THE IMPACT OF PRIOR USE OF ANTITHROMBOTIC AGENTS ON SEVERITY AND OUTCOME IN STROKE PATIENTS WITH ARTERIAL FIBRILLATION. THE JAPAN STROKE DATA BANK.

2018 ◽  
Author(s):  
Kazutaka Sonoda
Keyword(s):  
Data Bank ◽  
Antithrombotic Agents ◽  
Stroke Patients ◽  
Prior Use ◽  
Stroke Data Bank ◽  
The Impact

scholarly journals The Use of NeuroAiD (MLC601) in Postischemic Stroke Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Jose C. Navarro ◽  
Mark C. Molina ◽  
Alejandro C. Baroque II ◽  
Johnny K. Lokin
Keyword(s):  
Functional Recovery ◽  
Randomized Control Trial ◽  
Retrospective Cohort ◽  
Data Bank ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Open Label ◽  
Large Randomized Control Trial ◽  
Randomized Control ◽  
Stroke Data Bank

Aim. We aimed to assess the efficacy of MLC601 on functional recovery in patients given MLC601 after an ischemic stroke.Methods. This is a retrospective cohort study comparing poststroke patients given open-label MLC601 (; 9 female) for three months and matching patients who did not receive MLC601 from our Stroke Data Bank. Outcome assessed was modified Rankin Scale (mRS) at three months and analyzed according to: (1) achieving a score of 0-2, (2) achieving a score of 0-1, and (3) mean change in scores from baseline.Results. At three months, 21 patients on MLC601 became independent as compared to 17 patients not on MLC601 (OR 1.79; 95% CI 0.62–5.2; ). There were twice as many patients () on MLC601 who attained mRS scores similar to their prestroke state than in the non-MLC601 group () (OR 3.14; 95% CI 1.1–9.27; ). Mean improvement in mRS from baseline was better in the MLC601 group than in the non-MLC601 group (−1.7 versus −0.9; mean difference −0.73; 95% CI −1.09 to −0.38; ).Conclusion. MLC601 improves functional recovery at 3 months postischemic stroke. An ongoing large randomized control trial of MLC601 will help validate these results.

Safety of Combination Aspirin and Anticoagulation in Acute Ischemic Stroke

1994 ◽  
Vol 28 (4) ◽  
pp. 441-443 ◽  
Author(s):  
Susan C. Fagan ◽  
Heather R. Kertland ◽  
Gretchen E. Tietjen
Keyword(s):  
Data Bank ◽  
Bleeding Complications ◽  
Inpatient Setting ◽  
Stroke Patients ◽  
Bleeding Rate ◽  
Risk Of Bleeding ◽  
Major Bleed ◽  
Severe Epistaxis ◽  
The Mean ◽  
Stroke Data Bank

OBJECTIVE: To assess the risk of bleeding complications in patients treated with combination aspirin and heparin for cerebral ischemia. DESIGN: A retrospective, cohort study. SETTING: A large urban teaching hospital. PATIENTS: One hundred charts of stroke patients who had received anticoagulation with or without aspirin therapy were identified from the Stroke Data Bank. Bleeding rates were compared between the two groups. RESULTS: Forty-two patients who had received heparin and/or warfarin in combination with aspirin were compared with 33 patients who had received anticoagulation alone. The mean duration of anticoagulant therapy was 8.0 and 8.4 days, respectively. Bleeding rates were not different between the two groups: 23.8 percent (10/42) (p=0.78) and 24.2 percent (8/33), respectively. Although the bleeding rate was substantial, there was only one major bleed (severe epistaxis) occurring in a patient receiving anticoagulation only. No patient had an intracerebral hemorrhage. CONCLUSIONS: Our data suggest that combination antithrombotic therapy is safe in a controlled, inpatient setting.

Higher cortical function deficits among acute stroke patients: The stroke data bank experience

1997 ◽  
Vol 6 (3) ◽  
pp. 114-120 ◽  
Author(s):  
Michael Hoffmann ◽  
Ralph Sacco ◽  
Jay P. Mohr ◽  
Thomas K. Tatemichi
Keyword(s):  
Acute Stroke ◽  
Data Bank ◽  
Stroke Patients ◽  
Cortical Function ◽  
Stroke Data Bank

Abstract WP48: Impact of Rapid Complete Recanalization on Clinical Recovery in Cardioembolic Stroke Patients With M2 Occlusion

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Junya Aoki ◽  
Ryutaro Kimura ◽  
Shinichiro Numao ◽  
Kazutaka Sawada ◽  
Takehiro Katano ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Data Bank ◽  
Multivariate Regression Analysis ◽  
Study Data ◽  
Favorable Outcome ◽  
Stroke Patients ◽  
Endovascular Thrombectomy ◽  
Nihss Score ◽  
Mca Occlusion ◽  
The Impact

Background and purpose: Recent study reported the impact of complete recanalization beyond significant recanalization. The main of present study is to investigate the impact of complete recanalization in stroke patients with distal (M2) middle cerebral artery (MCA) occlusion. Methods: From our prospective endovascular thrombectomy (EVT) registry and multicenter tPA trial (YAMATO study) data bank, data on M2 occlusion and treated with EVT and/or tPA were retrospectively reviewed. In the YAMATO study, all tPA patients were examined using MRA before and at 1 hour after tPA. Thus, we defined the complete recanalization as a modified TICI of 3 at the end of EVT or similar appearances of both MCA on MRA at 1 hour after tPA. Significant recanalization was TICI ≥2b or >50% recanalization of MRA. At 3 months, favorable outcome was defined as mRS ≤ 2. Result: Data on 122 patients with M2 occlusion (median age 79 [72-85] years; male, 69 [57%], NIHSS score 13 [8-19]) received tPA and/or EVT were analyzed. Onset-to-admission was calculated as 95 (52-189) minutes. Complete recanalization was achieved in 27 (22%) patients, and significant recanalization was in 75 (61%) patients. Neither EVT administration it self, tPA, combined EVT and tPA were related to the complete recanalization (p=0.383, 0,237 and 0.612). At 3 months onset, patients with complete recanalization at the end of EVT/tPA frequently had favorable outcome than those without it (75% vs. 43%, p=0.013), while significant recanalization did not statistically increase the rate of favorable outcome (52% vs. 46%, p=0.673). Age, NIHSS score, DWI-ASPECTS, and plasma levels of d-dimer and brain benign peptide were also related to the favorable outcome (0.031, <0.001, 0.005, 0.011, and 0.010). Finally, multivariate regression analysis found that complete recanalization was an independent parameter related to the favorable outcome (odd ratio, 5.0 95%CI [1.1-23.0], p=0.038) as well as DWI-ASPECTS (odds ratio, 2.1, 95%CI [1.2-3.3], p=0.001). Conclusion: Complete recanalization but not significant recanalization was a parameter associated with favorable outcome in M2 occlusion patients. The goal of recanalization therapy may be immediate and complete recanalization even in patients with distal MCA occlusion.

ASSOCIATION OF PLATELET-DERIVED MICROVESICLES WITH HIGH ON-TREATMENT PLATELET REACTIVITY IN CONVALESCENT ISCHEMIC STROKE PATIENTS TREATED WITH ACETYLSALICYLIC ACID

2019 ◽  
Vol 72 (8) ◽  
pp. 1426-1436
Author(s):  
Justyna Rosińska ◽  
Joanna Maciejewska ◽  
Robert Narożny ◽  
Wojciech Kozubski ◽  
Maria Łukasik
Keyword(s):  
Platelet Aggregation ◽  
Treatment Failure ◽  
Acetylsalicylic Acid ◽  
Platelet Reactivity ◽  
Study Groups ◽  
Surface Expression ◽  
Cerebrovascular Diseases ◽  
Stroke Patients ◽  
Vascular Events ◽  
The Impact

Introduction: Elevated concentrations of platelet-derived microvesicles are found in cerebrovascular diseases. The impact of acetylsalicylic acid on these microvesicles remains inconsistent, despite its well-established effect on platelet aggregation. High residual platelet aggregation is defined as high on-treatment platelet reactivity, while “treatment failure” is the occurrence of vascular events despite antiplatelet treatment. The aim of this study was to determine whether the antiaggregatory effect of acetylsalicylic acid correlates with platelet-derived microvesicles in convalescent ischaemic stroke patients and cardiovascular risk factor controls as well as to evaluate the association between high on-treatment platelet reactivity and recurrent vascular events with the studied platelet-derived microvesicle parameters. Materials and methods: The study groups consisted of 76 convalescent stroke patients and 74 controls. Total platelet-derived microvesicles, annexino-positive microvesicles number, and platelet-derived microvesicles with surface expression of proinflammatory (CD40L, CD62P, CD31) and procoagulant (PS, GPIIb/IIIa) markers were characterized and quantified using flow cytometry. Cyclooxygenase-1-specific platelet responsiveness, with whole blood impedance platelet aggregation under arachidonic acid stimulation and the serum concentration of thromboxane B2, were evaluated. Results: Neither acetylsalicylic acid intake nor modification of its daily dose caused statistically significant differences in the studied microvesicle parameters. Additionally, no statistically significant differences in the studied microvesicle parameters were revealed between high on-treatment platelet reactivity and non-high on-treatment platelet reactivity subjects in either study subgroup. However, elevated concentrations of PAC-1+/CD61+, CD62P+/CD61+ and CD31+/CD61+ microvesicles were found in stroke patients with treatment failure, defined in this study as a recurrent vascular events in a one-year follow-up period. Conclusions: This study revealed no relationship between circulating microvesicle number and platelet aggregation. The procoagulant and proinflammatory phenotype of circulating platelet-derived microvesicles might contribute to acetylsalicylic acid treatment failure.

scholarly journals A comparison of feature extraction methods for prediction of neuropsychological scores from functional connectivity data of stroke patients

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Federico Calesella ◽  
Alberto Testolin ◽  
Michele De Filippo De Grazia ◽  
Marco Zorzi
Keyword(s):  
Feature Extraction ◽  
Functional Connectivity ◽  
Dimensionality Reduction ◽  
Verbal Memory ◽  
Resting State ◽  
Component Analysis ◽  
Model Complexity ◽  
Stroke Patients ◽  
Prediction Ability ◽  
The Impact

AbstractMultivariate prediction of human behavior from resting state data is gaining increasing popularity in the neuroimaging community, with far-reaching translational implications in neurology and psychiatry. However, the high dimensionality of neuroimaging data increases the risk of overfitting, calling for the use of dimensionality reduction methods to build robust predictive models. In this work, we assess the ability of four well-known dimensionality reduction techniques to extract relevant features from resting state functional connectivity matrices of stroke patients, which are then used to build a predictive model of the associated deficits based on cross-validated regularized regression. In particular, we investigated the prediction ability over different neuropsychological scores referring to language, verbal memory, and spatial memory domains. Principal Component Analysis (PCA) and Independent Component Analysis (ICA) were the two best methods at extracting representative features, followed by Dictionary Learning (DL) and Non-Negative Matrix Factorization (NNMF). Consistent with these results, features extracted by PCA and ICA were found to be the best predictors of the neuropsychological scores across all the considered cognitive domains. For each feature extraction method, we also examined the impact of the regularization method, model complexity (in terms of number of features that entered in the model) and quality of the maps that display predictive edges in the resting state networks. We conclude that PCA-based models, especially when combined with L1 (LASSO) regularization, provide optimal balance between prediction accuracy, model complexity, and interpretability.

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

scholarly journals Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early Sleep Apnoea Treatment in Stroke)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Simone B. Duss ◽  
Anne-Kathrin Brill ◽  
Sébastien Baillieul ◽  
Thomas Horvath ◽  
Frédéric Zubler ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Acute Stroke ◽  
Acute Ischaemic Stroke ◽  
Sleep Apnoea ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Adaptive Servo Ventilation ◽  
Randomized Controlled ◽  
The Impact

Abstract Background Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).

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