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Prehospital Phase of the Stroke Chain of Survival: A Prospective Observational Study Stroke
Conclusions Fast emergency medical services activation and ambulance transport promoted early hospital arrival and treatment. Although patient-dependent delays still dominate the prehospital process, it should be ensured that the minutes on the scene are well spent.
Source: JAHA:Journal of the American Heart Association - May 1, 2016 Category: Cardiology Authors: Puolakka, T., Strbian, D., Harve, H., Kuisma, M., Lindsberg, P. J. Tags: Stroke Source Type: research

Impact of Increased Early Statin Administration on Ischemic Stroke Outcomes: A Multicenter Electronic Medical Record Intervention Stroke
Conclusions A simple EMR change increased early statin administration in ischemic stroke and was associated with improved clinical outcomes. This is, to our knowledge, the first EMR intervention study to show that a modification of an electronic order set resulted in improved clinical outcomes.
Source: JAHA:Journal of the American Heart Association - July 28, 2016 Category: Cardiology Authors: Flint, A. C., Conell, C., Klingman, J. G., Rao, V. A., Chan, S. L., Kamel, H., Cullen, S. P., Faigeles, B. S., Sidney, S., Johnston, S. C. Tags: Ischemic Stroke, Neuroprotectants Source Type: research

Post-Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke Stroke
This study aimed to estimate the association between post–glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke.Methods and ResultsData were derived from the ACROSS‐China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry. Patients with ischemic stroke without a history of diabetes mellitus were included. Two post–glucose load measures of insulin sensitivity, the insulin sensitivity indices ISI(composite) and the ISI0,120, were calculated. Outcomes included stroke recurrence, all‐cause death, and poor functional outcome at 12 months. A...
Source: JAHA:Journal of the American Heart Association - January 20, 2017 Category: Cardiology Authors: Pan, Y., Jing, J., Chen, W., Zheng, H., Jia, Q., Mi, D., Li, H., Zhao, X., Liu, L., Wang, C., Gaisano, H. Y., He, Y., Wang, Y., Tags: Ischemic Stroke Original Research Source Type: research

Cost-Effectiveness of Clopidogrel-Aspirin Versus Aspirin Alone for Acute Transient Ischemic Attack and Minor Stroke Stroke
Conclusions Early 90-day clopidogrel-aspirin regimen for acute TIA or minor stroke is highly cost-effective in China. Although clopidogrel is generic, Plavix is brand in China. If Plavix were generic, treatment with clopidogrel-aspirin would have been cost saving.
Source: JAHA:Journal of the American Heart Association - June 5, 2014 Category: Cardiology Authors: Pan, Y., Wang, A., Liu, G., Zhao, X., Meng, X., Zhao, K., Liu, L., Wang, C., Johnston, S. C., Wang, Y., Wang, Y., the CHANCE Investigators 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

Trends in Acute Ischemic Stroke Hospitalizations in the United States Stroke
Conclusions Although overall stroke hospitalizations declined in the United States, the reduction was more pronounced among older individuals, women, Hispanics, and whites. Renewed efforts at targeting risk factor control among vulnerable individuals may be warranted.
Source: JAHA:Journal of the American Heart Association - May 10, 2016 Category: Cardiology Authors: Ramirez, L., Kim-Tenser, M. A., Sanossian, N., Cen, S., Wen, G., He, S., Mack, W. J., Towfighi, A. Tags: Cardiovascular Disease, Cerebrovascular Disease/Stroke, Ischemic Stroke Source Type: research

MKEY, a Peptide Inhibitor of CXCL4-CCL5 Heterodimer Formation, Protects Against Stroke in Mice Stroke
Conclusions MKEY injection protects against stroke-induced brain injury, probably by inhibiting MoM-mediated neuroinflammation.
Source: JAHA:Journal of the American Heart Association - September 14, 2016 Category: Cardiology Authors: Fan, Y., Xiong, X., Zhang, Y., Yan, D., Jian, Z., Xu, B., Zhao, H. Tags: Ischemic Stroke, Neuroprotectants Source Type: research

Coronary Artery Calcium Score Improves the Prediction of Occult Coronary Artery Stenosis in Ischemic Stroke Patients Stroke
BackgroundCoronary heart disease is a significant cause of morbidity and mortality in stroke patients. The coronary artery calcium score (CACS) has emerged as a robust and noninvasive predictor of coronary events. We assessed the predictive ability of CACS to identify stroke patients with severe (≥50%) occult coronary artery stenosis in a stroke/transient ischemic attack population, in addition to the PRECORIS score, based on Framingham Risk Score and presence of cervicocephalic artery stenosis, which was derived and validated for that purpose.Methods and ResultsWe enrolled consecutive patients aged 45 to 75 years refer...
Source: JAHA:Journal of the American Heart Association - October 30, 2016 Category: Cardiology Authors: Beigneux, Y., Sablayrolles, J.-L., Varenne, O., Mas, J.-L., Calvet, D. Tags: Computerized Tomography (CT), Ischemic Stroke, Transient Ischemic Attack (TIA), Atherosclerosis, Coronary Artery Disease Original Research Source Type: research

Sex–Specific Relationship Between Serum Uric Acid and Risk of Stroke: A Dose–Response Meta–Analysis of Prospective Studies Systematic Review and Meta-Analysis
BackgroundConflicting findings of the association between serum uric acid (UA) and stroke have been reported in both men and women, and it is unclear whether this association was different between men and women. We preformed this meta‐analysis to assess the sex‐specific effect of serum UA on the risk of stroke and its subtypes.Methods and ResultsProspective studies that reported sex‐specific association of UA levels with stroke or reported in a certain sex were included. Dose‐response relationships were assessed by the generalized least squares trend estimation, and summary effect estimates were evaluated with rand...
Source: JAHA:Journal of the American Heart Association - March 29, 2017 Category: Cardiology Authors: Zhong, C., Zhong, X., Xu, T., , Zhang, Y. Tags: Risk Factors, Cerebrovascular Disease/Stroke, Ischemic Stroke Systematic Review and Meta ‐ Analysis Source Type: research

Risk of Inhospital Stroke or Death Is Associated With Age But Not Sex in Patients Treated With Carotid Endarterectomy for Asymptomatic or Symptomatic Stenosis in Routine Practice: Secondary Data Analysis of the Nationwide German Statutory Quality Assurance Database From 2009 to 2014 Cardiovascular Surgery
ConclusionsThis study shows that increasing age, but not sex, is associated with a higher risk of in‐hospital stroke or death following carotid endarterectomy under everyday conditions in Germany. Whereas the risk of death (alone) is significantly associated with age, the association between age and the risk of stroke (alone) can be considered of minor importance.
Source: JAHA:Journal of the American Heart Association - March 13, 2017 Category: Cardiology Authors: Schmid, S., Tsantilas, P., Knappich, C., Kallmayer, M., Konig, T., Breitkreuz, T., Zimmermann, A., Kuehnl, A., Eckstein, H.–H. Tags: Aging, Women, Cardiovascular Surgery, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Research Source Type: research

Sex Differences in the Association Between Insulin Resistance and Incident Coronary Heart Disease and Stroke Among Blacks Without Diabetes Mellitus: The Jackson Heart Study Epidemiology
ConclusionsBoth HOMA‐IR and the McAuley index demonstrate strong associations with CHD but not stroke risk in blacks. The logHOMA‐IR and CHD association was present in men, but not in women.
Source: JAHA:Journal of the American Heart Association - February 2, 2017 Category: Cardiology Authors: Effoe, V. S., Wagenknecht, L. E., Echouffo Tcheugui, J. B., Chen, H., Joseph, J. J., Kalyani, R. R., Bell, R. A., Wu, W.-C. H., Casanova, R., Bertoni, A. G. Tags: Cardiovascular Disease, Epidemiology, Risk Factors, Cerebrovascular Disease/Stroke Original Research Source Type: research

Trials to Improve Blood Pressure Through Adherence to Antihypertensives in Stroke/TIA: Systematic Review and Meta-Analysis Stroke
Conclusions Multifactorial interventions including a component to improve medication adherence can lower blood pressure after stroke/TIA. However, it is not possible to say whether or not this is achieved through better medication adherence. Trials are needed of well-characterized interventions to improve medication adherence and clinical outcomes with measurement along the hypothesized causal pathway.
Source: JAHA:Journal of the American Heart Association - August 20, 2013 Category: Cardiology Authors: De Simoni, A., Hardeman, W., Mant, J., Farmer, A. J., Kinmonth, A. L. Tags: Stroke Source Type: research

Vitamin C Intake, Circulating Vitamin C and Risk of Stroke: A Meta-Analysis of Prospective Studies Stroke
Conclusions This meta-analysis suggests significant inverse relationships between dietary vitamin C intake, circulating vitamin C, and risk of stroke.
Source: JAHA:Journal of the American Heart Association - November 27, 2013 Category: Cardiology Authors: Chen, G.-C., Lu, D.-B., Pang, Z., Liu, Q.-F. Tags: Stroke Source Type: research

Clinical Prediction Model Suitable for Assessing Hospital Quality for Patients Undergoing Carotid Endarterectomy Stroke
Conclusions The NCDR CEA score, comprising 7 clinical variables, predicts in-hospital stroke or death after CEA. This model can be used to estimate hospital risk-adjusted outcomes for CEA and to assist with the assessment of hospital quality.
Source: JAHA:Journal of the American Heart Association - June 17, 2014 Category: Cardiology Authors: Wimmer, N. J., Spertus, J. A., Kennedy, K. F., Anderson, H. V., Curtis, J. P., Weintraub, W. S., Singh, M., Rumsfeld, J. S., Masoudi, F. A., Yeh, R. W. Tags: Stroke Source Type: research

Risk of Ischemic Stroke Associated With Calcium Supplements With or Without Vitamin D: A Nested Case-Control Study Stroke
BackgroundThere is controversy surrounding the risk of ischemic stroke associated with the use of calcium supplements either in monotherapy or in combination with vitamin D.Methods and ResultsA nested case‐control study was performed with patients aged 40 to 89 years old, among whom a total of 2690 patients had a first episode of nonfatal ischemic stroke and for which 19 538 controls were randomly selected from the source population and frequency‐matched with cases for age, sex, and calendar year. Logistic regression provided the odds ratios while adjusting for confounding factors. A sensitivity analysis was performe...
Source: JAHA:Journal of the American Heart Association - May 18, 2017 Category: Cardiology Authors: de Abaȷo, F. J., Rodriguez-Martin, S., Rodriguez-Miguel, A., Gil, M. J. Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Research Source Type: research

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