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Use of Tirofiban to Prevent Ischemic Events in Patients with CYP2C19 Loss-of-Function Alleles during Flow Diversion of Intracranial Aneurysm: A Multicenter Cohort Study
This study supports CYP2C19 genotyping before flow diversion because LOF alleles increase the risk of ischemic events. Prophylactic use of tirofiban may help reduce ischemic events in LOF allele carriers.
Source: Translational Stroke Research - July 31, 2023 Category: Neurology Source Type: research

Clopidogrel Is Associated with Reduced Likelihood of Aneurysmal Subarachnoid Hemorrhage: a Multi-Center Matched Retrospective Analysis
We present, to the best of our knowledge, the first large-scale multi-institutional analysis suggesting clopidogrel use is protective against intracranial aneurysm rupture. It is our hope that these data will guide future investigation, revealing the pathophysiologic underpinning of this association.
Source: Translational Stroke Research - July 20, 2023 Category: Neurology Source Type: research

The Effect of the ABCB1(MDR-1) C3435T Polymorphism in Turkish Patients with Aspirin Resistance in Acute Ischemic Stroke
This study aimed to investigate the rate of AR, the factors influencing AR in patients with acute ischemic stroke under regular aspirin use, and the relationship between AR and ABCB1 (MDR-1) C3435T (rs1045642) polymorphism. Throughout this multicenter prospective study, 174 patients with acute ischemic stroke who had been prescribed aspirin for at least one month due to the risk of vascular disease, along with 106 healthy volunteers, were included as part of the study group. The results of our study indicate that AR was detected in 21.3% of the patient group. According to the results of an analysis of the polymorphism of t...
Source: Translational Stroke Research - July 11, 2023 Category: Neurology Source Type: research

Aspirin and Subarachnoid Haemorrhage in the UK Biobank
In this study, we aimed to clarify the association between aspirin and SAH in the general population. The UK Biobank is a prospective population-based cohort study. Sex, age, smoking, alcohol, medication use, hypertension, blood pressure, ischaemic heart disease and stroke were recorded at baseline assessments. Follow-up is conducted through linkages to National Health Service data including electronic, coded death certificate, hospital and primary care data. Cox proportional hazards modelling was used to analyse the association between aspirin use and SAH. Of the 501,060 participants included in the analysis, a total of 5...
Source: Translational Stroke Research - June 29, 2023 Category: Neurology Source Type: research

MYPT1SMKO Mice Function as a Novel Spontaneous Age- and Hypertension-Dependent Animal Model of CSVD
AbstractCerebral small vessel disease (CSVD) is the most common progressive vascular disease that causes vascular dementia. Aging and hypertension are major contributors to CSVD, but the pathophysiological mechanism remains unclear, mainly due to the lack of an ideal animal model. Our previous study revealed that vascular smooth muscle cell (VSMC)-specific myosin phosphatase target subunit 1 (MYPT1) knockout (MYPT1SMKO) leads to constant hypertension, prompting us to explore whether hypertensive MYPT1SMKO mice can be considered a novel CSVD animal model. Here, we found that MYPT1SMKO mice displayed age-dependent CSVD-like ...
Source: Translational Stroke Research - February 27, 2023 Category: Neurology Source Type: research

Gut Microbiota in Ischemic Stroke: Role of Gut Bacteria-Derived Metabolites
AbstractIschemic stroke (IS) remains a leading cause of death and long-term disability globally. Several mechanisms including glutamate excitotoxicity, calcium overload, neuroinflammation, oxidative stress, mitochondrial damage, and apoptosis are known to be involved in the pathogenesis of IS, but the underlying pathophysiology mechanisms of IS are not fully clarified. During the past decade, gut microbiota were recognized as a key regulator to affect the health of the host either directly or via their metabolites. Recent studies indicate that gut bacterial dysbiosis is closely related to hypertension, diabetes, obesity, d...
Source: Translational Stroke Research - October 24, 2022 Category: Neurology Source Type: research

Genome-Wide Association Study of Intracranial Artery Stenosis Followed by Phenome-Wide Association Study
AbstractThe genetic background of intracranial artery stenosis (ICAS), a major cause of ischemic stroke, remains elusive. We performed the world ’s first genome-wide association study (GWAS) of ICAS using DNA samples from Japanese subjects, to identify the genetic factors associated with ICAS and their correlation with clinical features. We also conducted a phenome-wide association study (PheWAS) of the top variant identified via GWAS to d etermine its association with systemic disease. The GWAS involved 408 patients with ICAS and 349 healthy controls and utilized an Asian Screening Array of venous blood samples. The Phe...
Source: Translational Stroke Research - June 14, 2022 Category: Neurology Source Type: research

Association Between Regular Blood Pressure Monitoring and the Risk of Intracranial Aneurysm Rupture: a Multicenter Retrospective Study with Propensity Score Matching
AbstractAlthough hypertension is a known risk factor for intracranial aneurysm rupture, the benefit of the management of blood pressure in reducing the rupture risk of intracranial aneurysms remains largely unknown, especially for regular blood pressure monitoring. We conducted a retrospective analysis of a prospectively maintained database of 3965 patients with saccular intracranial aneurysms from 20 medical centers in China. The patients were divided into the non-hypertensive group and hypertensive group. Propensity score matching was applied to identify a cohort of patients with similar baseline characteristics. Univari...
Source: Translational Stroke Research - March 21, 2022 Category: Neurology Source Type: research

Circle of Willis Morphology in Primary Intracerebral Hemorrhage
AbstractWe aimed to study the distribution of Circle of Willis (CoW) morphology and its association with intracerebral hemorrhage (ICH) etiology and cerebral small vessel disease (CSVD) burden. Patients with primary ICH who had brain MRIs were consecutively enrolled between March 2012 and January 2021. CoW morphology, CSVD features and the combined CSVD burden (including global CSVD burden, total hypertensive arteriopathy [HA] burden, and total cerebral amyloid angiopathy [CAA] burden) were assessed. CoW morphology included poor CoW (defined as CoW score 0 –2), incomplete CoW, and complete fetal-variant of the posterior ...
Source: Translational Stroke Research - February 19, 2022 Category: Neurology Source Type: research

Ligands of the Neuropeptide Y Y2 Receptors as a Potential Multitarget Therapeutic Approach for the Protection of the Neurovascular Unit Against Acute Ischemia/Reperfusion: View from the Perspective of the Laboratory Bench
AbstractIschemic stroke is the third leading cause of death and disability worldwide, with no available satisfactory prevention or treatment approach. The current treatment is limited to the use of “reperfusion methods,” i.e., an intravenous or intra-arterial infusion of a fibrinolytic agent, mechanical removal of the clot by thrombectomy, or a combination of both methods. It should be stressed, however, that only approximately 5% of all acute strokes are eligible for fibrinolytic treatmen t and fewer than 10% for thrombectomy. Despite the tremendous progress in understanding of the pathomechanisms of cerebral ischemia...
Source: Translational Stroke Research - July 22, 2021 Category: Neurology Source Type: research

Plasma Kallikrein Contributes to Intracerebral Hemorrhage and Hypertension in Stroke-Prone Spontaneously Hypertensive Rats
This report investigates the role of PKa on hemorrhage and hypertension in stroke-prone spontaneously hypertensive rats (SHRSP). SHRSP were fed with a high salt –containing stroke-prone diet to increase blood pressure and induce intracerebral hemorrhage. The roles of PKa on blood pressure, hemorrhage, and survival in SHRSP were examined in rats receiving a PKa inhibitor or plasma prekallikrein antisense oligonucleotide (PK ASO) compared with rats receivin g control ASO. Effects on PKa on the proteolytic cleavage of atrial natriuretic peptide (ANP) were analyzed by tandem mass spectrometry. We show that SHRSP on high-salt...
Source: Translational Stroke Research - July 9, 2021 Category: Neurology Source Type: research

CYP2C19 Loss-of-Function Associated with First-Time Ischemic Stroke in Non-surgical Asymptomatic Carotid Artery Stenosis During Clopidogrel Therapy
This study measures effect ofCYP2C19 genotype on ischemic stroke risk during clopidogrel therapy for asymptomatic, extracranial carotid stenosis patients. Using deidentified electronic health records, patients were selected for retrospective cohort using administrative code for carotid stenosis, availability ofCYP2C19 genotype result, clopidogrel exposure, and established patient care. Patients with intracranial atherosclerosis, aneurysm, arteriovenous malformation, prior ischemic stroke, or observation time<1 month were excluded. Dual antiplatelet therapy patients were included. Patients with carotid endarterectomy or ...
Source: Translational Stroke Research - February 21, 2021 Category: Neurology Source Type: research

Associations of Blood Pressure and Carotid Flow Velocity with Brain Volume and Cerebral Small Vessel Disease in a Community-Based Population
AbstractCerebral small vessel disease (CSVD) is a common finding on brain magnetic resonance imaging (MRI). We previously demonstrated that high blood pressure (BP) and low carotid flow velocity were associated with cerebrovascular disease. However, their associations with brain volume and CSVD remain to be determined. A total of 721 adults ( ≥ 50 years) from the community-based I-Lan Longitudinal Aging Study were included. Flow velocities at the common (CCA) and internal carotid artery (ICA), including peak systolic velocity (PSV) and end-diastolic velocity (EDV), were measured with Doppler ultrasound. We further det...
Source: Translational Stroke Research - July 31, 2020 Category: Neurology Source Type: research

Low Serum Uric Acid Levels Promote Hypertensive Intracerebral Hemorrhage by Disrupting the Smooth Muscle Cell-Elastin Contractile Unit and Upregulating the Erk1/2-MMP Axis
In this study, we confirmed the association between low SUA levels and the risk for recurrence of ICH and for cardiac-cerebral vascular mortality in hypertensive patients. To determine the mechanism by which low SUA effects ICH pathogenesis, we developed the first low SUA mouse model and conducted transcriptome profiling of the cerebrovasculature of ICH mice. When combining these assessments with pathological morphology, we found that low SUA levels led to ICH in mice with angiotensin II (Ang II) –induced hypertension and aggravated the pathological progression of ICH. In vitro, our results showed that p-Erk1/2-MMP axis ...
Source: Translational Stroke Research - April 21, 2020 Category: Neurology Source Type: research

Intracranial Pressure Monitoring-Aided Management Associated with Favorable Outcomes in Patients with Hypertension-Related Spontaneous Intracerebral Hemorrhage
AbstractTo investigate the effect of intracranial pressure (ICP) monitoring on the functional outcome of patients with hypertension-related spontaneous intracerebral hemorrhage (ICH). We included 196 patients with Glasgow Coma Scale (GCS) scores of 3 –12 in this observational study, of which 103 underwent ICP monitors. Binary and ordinal regression analyses were used to estimate the effect of ICP monitoring on the functional outcome. The rate of adverse events, blood pressure control, and length of hospitalization were compared between the two groups. ICP monitoring had a significant impact on the clinical outcome of pat...
Source: Translational Stroke Research - March 5, 2020 Category: Neurology Source Type: research

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