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Source: The Lancet
Condition: Hemorrhagic Stroke
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Total 32 results found since Jan 2013.
Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. T...
Source: The Lancet - September 2, 2019 Category: General Medicine Source Type: research
Upadacitinib as monotherapy in patients with active rheumatoid arthritis and inadequate response to methotrexate (SELECT-MONOTHERAPY): a randomised, placebo-controlled, double-blind phase 3 study
This study is active but not recruiting and is registered with ClinicalTrials.gov, number NCT02706951.FindingsPatients were screened between Feb 23, 2016, and May 19, 2017 and 648 were randomly assigned to treatment. 598 (92%) completed week 14. At week 14, an ACR20 response was achieved by 89 (41%) of 216 patients (95% CI 35–48) in the continued methotrexate group, 147 (68%) of 217 patients (62–74) receiving upadacitinib 15 mg, and 153 (71%) of 215 patients (65–77) receiving upadacitinib 30 mg (p<0·0001 for both doses vs continued methotrexate). DAS28(CRP) 3·2 or lower was met by 42 (19%) of 216 (95% CI 14–2...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
Publication date: Available online 22 May 2019Source: The LancetAuthor(s): Colin Baigent, Daniel Lasserson, Frank Sullivan, Johanna Carrie, Javier Rojas, Shannon Amoils, John Bamford, Jane Armitage, Gabriel Rinkel, Gordon Lowe, Jonathan Emberson, Karen Innes, Lynn Dinsmore, Jonathan Drever, Carol Williams, David Perry, Connor McGill, David Buchanan, Allan Walker, Aidan HutchisonSummaryBackgroundAntiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial hae...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data
This study is registered with PROSPERO, number CRD42019128036.FindingsWe identified three trials that met eligibility criteria: EXTEND, ECASS4-EXTEND, and EPITHET. Of the 414 patients included in the three trials, 213 (51%) were assigned to receive alteplase and 201 (49%) were assigned to receive placebo. Overall, 211 patients in the alteplase group and 199 patients in the placebo group had mRS assessment data at 3 months and thus were included in the analysis of the primary outcome. 76 (36%) of 211 patients in the alteplase group and 58 (29%) of 199 patients in the placebo group had achieved excellent functional outcome a...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China
Publication date: Available online 4 April 2019Source: The LancetAuthor(s): Iona Y Millwood, Robin G Walters, Xue W Mei, Yu Guo, Ling Yang, Zheng Bian, Derrick A Bennett, Yiping Chen, Caixia Dong, Ruying Hu, Gang Zhou, Bo Yu, Weifang Jia, Sarah Parish, Robert Clarke, George Davey Smith, Rory Collins, Michael V Holmes, Liming Li, Richard PetoSummaryBackgroundModerate alcohol intake has been associated with reduced cardiovascular risk in many studies, in comparison with abstinence or with heavier drinking. Studies in east Asia can help determine whether these associations are causal, since two common genetic variants greatly...
Source: The Lancet - April 6, 2019 Category: General Medicine Source Type: research
Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial
This study supports the use of direct aspiration as an alternative to stent retriever as first-line therapy for stroke thrombectomy.FundingPenumbra.
Source: The Lancet - March 9, 2019 Category: General Medicine Source Type: research
Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial
This study is registered with ClinicalTrials.gov, number NCT01827046.FindingsBetween Dec 30, 2013, and Aug 15, 2017, 506 patients were randomly allocated: 255 (50%) to the MISTIE group and 251 (50%) to standard medical care. 499 patients (n=250 in the MISTIE group; n=249 in the standard medical care group) received treatment and were included in the mITT analysis set. The mITT primary adjusted efficacy analysis estimated that 45% of patients in the MISTIE group and 41% patients in the standard medical care group had achieved an mRS score of 0–3 at 365 days (adjusted risk difference 4% [95% CI −4 to 12]; p=0·33). Sensi...
Source: The Lancet - February 8, 2019 Category: General Medicine Source Type: research
Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial
Publication date: Available online 7 February 2019Source: The LancetAuthor(s): Craig S Anderson, Yining Huang, Richard I Lindley, Xiaoying Chen, Hisatomi Arima, Guofang Chen, Qiang Li, Laurent Billot, Candice Delcourt, Philip M Bath, Joseph P Broderick, Andrew M Demchuk, Geoffrey A Donnan, Alice C Durham, Pablo M Lavados, Tsong-Hai Lee, Christopher Levi, Sheila O Martins, Veronica V Olavarria, Jeyaraj D PandianSummaryBackgroundSystolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressu...
Source: The Lancet - February 8, 2019 Category: General Medicine Source Type: research
Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial
Publication date: Available online 6 February 2019Source: The LancetAuthor(s): Philip M Bath, Polly Scutt, Craig S Anderson, Jason P Appleton, Evind Berge, Lesley Cala, Mark Dixon, Timothy M England, Peter J Godolphin, Diane Havard, Lee Haywood, Trish Hepburn, Kailash Krishnan, Grant Mair, Alan A Montgomery, Keith Muir, Stephen J Phillips, Stuart Pocock, John Potter, Chris PriceSummaryBackgroundHigh blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains ...
Source: The Lancet - February 7, 2019 Category: General Medicine Source Type: research
Deep learning algorithms for detection of critical findings in head CT scans: a retrospective study
Publication date: Available online 11 October 2018Source: The LancetAuthor(s): Sasank Chilamkurthy, Rohit Ghosh, Swetha Tanamala, Mustafa Biviji, Norbert G Campeau, Vasantha Kumar Venugopal, Vidur Mahajan, Pooja Rao, Prashant WarierSummaryBackgroundNon-contrast head CT scan is the current standard for initial imaging of patients with head trauma or stroke symptoms. We aimed to develop and validate a set of deep learning algorithms for automated detection of the following key findings from these scans: intracranial haemorrhage and its types (ie, intraparenchymal, intraventricular, subdural, extradural, and subarachnoid); ca...
Source: The Lancet - October 12, 2018 Category: General Medicine Source Type: research
Intracerebral haemorrhage: current approaches to acute management
Publication date: 6–12 October 2018Source: The Lancet, Volume 392, Issue 10154Author(s): Charlotte Cordonnier, Andrew Demchuk, Wendy Ziai, Craig S AndersonSummaryAcute spontaneous intracerebral haemorrhage is a life-threatening illness of global importance, with a poor prognosis and few proven treatments. As a heterogeneous disease, certain clinical and imaging features help identify the cause, prognosis, and how to manage the disease. Survival and recovery from intracerebral haemorrhage are related to the site, mass effect, and intracranial pressure from the underlying haematoma, and by subsequent cerebral oedema from p...
Source: The Lancet - October 5, 2018 Category: General Medicine Source Type: research
Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial
This study is registered with ClinicalTrials.gov, number NCT00501059.FindingsBetween July 5, 2007, and Nov 15, 2016, 12 546 patients were enrolled and randomly assigned to receive aspirin (n=6270) or placebo (n=6276) at 501 study sites. Median follow-up was 60 months. In the intention-to-treat analysis, the primary endpoint occurred in 269 (4·29%) patients in the aspirin group versus 281 (4·48%) patients in the placebo group (hazard ratio [HR] 0·96; 95% CI 0·81–1·13; p=0·6038). Gastrointestinal bleeding events (mostly mild) occurred in 61 (0·97%) patients in the aspirin group versus 29 (0·46%) in the placebo gr...
Source: The Lancet - August 27, 2018 Category: General Medicine Source Type: research
Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial
Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Marco Valgimigli, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Martina Rothenbühler, Matteo Tebaldi, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Paolo Rubartelli, Carlo Briguori, Giuseppe Andó, Maurizio Ferrario, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Marco Nazzaro, Alessandro Lupi, Bernardo CorteseSummaryBackgroundThe Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) programme was designed to assess the comparative safety and effectiveness of ra...
Source: The Lancet - August 25, 2018 Category: General Medicine Source Type: research
Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial
Publication date: 9–15 June 2018 Source:The Lancet, Volume 391, Issue 10137 Author(s): P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, ...
Source: The Lancet - June 8, 2018 Category: General Medicine Source Type: research
Practice patterns and outcomes after stroke across countries at different economic levels (INTERSTROKE): an international observational study
Publication date: 19–25 May 2018 Source:The Lancet, Volume 391, Issue 10134 Author(s): Peter Langhorne, Martin J O'Donnell, Siu Lim Chin, Hongye Zhang, Denis Xavier, Alvaro Avezum, Nandini Mathur, Melanie Turner, Mary Joan MacLeod, Patricio Lopez-Jaramillo, Albertino Damasceno, Graeme J Hankey, Antonio L Dans, Ahmed Elsayed, Charles Mondo, Mohammad Wasay, Anna Czlonkowska, Christian Weimar, Afzal Hussein Yusufali, Fawaz Al Hussain, Liu Lisheng, Hans-Christoph Diener, Danuta Ryglewicz, Nana Pogosova, Romana Iqbal, Rafael Diaz, Khalid Yusoff, Aytekin Oguz, Xingyu Wang, Ernesto Penaherrera, Fernando Lanas, Okechukwu S Ogah...
Source: The Lancet - May 18, 2018 Category: General Medicine Source Type: research
