosclerosis in Type 2 Diabetes Mellitus Using Ultrasound Radiofrequency-Data Technique
To quantitatively evaluate changes in vascular elasticity and intima-media thickness (IMT) of the common carotid artery (CCA) with Ultrasound radiofrequency (RF)-data technology in asymptomatic patients with type-2 diabetes mellitus (T2DM) and controls.
Source: Journal of Stroke and Cerebrovascular Diseases - March 31, 2021 Category: Neurology Authors: Hai-Jun Dan, Hong Ji, Ya-Qing Zhou, Cai-Ying Li, Bu-Lang Gao Source Type: research

Sodium-Glucose Cotransporter-2 Inhibitors and Protection Against stroke in Patients with type 2 Diabetes and Impaired Renal Function: A Systematic Review and Meta-Analysis
It is well established that diabetes mellitus type 2 (T2DM) is associated with increased risk of cardiovascular disease, including ischemic stroke. Among past antidiabetic agents, only pioglitazone and glucagon-like peptide 1 receptor agonists (GLP-1RA) have been shown to decrease the risk of stroke.1-5 Similarly, sodium-glucose cotransporter-2 inhibitors (SGLT2i) were expected to reduce the risk of stroke, considering their blood pressure lowering and neuroprotective effects demonstrated by experimental studies.
Source: Journal of Stroke and Cerebrovascular Diseases - March 10, 2021 Category: Neurology Authors: Fotios Barkas, Sebastian Filippas Ntekouan, Evangelos Liberopoulos, Theodosios Filippatos, Haralampos Milionis Source Type: research

Association of Carotid Plaques and Common Carotid Intima-media Thickness with Modifiable Cardiovascular Risk Factors
Most interventions for the treatment or prevention of atherosclerosis are focused in modifiable traditional cardiovascular risk factors (CVRF), such as smoking, diabetes mellitus, hypertension, and hypercholesterolemia.1 However, there are numerous approaches for the detection and measurement of subclinical atherosclerosis. The B-mode ultrasound examination is arguably one of the best methods for detecting early stages of atherosclerotic disease in the carotid arteries.2 Assessments of atherosclerosis using carotid ultrasound imaging include carotid intima-media thickness (IMT) measurement and plaque detection.
Source: Journal of Stroke and Cerebrovascular Diseases - February 23, 2021 Category: Neurology Authors: Pedro J. Santos-Neto, Eduardo H. Sena-Santos, Danilo P. Meireles, M árcio Sommer Bittencourt, Itamar S. Santos, Isabela M. Bensenor, Paulo A. Lotufo Source Type: research

Risk Factor Control in Stroke Survivors with Diagnosed and Undiagnosed Diabetes: A Ghanaian Registry Analysis
According to the World Health Organization (WHO), more than 80% of worldwide diabetes (DM)-related deaths presently occur in low- and middle- income countries (LMIC). DM-related deaths is projected to double over the next 20 years.1,2 As of 2012, ∼14 million Africans (4.8%) had diabetes mellitus (DM), and 81% were undiagnosed (vs. 50% worldwide), making Africa the continent with the highest proportion of people with undiagnosed DM.3 Projections for sub-Saharan Africa (SSA) indicate diabetes will rise by 71–23.9 million by 2030 (predicted global increase is 37%).
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2020 Category: Neurology Authors: Fred Stephen Sarfo, John Akassi, Martin Agyei, Samuel Kontoh, Bruce Ovbiagele Source Type: research

Predictors of Recurrent Ischemic Stroke in Obese Patients With Type 2 Diabetes Mellitus: A Population-based Study
Each year, approximately 0.8 million people are estimated to experience a new or recurrent stroke, according to the 2019 report of the American Heart Association.1 In Malaysia, stroke is the third leading cause of death after ischemic heart disease (IHD) and pneumonia.2 Both obesity and diabetes are considered as the established independent risk factors for ischemic stroke.3 Type 2 diabetes mellitus (T2DM) was also found to be associated with an increase in all-cause as well as cardiovascular mortality following the stroke,4,5 and in a meta-analysis of 18 studies, patients with diabetes had a higher stroke recurrence as co...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Orwa Albitar, Sabariah Noor Harun, Nur Ezzati Abidin, Balamurugan Tangiisuran, Hadzliana Zainal, Irene Looi, Khairul Azmi Ibrahim, Norsima Nazifah Sidek, Keat Wei Loo, Keng Yee Lee, Zariah Abdul Aziz, Siti Maisharah Sheikh Ghadzi Source Type: research

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