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Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta-Analysis Stroke
Conclusions Long-term monotherapy was a better choice than long-term dual therapy, and cilostazol had the best risk–benefit profile for long-term secondary prevention after stroke or transient ischemic attack. More randomized controlled trials in non–East Asian patients are needed to determine whether long-term use of cilostazol is the best option for the prevention of recurrent stroke.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Xie, W., Zheng, F., Zhong, B., Song, X. Tags: Stroke Source Type: research

Incidence of First Stroke in Pregnant and Nonpregnant Women of Childbearing Age: A Population-Based Cohort Study From England Epidemiology
ConclusionsAlthough the absolute risk of first stroke is low in women of childbearing age, healthcare professionals should be aware of a considerable increase in relative risk during the peripartum and early postpartum periods.
Source: JAHA:Journal of the American Heart Association - April 21, 2017 Category: Cardiology Authors: Ban, L., Sprigg, N., Abdul Sultan, A., Nelson-Piercy, C., Bath, P. M., Ludvigsson, J. F., Stephansson, O., Tata, L. J. Tags: Epidemiology, Pregnancy, Women, Cerebrovascular Disease/Stroke Original Research Source Type: research

Comparative Effectiveness of Standard Care With IV Thrombolysis Versus Without IV Thrombolysis for Mild Ischemic Stroke Stroke
Conclusions In this observational registry-based study, standard care with IVT is more effective than not receiving IVT in mild ischemic stroke patients, and there is a statistically nonsignificant risk of symptomatic hemorrhagic transformation.
Source: JAHA:Journal of the American Heart Association - January 9, 2015 Category: Cardiology Authors: Choi, J. C., Jang, M. U., Kang, K., Park, J.-M., Ko, Y., Lee, S.-J., Cha, J.-K., Kim, D.-H., Park, S. S., Park, T. H., Lee, K. B., Lee, J., Kim, J.-T., Cho, K.-H., Yu, K.-H., Oh, M.-S., Lee, B.-C., Cho, Y.-J., Kim, D.-E., Lee, J. S., Lee, J., Gorelick, P. Tags: Stroke Source Type: research

Short-term Changes in Ambient Particulate Matter and Risk of Stroke: A Systematic Review and Meta-analysis Stroke
Conclusions We found that PM2.5 and PM10 are associated with a 1.4% (95% CI 0.9% to 1.9%) and 0.5% (95% CI 0.3% to 0.7%) higher total cerebrovascular disease mortality, respectively, with evidence of inconsistent, nonsignificant associations for hospital admission for total cerebrovascular disease or ischemic or hemorrhagic stroke. Current limited evidence does not suggest an association between PM2.5-10 and cerebrovascular mortality or morbidity. We discuss the potential sources of variability in results across studies, highlight some observations, and identify gaps in literature and make recommendations for future studies.
Source: JAHA:Journal of the American Heart Association - August 7, 2014 Category: Cardiology Authors: Wang, Y., Eliot, M. N., Wellenius, G. A. Tags: Stroke Source Type: research

Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke Stroke
Conclusions Four in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes.
Source: JAHA:Journal of the American Heart Association - February 23, 2015 Category: Cardiology Authors: Prvu Bettger, J., McCoy, L., Smith, E. E., Fonarow, G. C., Schwamm, L. H., Peterson, E. D. Tags: Stroke Source Type: research

Age-Specific Vascular Risk Factor Profiles According to Stroke Subtype Stroke
BackgroundIschemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age.Methods and ResultsWe studied a prospective multicenter university hospital–based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or an...
Source: JAHA:Journal of the American Heart Association - May 8, 2017 Category: Cardiology Authors: Hauer, A. J., Ruigrok, Y. M., Algra, A., van Diȷk, E. J., Koudstaal, P. J., Luiȷckx, G.–J., Nederkoorn, P. J., van Oostenbrugge, R. J., Visser, M. C., Wermer, M. J., Kappelle, L. J., Kliȷn, C. J. M., the Dutch Parelsnoer Instit Tags: Risk Factors, Intracranial Hemorrhage, Ischemic Stroke Original Research Source Type: research

Clopidogrel Use Is Associated With an Increased Prevalence of Cerebral Microbleeds in a Stroke-Free Population: The Rotterdam Study Stroke
Conclusions In stroke-free individuals, clopidogrel use was associated with a higher prevalence and higher number of CMBs. Whether this association is causal requires confirmation in prospective studies, especially given the small number of participants taking clopidogrel and the possibility of residual confounding in this study.
Source: JAHA:Journal of the American Heart Association - September 26, 2013 Category: Cardiology Authors: Darweesh, S. K. L., Leening, M. J. G., Akoudad, S., Loth, D. W., Hofman, A., Arfan Ikram, M., Vernooij, M. W., Stricker, B. H. Tags: Stroke Source Type: research

Association of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post-Thrombolysis: Findings From Get With The Guidelines-Stroke Stroke
Conclusion Acute and chronic hyperglycemia are both associated with increased mortality and worse clinical outcomes in AIS patients treated with tPA. Controlled trials are needed to determine whether acute correction of hyperglycemia can improve outcomes after thrombolysis.
Source: JAHA:Journal of the American Heart Association - September 25, 2015 Category: Cardiology Authors: Masrur, S., Cox, M., Bhatt, D. L., Smith, E. E., Ellrodt, G., Fonarow, G. C., Schwamm, L. Tags: Stroke Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Receiving Antiplatelet Therapy: A Systematic Review and Meta-analysis of 19 Studies Stroke
Conclusions Patients with acute ischemic stroke receiving long-term antiplatelet medications were associated with greater risks of developing symptomatic intracranial hemorrhage after systemic thrombolysis. However, the overall independent association between prestroke antiplatelet therapy and unfavorable outcomes or mortality was insignificant.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Luo, S., Zhuang, M., Zeng, W., Tao, J. Tags: Meta Analysis, Quality and Outcomes, Ischemic Stroke Source Type: research

Systolic Blood Pressure Within 24 Hours After Thrombectomy for Acute Ischemic Stroke Correlates With Outcome Stroke
ConclusionsHigher peak values of systolic blood pressure independently correlated with worse 90‐day modified Rankin scale and a higher rate of hemorrhagic complications. Further prospective studies are warranted to identify whether systolic blood pressure is a therapeutic target to improve outcomes.
Source: JAHA:Journal of the American Heart Association - May 18, 2017 Category: Cardiology Authors: Mistry, E. A., Mistry, A. M., Nakawah, M. O., Khattar, N. K., Fortuny, E. M., Cruz, A. S., Froehler, M. T., Chitale, R. V., James, R. F., Fusco, M. R., Volpi, J. J. Tags: High Blood Pressure, Revascularization, Complications, Quality and Outcomes, Ischemic Stroke Original Research Source Type: research

Door-to-Puncture: A Practical Metric for Capturing and Enhancing System Processes Associated With Endovascular Stroke Care, Preliminary Results From the Rapid Reperfusion Registry Stroke
Conclusions The time interval of D2P presents a clinically relevant time frame by which system processes can be targeted to streamline the delivery of IAT care nationally. At present, there is much opportunity to enhance outcomes through reducing D2P.
Source: JAHA:Journal of the American Heart Association - April 25, 2014 Category: Cardiology Authors: Sun, C.-H. J., Ribo, M., Goyal, M., Yoo, A. J., Jovin, T., Cronin, C. A., Zaidat, O., Nogueira, R., Nguyen, T., Hussain, M. S., Menon, B. K., Mehta, B., Jindal, G., Horev, A., Norbash, A., Leslie-Mazwi, T., Wisco, D., Gupta, R. Tags: Stroke Source Type: research

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Race-Specific Predictors of Mortality in Intracerebral Hemorrhage: Differential Impacts of Intraventricular Hemorrhage and Age Among Blacks and Whites Stroke
Conclusions IVH and age differentially predict mortality among blacks and whites. Blacks have higher rates of obstructive hydrocephalus and more frequently require EVD placement compared to their white counterparts.
Source: JAHA:Journal of the American Heart Association - August 15, 2016 Category: Cardiology Authors: Faigle, R., Marsh, E. B., Llinas, R. H., Urrutia, V. C., Gottesman, R. F. Tags: Intracranial Hemorrhage Stroke Source Type: research

Thrombolysis Delivery by a Regional Telestroke Network--Experience From the UK National Health Service Stroke
Conclusions We demonstrate the safety and effectiveness of a horizontal networking approach for stroke telemedicine, which may be applicable to areas where traditional "hub-and-spoke" models may not be geographically feasible.
Source: JAHA:Journal of the American Heart Association - February 26, 2014 Category: Cardiology Authors: Agarwal, S., Day, D. J., Sibson, L., Barry, P. J., Collas, D., Metcalf, K., Cotter, P. E., Guyler, P., O'Brien, E. W., O'Brien, A., O'Kane, D., Owusu-Agyei, P., Phillips, P., Shekhar, R., Warburton, E. A. Tags: Stroke Source Type: research

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