Faculty Opinions recommendation of Erythropoietin improves long-term neurological outcome in acute ischemic stroke patients: a randomized, prospective, placebo-controlled clinical trial.

Introduction: Ticagrelor is one of the most recent antiplatelet drugs used to treat ischemic heart disease. Its efficacy may equal or exceed aspirin in improving clinical outcomes in patients with acute ischemic stroke who are ineligible for rt-PA. Aim of the Work: We aimed at evaluating the safety (as a primary endpoint) and efficacy (as a secondary endpoint) of a 180 mg loading dose of ticagrelor given within 9 h from the onset of first-ever ischemic stroke. Methods: We conducted an open-label, randomized prospective controlled clinical trial between May 2019 and September 2020 on patients who presented with their first-ever ischemic stroke and were recruited from the emergency department, of Kafr el-sheik University Hospitals, Egypt. Eligible patients randomly received aspirin or ticagrelor loading and maintenance doses. Treatment began within 9 h of stroke onset. Results: Aspirin was given to 84 patients; ticagrelor was given to 85. There was no significant difference between the 2 groups regarding the hemorrhagic and nonhemorrhagic complications. Patients who received ticagrelor had a better outcome regarding NIHSS improvement at 2 days and 1 week or discharge and a favorable mRS score after 1 week or discharge and at 90-day follow-up. Conclusion: Ticagrelor was noninferior to aspirin regarding safety profile. Compared with aspirin, ticagrelor had a better clinical outcome based on NIHSS and mRS in first-ever acute ischemic stroke patients who received it within 9 h from symptom onset, leading to a shorter hospital stay.

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Abstract 176: Long Term Mortality in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation According to Location and Burden of Cerebral Microbleeds

Stroke ◽

10.1161/str.45.suppl_1.176 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Tae-Jin Song ◽

Jinkwon Kim ◽

Dongbeom Song ◽

Yong-Jae Kim ◽

Hyo Suk Nam ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Hemorrhagic Stroke ◽

Independent Predictor ◽

Stroke Patients ◽

Risk Of Death ◽

Long Term Mortality

Background: Cerebral microbleeds (CMBs) were predictive of mortality in elderly and considered as a putative marker for risk of intracranial hemorrhage. Stroke patients with non valvular atrial fibrillation (NVAF) require anticoagulation, which increases the risk of hemorrhages. We investigated association of CMBs with the long term mortality in acute ischemic stroke patients with NVAF. Methods: During 6 years , consecutive ischemic stroke patients who had NVAF and who had undergone brain MRI with a gradient-recalled echo sequence were enrolled. Long-term mortality and causes of death were identified using data from Korean National Statistical Office. Survival analysis was performed whether the presence, number and location of CMBs were related with all causes, cardiovascular, and cerebrovascular mortality during follow-up. Results: Total 506 patients were enrolled during the study period and were followed up for median 2.5 years. CMBs were found in 30.8% of patients (156/506). Oral anticoagulation with warfarin was prescribed at discharge in 477 (82.7%) patients. During follow up, 177 (35%) patients died and cerebrovascular death was noted in 93 patients (81 ischemic stroke and 12 hemorrhagic stroke). After adjusting age, sex and significant variables in univariate analysis (p<0.1), multiple CMBs (≥5) were the independent predictor for all-cause, cardiovascular and ischemic stroke mortalities. The strictly lobar CMBs were associated with hemorrhagic stroke mortality in multivariate Cox regression analysis (HR 4.776, p=0.032) (Figure 1). Conclusions: Multiple CMBs were the independent predictor for the long term mortality in stroke patients with NVAF. Among them, patients with strictly lobar CMBs had a high risk of death due to hemorrhagic stroke. Our findings suggest that detection of CMBs in stroke patients with NVAF are of clinical relevance for predicting long term outcome and that particular concern is necessary in those with strictly lobar CMBs for their increased risk of death due to hemorrhagic stroke. Figure 1.

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Anestezijos metodo reikšmė pacientų, sergančių ūminiu išeminiu insultu ir gydytų mechanine trombektomija, ankstyvai neurologinei būklei Relevance of anaesthesia type on early neurological outcome in acute ischemic stroke patients undergoing mechanical thrombectomy

Neurologijos seminarai ◽

10.29014/ns.2018.34 ◽

2019 ◽

Vol 22 (78) ◽

pp. 325-329

Author(s):

L. Šalaševičius ◽

A. Vilionskis

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Neurological Outcome ◽

Mechanical Thrombectomy ◽

Stroke Patients

Įvadas. Sąmonės sedacija (SS) ir bendroji endotrachėjinė anestezija (BETA) – anestezijos metodai, taikomi mechaninės trombektomijos (MTE) metu. Tikslių rekomendacijų dėl anestezijos metodo pasirinkimo MTE metu nėra. Retrospektyviniai tyrimai teigia, kad BETA yra susijusi su blogesnėmis pacientų išeitimis, tačiau naujuose klinikiniuose tyrimuose tokio skirtumo nestebima. Darbo tikslas buvo nustatyti anestezijos metodo įtaką mechaninės trombektomijos efektyvumui ir saugumui ligoniams, patyrusiems ūminį išeminį insultą. Tiriamieji ir tyrimo metodai. Į tyrimą įtraukti dviejuose Vilniaus centruose gydyti ūminį išeminį insultą patyrę ligoniai, kuriems buvo atlikta MTE. Ligoniai suskirstyti į 2 grupes pagal taikytą anestezijos metodą: bendroji endotrachėjinė anestezija (BETA) ir sąmonės sedacija (SS). Abiejose grupėse vertinti demografiniai, klinikiniai ir logistiniai rodikliai. Pirminiu vertinimo kriterijumi pasirinkta gera baigtis po 24 valandų. MTE saugumas vertintas pagal 7 parų mirštamumą ir simptominių intrasmegeninių kraujosruvų (sISK) dažnį. Rezultatai. Į tyrimą įtraukta 248 pacientai. 105 pacientams (42,3 %) taikyta BETA ir 143 (57,7 %) – SS. Pagal pradines charakteristikas abi grupės statistiškai nesiskyrė, išskyrus prieširdžių virpėjimo dažnį (55,9 % – SS vs 37,1 % – BETA grupėje, p = 0,003) ir intraveninės trombolizės taikymą iki MTE (66,4 % – SS grupėje ir 46,7 % – BETA grupėje, p = 0,003). Gera baigtis po 24 val. nustatyta 51,4 % (n = 54) ligonių – BETA grupėje ir 58,7 % (n = 84) ligonių – SS grupėje (p = 0,252). 7 parų mirštamumo sISK dažnis abiejose grupėse statistiškai reikšmingai nesiskyrė. Regresinė analizė parodė, kad geros baigties nepriklausomi prognoziniai veiksniai yra laikas nuo atvykimo į stacionarą iki rekanalizacijos ir sėkminga rekanalizacija. Išvados. Anestezijos tipas nėra reikšmingas mechaninės trombektomijos efektyvumo ir saugumo veiksnys ankstyvai pacientų baigčiai. Siekiant tiksliau įvertinti anestezijos reikšmę mechaninės trombektomijos baigčiai ir nustatyti procedūros baigties prognozinius veiksnius, reikalingi papildomi atsitiktinės atrankos tyrimai.

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Abstract WP398: Timing of Starting Doacs and Short- and Long-Term Clinical Outcomes for Acute Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation: The Samurai-nvaf Study

Stroke ◽

10.1161/str.49.suppl_1.wp398 ◽

2018 ◽

Vol 49 (Suppl_1) ◽

Author(s):

Tadataka Mizoguchi ◽

Masahito Takagi ◽

Shoichiro Sato ◽

Hiroshi Yamagami ◽

Toshihiro Ide ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Stroke Patients ◽

Nonvalvular Atrial Fibrillation ◽

Short And Long Term

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Pneumonia in acute ischemic stroke patients requiring invasive ventilation: Impact on short and long-term outcomes

Journal of Infection ◽

10.1016/j.jinf.2019.06.012 ◽

2019 ◽

Vol 79 (3) ◽

pp. 220-227 ◽

Cited By ~ 4

Author(s):

Etienne de Montmollin ◽

Stephane Ruckly ◽

Carole Schwebel ◽

Francois Philippart ◽

Christophe Adrie ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Invasive Ventilation ◽

Stroke Patients ◽

Long Term Outcomes ◽

Short And Long Term

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O-001 Thrombectomy for acute ischemic stroke patients aged 80 years or older: long-term outcomes in 233 patients

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2011-010097.1 ◽

2011 ◽

Vol 3 (Suppl_1) ◽

pp. A1-A1

Author(s):

R. Nogueira ◽

W. Smith ◽

T. Jovin ◽

D. Liebeskind ◽

R. Budzik ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Patients ◽

Long Term Outcomes

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Elevated Serum Fibrin-Monomer Levels are Associated With High Long-Term Cerebrovascular Event Rates in Acute Ischemic Stroke Patients

Circulation Journal ◽

10.1253/circj.71.1573 ◽

2007 ◽

Vol 71 (10) ◽

pp. 1573-1579 ◽

Cited By ~ 4

Author(s):

Harutoshi Tamura ◽

Osamu Hirono ◽

Hidenobu Okuyama ◽

Ling Liu ◽

Satoshi Nishiyama ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Elevated Serum ◽

Cerebrovascular Event ◽

Stroke Patients ◽

Fibrin Monomer ◽

Event Rates

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Abstract WP94: Higher Mortality in Slow Blood Pressure Droppers: Blood Pressure Trajectory Groups of 1-Year After Acute Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.wp94 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Keon-Joo Lee ◽

Beom Joon Kim ◽

Moon-Ku Han ◽

Joon-Tae Kim ◽

Kang Ho Choi ◽

...

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Symptom Onset ◽

Time Course ◽

Information Criterion ◽

Stroke Recurrence ◽

Stroke Patients ◽

Composite Events

Introduction: Although the effect of blood pressure in post-stroke outcome is well recognized, the long-term time course of BP following acute ischemic stroke and it’s influence to outcomes have not been well elucidated. Method: From a multicenter prospective registry of acute ischemic stroke patients, a total of 5,514 patients with measurement of systolic blood pressure (SBP) in more than 2 of 7 prespecified time points up to 1 year after symptom onset were analyzed. The patients were grouped according to longitudinal SBPs of each patient using a group-based trajectory model, and number of groups were determined by the optimal delta-Bayesian Information Criterion. Outcome measures, which were stroke recurrence, mortality and composite of each events along with myocardial infarction were prospectively collected up to 1 year after symptom onset. Results: Patients were categorized into four groups according to their SBP trajectories: low (27.0%), moderate (59.5%), persistently high (1.2%), and slowly dropping (12.4%). After adjustment for pre-determined covariates, there were higher risk of stroke recurrence in persistently high SBP group (hazard ratio (HR), 2.28 [95% confidence interval (CI), 1.01-5.12]). Mortality was higher only in the slowly dropping SBP group (HR, 1.50 [95% CI, 1.09-2.05]). Composite events were higher in both persistently high (HR, 1.96 [95% CI, 1.02-3.75]) and slowing dropping (HR, 1.54 [95% CI, 1.18-2.00]) SBP groups. Conclusion: There were a group of patterns in long-term longitudinal SBP changes after acute ischemic stroke. Especially, slow BP droppers might have a distinct nature with higher mortality and would be a target for future investigations.

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