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Prevalence and predictors of low folate levels among stroke survivors in a country without mandatory folate food fortification: Analysis of a Ghanaian sample
Vitamin supplementation with folic acid (FA) reduces hyperhomocysteinemia (Hcy), a vascular risk factor with a strong, graded, and independent association with stroke and other vascular diseases.1 Available data suggest that a 25% reduction in total plasma homocysteine level is accompanied by a 19% lower stroke risk.1,2 Evidence from clinical trials on the effect of folate supplementation on mitigation of stroke risk has however been conflicting. A synthesis of clinical trial data has shown that supplemental FA had a neutral effect on reducing vascular events in countries with a mandate for folate fortification of food, fo...
Source: Journal of Stroke and Cerebrovascular Diseases - July 20, 2023 Category: Neurology Authors: Fred Stephen Sarfo, Richard Boateng, Priscilla Abrafi Opare-Addo, Rexford Adu Gyamfi, Samuel Blay Nguah, Bruce Ovbiagele Source Type: research

The impact of the approval of prothrombin complex concentrates for vitamin K antagonist-related intracerebral hemorrhage: A retrospective study
This study aimed to determine the impact of the approval of prothrombin complex concentrates on the treatment of vitamin K antagonist-related intracerebral hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - October 27, 2022 Category: Neurology Authors: Sadayoshi Watanabe, Shoji Matsumoto, Ichiro Nakahara, Jun Morioka, Akiko Hasebe, Jun Tanabe, Kenichiro Suyama, Takuma Ishihara, Tsuyoshi Ohta, Taketo Hatano, Izumi Nagata, Yuichi Hirose Source Type: research

Association between white matter hyperintensity volume and social functioning limitations among stroke survivors
Existing literature on white matter hyperintensity volume (WMHV) in stroke patients has rarely focused on post-stroke outcomes related to social functioning limitations, such as transportation, social interaction, food preparation, grocery shopping, and housekeeping. Using prospective data from the VITamin D and OmegA-3 TriaL (VITAL) study, we evaluated the association between WMHV and social functioning limitations among 151 ischemic stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - September 1, 2022 Category: Neurology Authors: Flora G. Chang, Natalia S. Rost, JoAnn E. Manson, Julie E. Buring, Pamela M. Rist Source Type: research

Use of Antipsychotics is Negatively Associated with Muscle Strength in Older Adults with Sarcopenia after Stroke
The mainstay of treatment for sarcopenia is muscle mass and strength increase through exercise and nutritional intervention.1 A systematic review and meta-analysis of the effects of combined exercise and nutritional therapy for sarcopenia in older people showed that this combination may have positive effects on improving walking speed within 3 months of intervention.2 Furthermore, supplementation with whey protein, essential amino acids, and vitamin D, in conjunction with age-appropriate exercise has been reported to boost fat-free mass and strength.
Source: Journal of Stroke and Cerebrovascular Diseases - July 3, 2022 Category: Neurology Authors: Eiji Kose, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ayaka Matsumoto Source Type: research

Pharmacological Difference Between Platelet Aggregations in Cardioembolic Stroke Patients with Direct Oral Anticoagulants: A Pilot Study
Major hemorrhagic complication incidence in patients with arterial fibrillation (AF), and treated with direct oral anticoagulants (DOACs), is lower than in vitamin K antagonist-treated patients.1 –5 Additionally, among DOACs, the direct oral thrombin inhibitor (dabigatran) and direct oral factor Xa (FXa) inhibitors (apixaban and rivaroxaban) seem to affect the coagulation system differently, which could provide distinct clinical outcomes.6,7 The results from the US6 and Denmark8 cohort stu dies suggest there is a minute, but notable difference in major bleeding complication incidence between dabigatran and FXa inhibitors.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2022 Category: Neurology Authors: Masahito Nakazaki, Shinichi Oka, Hirotoshi Magota, Ryo Kiyose, Rie Onodera, Ryo Ukai, Yuko Kataoka-Sasaki, Masanori Sasaki, Osamu Honmou Source Type: research

Malignant Left Atrial Appendage Morphology: Current Classification vs H-L System
In non-valvular atrial fibrillation (AF), more than 90% of thrombus formation occurs in the left atrial appendage (LAA).1-3 Current guidelines have established direct oral anticoagulants (DOACs) as the treatment of choice in patients with AF and high risk of stroke or transient ischemic attack (TIA), while vitamin K antagonists (VKA) can be considered in patients not suitable for DOACs.4,5 This strategy significantly reduces the risk of thromboembolism; however, there is a subset of patients that suffer recurrent embolic strokes despite appropriate anticoagulant therapy, known as malignant LAA.
Source: Journal of Stroke and Cerebrovascular Diseases - December 30, 2020 Category: Neurology Authors: Paloma Parra-D íaz, Luisa Salido-Tahoces, Ana Pardo-Sanz, Álvaro Beltrán-Corbellini, Fernando Rodríguez-Jorge, Juan Luis Chico-García, Sebastián García-Madrona, Consuelo Matute-Lozano, Rocío Vera-Lechuga, Antonio Cruz-Culebras, Jaime Masjuan, Alic Source Type: research

Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke by about five times.1 Oral anticoagulation (OAC) with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) reduces ischemic stroke risk in AF patients. Currently, DOAC (apixaban, dabigatran, edoxaban and rivaroxaban) are recommended as first-line treatment for stroke prevention in AF patients.2 Despite several advantages compared to VKA, DOAC have a short half-life of about 12 h. Missing more than 5% of intakes is associated with a higher occurrence of thromboembolic events in OAC-treated AF patients.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2020 Category: Neurology Authors: Valerie Albert, Alexandros A. Polymeris, Fine Dietrich, Stefan T. Engelter, Kurt E. Hersberger, Sabine Schaedelin, Philippe A. Lyrer, Isabelle Arnet Source Type: research

Temporal Trends in Pharmacological Stroke Prevention in Patients with Acute Ischemic Stroke and Known Atrial Fibrillation
Oral anticoagulation (OAC) substantially reduces stroke risk in patients with atrial fibrillation (AF) at risk for stroke. Whether non-vitamin K-dependent oral anticoagulants (NOACs) improve OAC use in stroke prevention requires investigation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2020 Category: Neurology Authors: Simon Hellwig, Ulrike Grittner, Juliane Herm, Rudi Ruschmann, Maria Konieczny, Matthias Endres, Karl Georg Haeusler Source Type: research

Non-vitamin K oral anticoagulants as first-line regimen for acute ischemic stroke with non-valvular atrial fibrillation
There are various patterns in determining the choice of the first-line antithrombotic agent for acute stroke with non-valvular atrial fibrillation. We investigated the efficacy and safety of non-vitamin K oral anticoagulants as first-line antithrombotics for patients with acute stroke and non-valvular atrial fibrillation.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2020 Category: Neurology Authors: Chan Wook Park, Hyo Suk Nam, Ji Hoe Heo, Hyung Jong Park, Jin Kyo Choi, Hye Sun Lee, Han Kyu Na, Young Dae Kim Source Type: research

Cryptogenic Intracranial Hemorrhagic Strokes Associated with Hypervitaminosis E and Acutely Elevated α-Tocopherol Levels
Objectives: Up to 41% of intracerebral hemorrhages (ICH) are considered cryptogenic despite a thorough investigation to determine etiology. Certain over-the-counter supplements may increase proclivity to bleeding, and we hypothesize that specifically vitamin E may have an association with ICH and acutely elevated serum levels of α-tocopherol. Our aim is to report 3 cases of recently admitted patients with hypervitaminosis E and otherwise cryptogenic ICH. Methods: At our institution between January and December 2018, 179 patients were admitted with ICH with 73 imputed to be “cryptogenic” (without clear etiology as per ...
Source: Journal of Stroke and Cerebrovascular Diseases - March 5, 2020 Category: Neurology Authors: Nicole K. Le, Tigran Kesayan, Jane Y. Chang, David Z. Rose Source Type: research

Racial Disparity in the Prescription of Anticoagulants and Risk of Stroke and Bleeding in Atrial Fibrillation Patients
Background: Oral anticoagulant (OAC) therapy is proven to be effective at reducing risk of stroke in patients with atrial fibrillation (AF). However, racial minorities with AF are less likely to be prescribed vitamin K anticoagulants (VKA). There is little information on the racial disparity in the prescription of the non-vitamin K oral anticoagulants (NOACs) and the associated risks of stroke and bleeding. Methods: We used data from the Northwestern Medicine Enterprise Data Warehouse – a joint initiative across 11 Northwestern Medicine affiliated healthcare centers within metropolitan Chicago, Illinois.
Source: Journal of Stroke and Cerebrovascular Diseases - February 27, 2020 Category: Neurology Authors: Yacob G. Tedla, Sarah M. Schwartz, Philip Silberman, Philip Greenland, Rod S. Passman Source Type: research

Acute Ischemic Stroke Outcome and Preceding Anticoagulation: Direct Oral Anticoagulants Versus Vitamin K Antagonists
Oral anticoagulation is recommended for primary and secondary prevention of cardioembolic acute ischemic stroke (AIS). In nonvalvular atrial fibrillation (AF), direct oral anticoagulants (DOAC) efficacy and safety have been largely proven and are recommended over vitamin K antagonists (VKA) by international guidelines.1-3 AIS in the setting of AF is more often disabling and leads to increased mortality compared with stroke in patients without AF.4
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2020 Category: Neurology Authors: Sofia Fel ício Tavares, Inês Ferreira, Vanessa Chaves, Luis Flores, Cristina Correia, Jorge Almeida, Luísa Fonseca, Paulo Castro Chaves Source Type: research

Serum Retinoic Acid Level and The Risk of Poststroke Cognitive Impairment in Ischemic Stroke Patients
This study aimed to detect the association between RA level and PSCI among patients with first-ever acute ischemic stroke. Methods: Two hundred and 61 consecutive patients were prospectively recruited during March 2018 and March 2019.
Source: Journal of Stroke and Cerebrovascular Diseases - September 5, 2019 Category: Neurology Authors: Le Hou, Caixia Ding, Zhao Chen, Yuanyue Liu, Haishan Shi, Cong Zou, Hui Zhang, Zhiwei Lu, Dong Zheng Source Type: research

A Narrative Review of Nonvitamin K Antagonist Oral Anticoagulant Use in Secondary Stroke Prevention
The prevalence of atrial fibrillation (AF), the most common cardiac arrhythmia, increases with age, predisposing elderly patients to an increased risk of embolic stroke. With an increasingly aged population the number of people who experience a stroke every year, overall global burden of stroke, and numbers of stroke survivors and related deaths continue to increase. Anticoagulation with vitamin K antagonists (VKAs) reduces the risk of ischemic stroke in patients with AF; however, increased bleeding risk is well documented, particularly in the elderly.
Source: Journal of Stroke and Cerebrovascular Diseases - July 4, 2019 Category: Neurology Authors: Valeria Caso, Florian Masuhr Tags: Review Article Source Type: research

Treatment Approaches to Lacunar Stroke
Lacunar strokes are appropriately named for their ability to cavitate and form ponds or “little lakes” (Latin: lacune -ae meaning pond or pit is a diminutive form of lacus meaning lake). They account for a substantial proportion of both symptomatic and asymptomatic ischemic strokes. In recent years, there have been several advances in the management of large vessel occlusions. New therapies such as non-vitamin K antagonist oral anticoagulants and left atrial appendage closure have recently been developed to improve stroke prevention in atrial fibrillation; however, the treatment of small vessel disease-related strokes ...
Source: Journal of Stroke and Cerebrovascular Diseases - May 27, 2019 Category: Neurology Authors: Alvin S. Das, Robert W. Regenhardt, Steven K. Feske, Mahmut Edip Gurol Tags: Review Article Source Type: research

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