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Proteinuria Predicts Resistance to Antiplatelet Therapy in Ischemic Stroke
AbstractThe occurrence of a stroke while on antiplatelet agents presents a therapeutic dilemma. One of the main causes for recurrent strokes is antiplatelet resistance more commonly known as high on treatment platelet reactivity (HTPR). Prior studies have established that proteinuria is associated with HTPR following myocardial infarction. Here, we investigated whether dipstick proteinuria correlates with HTPR in patients presenting with stroke. We performed a retrospective cohort analysis of 102 patients admitted for a recurrent ischemic stroke that had either a VerifyNow aspirin or VerifyNow clopidogrel laboratory test p...
Source: Translational Stroke Research - September 5, 2017 Category: Neurology Source Type: research

Midlife Orthostatic Hypotension May Increase Risk of Dementia, Stroke
People with orthostatic hypotension (an excessive drop in blood pressure when standing up that can lead to dizziness and fainting) in midlife may be more likely than those without the condition to develop stroke and dementia later in life, according to astudy inNeurology.“The presence of orthostasis, especially in midlife, might identify individuals in whom more careful monitoring or risk factor management might be warranted,” wrote lead author Andreea Rawlings, Ph.D., of the Johns Hopkins Bloomberg School of Public Health and colleagues.These findings come from an analysis of data from 11,709 participants without a hi...
Source: Psychiatr News - July 30, 2018 Category: Psychiatry Tags: Alzheimer's Alzheimer's risk factors dementia dizziness orthostatic hypotension stroke Source Type: research

The Impact of Diabetes on Outcomes After Acute Ischemic Stroke: A Prospective Observational Study
Background: Stroke in diabetics may delay recovery and increases the risk of early recurrence of stroke. We compared the outcomes of patients (with and without diabetes) admitted with an acute ischemic stroke (AIS) in the state of Qatar. Patients and methods: We prospectively compared the clinical presentation, complications, discharge outcome, and stroke recurrence at 90 days in patients with and without diabetes. Results: Five thousand two hundred twenty-eight stroke patients were admitted between January 2014 and December 2017.
Source: Journal of Stroke and Cerebrovascular Diseases - December 10, 2018 Category: Neurology Authors: Naveed Akhtar, Saadat Kamran, Rajvir Singh, Rayaz A. Malik, Dirk Deleu, Paula J. Bourke, Sujatha Joseph, Mark D. Santos, Deborah M. Morgan, Faisal M. Wadiwala, Reny Francis, Blessy M. Babu, Pooja George, Rumissa Ibrahim, Pablo Garcia-Bermejo, Ashfaq Shuai Source Type: research

Poor glycemic control and posterior circulation ischemic stroke
Conclusions Poor glycemic control may be associated with an increased risk of thrombotic infarction that occurs preferentially in the posterior circulation of the brain.
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Kuroda, J., Matsuo, R., Yamaguchi, Y., Sato, N., Kamouchi, M., Hata, J., Wakisaka, Y., Ago, T., Kitazono, T., on behalf of the Fukuoka Stroke Registry Investigators Tags: Infarction Research Source Type: research

Delayed Administration of Angiotensin II Type 2 Receptor (AT2R) Agonist Compound 21 Prevents the Development of Post-stroke Cognitive Impairment in Diabetes Through the Modulation of Microglia Polarization
AbstractA disabling consequence of stroke is cognitive impairment, occurring in 12% –48% of patients, for which there is no therapy. A critical barrier is the lack of understanding of how post-stroke cognitive impairment (PSCI) develops. While 70% of stroke victims present with comorbid diseases such as diabetes and hypertension, the limited use of comorbid disease models in prec linical research further contributes to this lack of progress. To this end, we used a translational model of diabetes to study the development of PSCI. In addition, we evaluated the application of compound 21 (C21), an angiotensin II Type 2 rece...
Source: Translational Stroke Research - December 2, 2019 Category: Neurology Source Type: research

Endogenous Regulatory T Cells Promote M2 Macrophage Phenotype in Diabetic Stroke as Visualized by Optical Imaging
AbstractRegulatory T cells (Tregs) play an immunosuppressive role in various diseases, yet their function remains controversial in stroke and obscure in diabetic stroke. In the present study, Tregs were found downregulated in the peripheral blood of type 2 diabetes mellitus (T2DM) stroke models and patients compared with controls. In ischemic stroke mice (both T2DM and wild type), endogenous Tregs boosted by CD28SA increased CD206+ M2 macrophage/microglia cells, decreased infarct volumes, and improved neurological recovery. Our results demonstrated the potential of boosting Tregs for treating T2DM stroke. Furthermore, we u...
Source: Translational Stroke Research - April 1, 2020 Category: Neurology Source Type: research

Deferoxamine Treatment Prevents Post-Stroke Vasoregression and Neurovascular Unit Remodeling Leading to Improved Functional Outcomes in Type 2 Male Diabetic Rats: Role of Endothelial Ferroptosis
This study aimed to determine the impact of iron chelation with deferoxamine (DFX) on (1) cerebral vascularization patterns and (2) functional outcomes after stroke in control and diabetic rats. After 8  weeks of type 2 diabetes induced by a combination of high-fat diet and low-dose streptozotocin, male control and diabetic animals were subjected to thromboembolic middle cerebral artery occlusion (MCAO) and randomized to vehicle, DFX, or tPA/DFX and followed for 14 days with behavioral tests. Vas cular indices (vascular volume and surface area), neurovascular remodeling (AQP4 polarity), and microglia activation were meas...
Source: Translational Stroke Research - August 31, 2020 Category: Neurology Source Type: research

Predictors of Recurrent Ischemic Stroke in Obese Patients With Type 2 Diabetes Mellitus: A Population-based Study
Each year, approximately 0.8 million people are estimated to experience a new or recurrent stroke, according to the 2019 report of the American Heart Association.1 In Malaysia, stroke is the third leading cause of death after ischemic heart disease (IHD) and pneumonia.2 Both obesity and diabetes are considered as the established independent risk factors for ischemic stroke.3 Type 2 diabetes mellitus (T2DM) was also found to be associated with an increase in all-cause as well as cardiovascular mortality following the stroke,4,5 and in a meta-analysis of 18 studies, patients with diabetes had a higher stroke recurrence as co...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Orwa Albitar, Sabariah Noor Harun, Nur Ezzati Abidin, Balamurugan Tangiisuran, Hadzliana Zainal, Irene Looi, Khairul Azmi Ibrahim, Norsima Nazifah Sidek, Keat Wei Loo, Keng Yee Lee, Zariah Abdul Aziz, Siti Maisharah Sheikh Ghadzi Source Type: research

Coffee Consumption and Stroke Risk: Evidence from a Systematic Review and Meta-Analysis of more than 2.4 Million Men and Women
Stroke remains the leading cause of disability and mortality globally. Based on the Global Burden of Disease Study 2016, it was estimated that there were 13.7 million new stroke cases, 5.5 million deaths, 80.1 million prevalent cases, and 116.4 million disability-adjusted life-years.1 About 75% of stroke cases are ischemic, whereas the remaining cases are hemorrhagic.2 Stroke incidence increases with age. Well-known risk factors for stroke include personal history of hypertension, diabetes and cardiac diseases, unhealthy behavioral factors (heavy cigarette consumption, less physical inactivity, poor diet), and serious environmental risks.
Source: Journal of Stroke and Cerebrovascular Diseases - November 11, 2020 Category: Neurology Authors: Chuan Shao, Hui Tang, Xiaoya Wang, Jiaquan He Source Type: research

Diabetes Mellitus/Poststroke Hyperglycemia: a Detrimental Factor for tPA Thrombolytic Stroke Therapy
AbstractIntravenous administration of tissue-type plasminogen activator (IV tPA) therapy has long been considered a mainstay in ischemic stroke management. However, patients respond to IV tPA therapy unequally with some subsets of patients having worsened outcomes after treatment. In particular, diabetes mellitus (DM) is recognized as a clinically important vascular comorbidity that leads to lower recanalization rates and increased risks of hemorrhagic transformation (HT). In this short-review, we summarize the recent advances in understanding of the underlying mechanisms involved in post-IV tPA worsening of outcome in dia...
Source: Translational Stroke Research - April 20, 2021 Category: Neurology Source Type: research

Chronic Kidney Disease is A Biomarker Rather Than A Risk Factor for Stroke
Over the last approximate 15 years some have suggested that chronic kidney disease (CKD) is a risk factor for stroke in and of itself. The assertion that CKD is a risk factor for stroke requires more scrutiny. It is possible that CKD is a reflection of severity of conditions such as hypertension and diabetes that are themselves among the most treatable risk factors for stroke or it is possible that the effects of CKD change vascular and related physiological functions and therefor directly contribute to increased risk of stroke and it is also possible that treatments for advance CKD such has hemodialysis could contribute t...
Source: Journal of Stroke and Cerebrovascular Diseases - May 29, 2021 Category: Neurology Authors: Judy Dawod, Bruce M Coull Source Type: research

Skin Autofluorescence is an Independent Predictor of Post Stroke Infection in Diabetes
Post stroke infection occurs in 15 –20% of acute stroke patients and is associated with a poor longterm outcome. In a prospective study on 113 acute ischemic stroke patients with diabetes mellitus 15.9% suffered nosocomial infection. We found chronic hyperglycemia measured by skin autofluorescence in arbitrary units to be an indepe ndent predictor of a nosocomial infection post stroke (OR = 3.24 [CI 95%: 1.13; 9.26], p = 0.029). Skin autofluorescence represents the glycemic memory beyond HbA1c. Potential mechanisms leading from increased skin autofluorescence to vulnerability for infectious complications include ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 26, 2021 Category: Neurology Authors: Alexandra Filipov, Heike Fuchshuber, Josephine Kraus, Anne D. Ebert, Vesile Sandikci, Angelika Alonso Source Type: research

Premature atherosclerosis: A major contributor to early-onset ischemic stroke
Atherosclerosis is an age-dependent process. The prevalence of large-artery atherosclerosis in case series of ischemic stroke in young adults has been substantially less than in older adults.1–4 Historically, data on the role of atherosclerosis in early-onset stroke have been limited for a variety of reasons. First, multi-institutional studies often have inconsistent evaluations of the cerebral vasculature, particularly the intracranial circulation. Second, studies may not report evidence for proximal atherosclerosis less severe than necessary to meet criteria for etiology. Emerging data, however, show a high inciden...
Source: Neurology - April 1, 2013 Category: Neurology Authors: Kittner, S. J., Singhal, A. B. Tags: Stroke in young adults, Ultrasound, Prevalence studies, Risk factors in epidemiology EDITORIALS Source Type: research

Deficient eNOS Phosphorylation Is a Mechanism for Diabetic Vascular Dysfunction Contributing to Increased Stroke Size Basic Sciences
Conclusions— Diminished eNOS phosphorylation is a mechanism of vascular dysfunction in db/db mice. We show here that modulation of the eNOS S1176 phosphorylation site in db/db mice is associated with improved vascular reactivity and improved outcome to stroke after middle cerebral artery occlusion.
Source: Stroke - October 21, 2013 Category: Neurology Authors: Li, Q., Atochin, D., Kashiwagi, S., Earle, J., Wang, A., Mandeville, E., Hayakawa, K., d'Uscio, L. V., Lo, E. H., Katusic, Z., Sessa, W., Huang, P. L. Tags: Animal models of human disease, Genetically altered mice, Type 2 diabetes, Acute Cerebral Infarction, Endothelium/vascular type/nitric oxide Basic Sciences Source Type: research

Usefulness of N-Terminal Pro-B-Type Natriuretic Peptide Levels for Stroke Risk Prediction in Anticoagulated Patients With Atrial Fibrillation Clinical Sciences
Conclusions— In real-world cohort of anticoagulated patients with AF, NT-proBNP provided complementary prognostic information to an established clinical risk score (CHA2DS2–VASc) for the prediction of stroke/systemic embolism. NT-proBNP was also predictive of all-cause mortality, suggesting that this biomarker may potentially be used to refine clinical risk stratification in anticoagulated patients with AF.
Source: Stroke - February 24, 2014 Category: Neurology Authors: Roldan, V., Vilchez, J. A., Manzano-Fernandez, S., Jover, E., Galvez, J., Puche, C. M., Valdes, M., Vicente, V., Lip, G. Y. H., Marin, F. Tags: Arterial thrombosis, Coumarins, Anticoagulants Clinical Sciences Source Type: research