Effect of a novel designed intensive patient care program on cognitive impairment, anxiety, depression as well as relapse free survival in acute ischemic stroke patients: a randomized controlled study

2019 ◽  
Vol 41 (9) ◽  
pp. 857-866
Author(s):  
Hong-Li Yu ◽  
Dong-Xue Cao ◽  
Jing Liu
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Acute Ischemic Stroke ◽  
Care Program ◽  
Controlled Study ◽  
Stroke Patients ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Randomized Controlled ◽  
Anxiety Depression

scholarly journals Influence of recent direct-to-EVT trials on practical decision-making for the treatment of acute ischemic stroke patients

2021 ◽  
pp. 159101992110579
Author(s):  
Rosalie McDonough ◽  
Johanna Ospel ◽  
Nima Kashani ◽  
Manon Kappelhof ◽  
Jianmin Liu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Treatment Strategies ◽  
Large Vessel Occlusion ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Randomized Controlled ◽  
Intravenous Alteplase ◽  
Short Time ◽  
Current Guidelines

Background Current guidelines recommend that eligible acute ischemic stroke (AIS) patients receive intravenous alteplase (IVT) prior to endovascular treatment (EVT). Six randomized controlled trials recently sought to determine the risks of administering IVT prior to EVT, five of which have been published/presented. It is unclear whether and how the results of these trials will change guidelines. With the DEBATE survey, we assessed the influence of the recent trials on physicians’ IVT treatment strategies in the setting of EVT for large vessel occlusion (LVO) stroke. Methods Participants were provided with 15 direct-to-mothership case-scenarios of LVO stroke patients and asked whether they would treat with IVT  +  EVT or EVT alone, a) before publication/presentation of the direct-to-EVT trials, and b) now (knowing the trial results). Logistic regression clustered by respondent was performed to assess factors influencing the decision to adopt an EVT-alone paradigm after publication/presentation of the trial results. Results 289 participants from 37 countries provided 4335 responses, of which 13.5% (584/4335) changed from an IVT  +  EVT strategy to EVT alone after knowing the trial results. Very few switched from EVT alone to IVT  +  EVT (8/4335, 0.18%). Scenarios involving a long thrombus (RR 1.88, 95%CI:1.56–2.26), cerebral micro-hemorrhages (RR 1.78, 95%CI:1.43–2.23), and an expected short time to recanalization (RR 1.46 95%CI:1.19–1.78) had the highest chance of participants switching to an EVT-only strategy. Conclusion In light of the recent direct-to-EVT trials, a sizeable proportion of stroke physicians appears to be rethinking IVT treatment strategies of EVT-eligible mothership patients with AIS due to LVO in specific situations.

scholarly journals Soluble ST2 and risk of cognitive impairment after acute ischemic stroke: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinwei Zhu ◽  
Chongquan Fang ◽  
Qi Zhang ◽  
Yaling Lu ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Acute Ischemic Stroke ◽  
Sex Education ◽  
Mmse Score ◽  
Cognitive Status ◽  
Stroke Patients ◽  
The Impact ◽  
State Examination ◽  
Conventional Risk Factors

Abstract Background Soluble suppression of tumorigenesis-2 (sST2) was reported to be associated with cognitive performance and risk of incident stroke. However, the impact of sST2 on cognitive function after ischemic stroke is unclear. We aimed to assess the association of sST2 and cognitive impairment at 3 months in acute ischemic stroke patients. Methods Baseline plasma sST2 levels were measured in 619 ischemic stroke patients (mean age: 60.0 ± 10.5 years) from 7 participating hospitals of the China Antihypertensive Trial in Acute Ischemic Stroke. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to assess cognitive status. Cognitive impairment was defined as a MoCA score < 23 or MMSE score < 27. The association between sST2 and cognitive impairment was evaluated by logistic regression analysis. Results 325 (52.5%) or 323 (52.2%) participants developed cognitive impairment according to MoCA or MMSE. After adjustment for age, sex, education, and other covariates, the odds ratio for the highest vs lowest quartile of sST2 was 2.38 (95% CI, 1.42–4.00) and 1.82 (95% CI 1.09–3.03) risk of cognitive impairment defined by MoCA and MMSE score, respectively. Incorporation sST2 into a model containing conventional risk factors significantly improved reclassification. Conclusions Elevated plasma sST2 levels were significantly associated with post-stroke cognitive impairment.

Effects of Heart Rate Variability Biofeedback in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

2019 ◽  
Vol 22 (1) ◽  
pp. 34-44
Author(s):  
Wan-Ling Chang ◽  
Jiunn-Tay Lee ◽  
Chi-Rong Li ◽  
Amy H. T. Davis ◽  
Chia-Chen Yang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Psychological Distress ◽  
Acute Ischemic Stroke ◽  
Autonomic Function ◽  
Control Group ◽  
Randomized Controlled ◽  
Experimental Group

Background: Autonomic dysfunction, cognitive impairment, and psychological distress are associated with poorer prognosis in patients with acute ischemic stroke (AIS). Heart rate variability (HRV) biofeedback (BF) improves autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with AIS is still unclear. Objective: This study investigated the effects of an HRVBF intervention on autonomic function, cognitive impairment, and psychological distress in patients with AIS. Method: In this randomized, controlled, single-blind trial, patients with AIS were randomly assigned to the experimental or control group. The experimental group received four HRVBF training sessions. The control group received usual care. Repeated measures of HRV, mini-mental status examination (MMSE), and Hospital Anxiety and Depression Scales (HADS) were collected prior to and at 1 and 3 months postintervention. Results: A total of 35 patients completed the study (19 experimental, 16 control). HRV and HADS significantly improved in the experimental group ( p < .001) but not in the control group. Likewise, only the experimental group showed significant improvements in HRV, MMSE, and HADS over time ( p < .05). Conclusion: HRVBF is a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with AIS. More studies of HRVBF interventions are needed to further optimize the effects of HRVBF on autonomic, cognitive, and psychological function in patients with AIS.

A randomized controlled study of intravenous fluid in acute ischemic stroke

2017 ◽  
Vol 161 ◽  
pp. 98-103 ◽  
Author(s):  
Nijasri C. Suwanwela ◽  
Aurauma Chutinet ◽  
Seangduan Mayotarn ◽  
Ratchayut Thanapiyachaikul ◽  
Napasri Chaisinanunkul ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intravenous Fluid ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled
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