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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

Ischemic Stroke in Children and Young Adults With Congenital Heart Disease Congenital Heart Disease
Conclusions The risk of developing ischemic stroke was almost 11 times higher in young patients with CHD than in the general population, although absolute risk is low. Cardiovascular comorbidities were strongly associated with the development of ischemic stroke in young CHD patients.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Mandalenakis, Z., Rosengren, A., Lappas, G., Eriksson, P., Hansson, P.-O., Dellborg, M. Tags: Epidemiology, Congenital Heart Disease, Ischemic Stroke Source Type: research

Cardiac Vulnerability to Cerebrogenic Stress as a Possible Cause of Troponin Elevation in Stroke Stroke
ConclusionsCertain cardiac and neurological conditions in acute ischemic stroke may contribute to troponin elevation. The proposed concept of cardiac vulnerability to cerebrogenic stress can be a practical interpretation of troponin elevation and electrocardiography abnormalities in stroke patients.
Source: JAHA:Journal of the American Heart Association - October 5, 2016 Category: Cardiology Authors: Ahn, S.-H., Kim, Y.-H., Shin, C.-H., Lee, J.-S., Kim, B.-J., Kim, Y.-J., Noh, S.-M., Kim, S.-M., Kang, H.-G., Kang, D.-W., Kim, J. S., Kwon, S. U. Tags: Biomarkers, Ischemic Stroke Original Research 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

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

Association of Geographical Factors With Administration of Tissue Plasminogen Activator for Acute Ischemic Stroke Stroke
Conclusion The association between ambulance use and tPA administration suggests the importance of calling an ambulance for suspected stroke. Promoting ambulance use for acute ischemic stroke patients may increase tPA use.
Source: JAHA:Journal of the American Heart Association - September 17, 2013 Category: Cardiology Authors: Kunisawa, S., Morishima, T., Ukawa, N., Ikai, H., Otsubo, T., Ishikawa, K. B., Yokota, C., Minematsu, K., Fushimi, K., Imanaka, Y. Tags: Stroke 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

Dysbiosis of Gut Microbiota With Reduced Trimethylamine-N-Oxide Level in Patients With Large-Artery Atherosclerotic Stroke or Transient Ischemic Attack Stroke
Conclusions Participants with asymptomatic atherosclerosis did not exhibit an obvious change in gut microbiota and blood TMAO levels; however, stroke and transient ischemic attack patients showed significant dysbiosis of the gut microbiota, and their blood TMAO levels were decreased.
Source: JAHA:Journal of the American Heart Association - November 23, 2015 Category: Cardiology Authors: Yin, J., Liao, S.-X., He, Y., Wang, S., Xia, G.-H., Liu, F.-T., Zhu, J.-J., You, C., Chen, Q., Zhou, L., Pan, S.-Y., Zhou, H.-W. 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

Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes Health Services and Outcomes Research
ConclusionsSignificant variation exists in regional availability of healthcare resources for acute ischemic stroke treatment, yet among Get With the Guidelines‐Stroke hospitals, quality of care and in‐hospital outcomes did not differ by regional resource availability.
Source: JAHA:Journal of the American Heart Association - February 3, 2017 Category: Cardiology Authors: O'Brien, E. C., Wu, J., Zhao, X., Schulte, P. J., Fonarow, G. C., Hernandez, A. F., Schwamm, L. H., Peterson, E. D., Bhatt, D. L., Smith, E. E. Tags: Quality and Outcomes, Ischemic Stroke Original Research 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

Joint Commission Primary Stroke Centers Utilize More rt-PA in the Nationwide Inpatient Sample Stroke
Conclusions Subjects evaluated at PSCs were more likely to receive rt-PA than those evaluated at non-PSCs. This association was significant after adjustment for patient and hospital-level variables. Systems of care are necessary to ensure stroke patients have rapid access to PSCs throughout the United States.
Source: JAHA:Journal of the American Heart Association - March 26, 2013 Category: Cardiology Authors: Mullen, M. T., Kasner, S. E., Kallan, M. J., Kleindorfer, D. O., Albright, K. C., Carr, B. G. Tags: Stroke 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

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

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