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Thrombolytic Recanalization of Carotid Arteries Is Highly Dependent on Degree of Stenosis, Despite Sonothrombolysis Stroke
Conclusions In this model, the degree of carotid stenosis had a large effect on thrombolytic recanalization. Sonothrombolysis using standard parameters for intracranial sonothrombolysis did not increase recanalization. Further testing is warranted. The degree of underlying stenosis may be an important predictor of thrombolytic recanalization, and clinical correlation of these findings may provide new approaches to treatment selection for patients with carotid occlusion.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Tomkins, A. J., Hood, R. J., Pepperall, D., Null, C. L., Levi, C. R., Spratt, N. J. Tags: Ultrasound, Cerebrovascular Disease/Stroke, Stenosis, Thrombosis Source Type: research

Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers Stroke
Conclusions Racial disparities in intravenous rt-PA use were not reduced by presentation to PSCs. Black patients were less likely to receive thrombolytic treatment than white patients at both non-PSCs and PSCs. Hispanic patients were less likely to be seen at PSCs relative to white patients and were less likely to receive intravenous rt-PA in the fully adjusted model.
Source: JAHA:Journal of the American Heart Association - October 14, 2015 Category: Cardiology Authors: Aparicio, H. J., Carr, B. G., Kasner, S. E., Kallan, M. J., Albright, K. C., Kleindorfer, D. O., Mullen, M. T. Tags: Stroke Source Type: research

Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research

Perception Versus Actual Performance in Timely Tissue Plasminogen Activation Administration in the Management of Acute Ischemic Stroke Stroke
Conclusions Hospitals often overestimate their ability to deliver timely tPA to treated patients. Our findings indicate the need to routinely provide comparative provider performance rates as a key step to improving the quality of acute stroke care.
Source: JAHA:Journal of the American Heart Association - July 22, 2015 Category: Cardiology Authors: Lin, C. B., Cox, M., Olson, D. M., Britz, G. W., Constable, M., Fonarow, G. C., Schwamm, L., Peterson, E. D., Shah, B. R. Tags: Stroke Source Type: research

Clinical Efficacy of Thrombus Aspiration on 5-Year Clinical Outcomes in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Interventional Cardiology
Conclusions Adjunctive TA during primary PCI was not associated with better 5-year mortality in STEMI patients.
Source: JAHA:Journal of the American Heart Association - June 15, 2015 Category: Cardiology Authors: Watanabe, H., Shiomi, H., Nakatsuma, K., Morimoto, T., Taniguchi, T., Furukawa, Y., Nakagawa, Y., Horie, M., Kimura, T., the CREDO-Kyoto AMI investigators, Kimura, T., Sakata, R., Marui, A., Matsuda, M., Mitsuoka, H., Onoe, M., Nakagawa, Y., Yamanaka, K., Tags: Interventional Cardiology Source Type: research

American Heart Association's Life's Simple 7 and Risk of Venous Thromboembolism: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study Epidemiology
Conclusions Life's Simple 7, a CVH metric, was associated with reduced VTE risk. Findings suggest that efforts to improve the population's CVH may reduce VTE incidence.
Source: JAHA:Journal of the American Heart Association - February 27, 2015 Category: Cardiology Authors: Olson, N. C., Cushman, M., Judd, S. E., McClure, L. A., Lakoski, S. G., Folsom, A. R., Safford, M. M., Zakai, N. A. Tags: Epidemiology Source Type: research

Pulmonary Embolism in Ischemic Stroke: Clinical Presentation, Risk Factors, and Outcome Stroke
Conclusions In this large cohort study, PE occurred in nearly 1% of AIS patients. PE was more common in patients with severe stroke, history of cancer, previous DVT/PE or acute DVT and associated with lower short- and long-term survival, greater disability, and longer length of stay.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Pongmoragot, J., Rabinstein, A. A., Nilanont, Y., Swartz, R. H., Zhou, L., Saposnik, G., The Investigators of the Registry of the Canadian Stroke Network (RCSN) and University of Toronto Stroke Program for the Stroke Outcomes Research Canada (SORCan [www. Tags: Stroke Source Type: research

Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization Stroke
Conclusion In a single-center, retrospective assessment over nearly 20 years, cardiac catheterization-related CVEs were very rare and nearly exclusively ischemic. The independent predictors for these events were found to be the performance of an intervention and those associated with increased atherosclerotic burden, specifically older age, triple vessel disease, and prior stroke. The presence of intracoronary thrombus appears also to raise the risk of procedure-related CVE.
Source: JAHA:Journal of the American Heart Association - November 14, 2013 Category: Cardiology Authors: Korn-Lubetzki, I., Farkash, R., Pachino, R. M., Almagor, Y., Tzivoni, D., Meerkin, D. Tags: Stroke Source Type: research

Paradoxical Association of Smoking With In-Hospital Mortality Among Patients Admitted With Acute Ischemic Stroke Stroke
Conclusions Similar to myocardial ischemia, smoking was independently associated with lower inpatient mortality in acute ischemic stroke. This effect may be due to tobacco-induced changes in cerebrovascular vasoreactivity, or may be due in part to residual confounding. Larger, multicenter studies are needed to confirm the finding and the effect on 30-day and 1-year mortality.
Source: JAHA:Journal of the American Heart Association - June 19, 2013 Category: Cardiology Authors: Ali, S. F., Smith, E. E., Bhatt, D. L., Fonarow, G. C., Schwamm, L. H. Tags: Stroke Source Type: research

A New Risk Scheme to Predict Ischemic Stroke and Other Thromboembolism in Atrial Fibrillation: The ATRIA Study Stroke Risk Score Arrhythmia and Electrophysiology
Conclusions The ATRIA stroke risk score performed better than existing risk scores, was validated successfully, and showed improvement in predicting severe events, which is of greatest concern. The ATRIA score should improve the antithrombotic decision for patients with AF and should provide a secure foundation for the addition of biomarkers in future prognostic models.
Source: JAHA:Journal of the American Heart Association - June 19, 2013 Category: Cardiology Authors: Singer, D. E., Chang, Y., Borowsky, L. H., Fang, M. C., Pomernacki, N. K., Udaltsova, N., Reynolds, K., Go, A. S. Tags: Arrhythmia and Electrophysiology Source Type: research

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