scholarly journals Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA

2018 ◽  
Vol 379 (3) ◽  
pp. 215-225 ◽  
Author(s):  
S. Claiborne Johnston ◽  
J. Donald Easton ◽  
Mary Farrant ◽  
William Barsan ◽  
Robin A. Conwit ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Acute Ischemic Stroke

Abstract 2771: Incidence of High Risk Atherosclerotic Lesions in Intracranial and Extracranial Carotid Arteries in Patients with Acute Ischemic Stroke: A 3.0T Magnetic Resonance Imaging Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Xihai Zhao ◽  
Huilin Zhao ◽  
Feiyu Li ◽  
Jie Sun ◽  
Ye Cao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Cerebral Artery ◽  
Carotid Arteries ◽  
Atherosclerotic Plaques ◽  
Slice Thickness ◽  
Atherosclerotic Lesions ◽  
Vascular Beds

Introduction Rupture of vulnerable atherosclerotic plaques in the intracranial and extracranial carotid arteries could trigger ischemic stroke. However, the incidence of high risk atherosclerotic lesions in these vascular beds is not well known. This study sought to investigate the incidence of high risk atherosclerotic lesions in intracranial and extracranial carotid arteries in stroke patients using magnetic resonance (MR) imaging. Methods Seventy-five patients (mean age 62.7 years, 56 males) with acute ischemic stroke underwent MR imaging for index carotid arteries, assigned as the same side as the brain lesions, with a Philips 3.0T MR scanner. Intracranial carotid MR angiography was performed using 3D TOF sequence with FOV of 23 × 23 cm 2 , matrix of 256 × 256, and a slice thickness of 1mm. The multi-contrast vessel wall images (3D TOF, T1W, T2W, and MP-RAGE) were acquired for extracranial carotid arteries with FOV of 14 × 14 cm 2 , matrix of 256 × 256, and slice thickness of 2 mm. The intracranial artery includes middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA). The extracranial carotid artery was divided into internal carotid artery (ICA), bulb, and common carotid artery (CCA). Luminal stenosis for each intracranial and extracranial carotid segment was measured and graded (normal or mild = 0-29%, moderate =30-69%, severe=70-99%). Normalized wall index (NWI = wall area/total vessel area × 100%), and presence/absence of calcification, lipid-rich necrotic core (LRNC), and intraplaque hemorrhage (IPH) and/or fibrous cap rupture in each extracranial carotid segment were determined. Results MCAs developed more severe stenotic lesions (24.6%), followed by extracranial carotids (16.5%), PCAs (5.4%), and ACAs (4.1%) in stroke patients ( Figure 1 A). For extracranial carotid arteries, ICAs showed the largest plaque burden as measured by NWI (44.3%±13.1%), followed by bulbs (39.4%±13%), and CCAs (37%±6.8%). Compared to CCAs, ICAs and bulb regions had more LRNCs (38.4% and 49.3% for ICA and bulb respectively) and IPH and/or rupture (11% and 9.6% for ICA and bulb respectively) ( Figure 1 B). Conclusions In patients with acute ischemic stroke, high risk atherosclerotic plaques can be found in both intracranial and extracranial carotid arteries, particularly in the MCA, ICA and bulb regions. Compared to extracranial carotid arteries, intracranial arteries develop more high risk lesions. The findings of this study suggest the necessity for early screening to detect high risk atherosclerotic lesions in these carotid vascular beds prior to cerebravascular events.

Clinical conundrum: concomitant high-risk pulmonary embolism and acute ischemic stroke

2020 ◽  
Vol 27 (4) ◽  
pp. 433-439
Author(s):  
Ka U. Lio ◽  
David Jiménez ◽  
Lisa Moores ◽  
Parth Rali
Keyword(s):  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
High Risk ◽  
Acute Ischemic Stroke

scholarly journals Circular RNA FUNDC1 improves prediction of stroke associated infection in acute ischemic stroke patients with high risk

2020 ◽  
Vol 40 (6) ◽  
Author(s):  
Lei Zuo ◽  
Cai Li ◽  
Juan Zu ◽  
Honghong Yao ◽  
Fuling Yan
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Acute Ischemic Stroke ◽  
Risk Model ◽  
Area Under The Curve ◽  
Preventive Treatment ◽  
Roc Curves ◽  
Circular Rna ◽  
Diagnosis And Prognosis ◽  
Sensitivity Specificity

Abstract Identifying those patients who were at high risk of stroke associated infection (SAI) for preventive antibiotic therapy was imperative for patients’ benefits, thus improving prediction of SAI was critical for all acute ischemic stroke (AIS) patients. Circular RNA FUNDC1 (circFUNDC1) has been reported to be the diagnosis and prognosis biomarker of AIS. Therefore, the present study aimed to figure out whether circFUNDC1 could be the potential predictor of SAI that could help to guide preventive treatment. In total, 68 patients were included in the study, 26 of which had infection and 42 without. Copy number of circFUNDC1 in plasma were quantified by quantitative real-time polymerase chain reaction (qPCR). Platelet spike-in experiment and correlation analysis were conducted to explore possible origins of circFUNDC1 in plasma. A significantly elevated level of circFUNDC1 was found in SAI patients compared with not infected AIS patients (P=0.0258). Receiver operating characteristic (ROC) curves demonstrated the prediction significance of circFUNDC1, with the area under the curve (AUC) at 0.6612 and sensitivity, specificity at 69.23%, 61.90% respectively in predicting SAI. Then, when adding circFUNDC1 in the risk model, the AUC increased from 0.7971 in model A to 0.8038 in model B. Additionally, positive correlation was observed between circFUNDC1 level and neutrophils counts. WBC and neutrophil ratios were significantly elevated in SAI patients compared with non-SAI patients. Therefore, circFUNDC1 could be used to construct a risk model for the prediction of SAI that is beneficial for AIS patients’ preventive treatment.

scholarly journals Identifying Patients at High Risk for Poor Outcome After Intra-Arterial Therapy for Acute Ischemic Stroke

Stroke ◽  
2009 ◽  
Vol 40 (5) ◽  
pp. 1780-1785 ◽  
Author(s):  
Hen Hallevi ◽  
Andrew D. Barreto ◽  
David S. Liebeskind ◽  
Miriam M. Morales ◽  
Sheryl B. Martin-Schild ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
High Risk ◽  
Acute Ischemic Stroke ◽  
Poor Outcome

scholarly journals 0822 Association Between High Risk Of Obstructive Sleep Apnea And Intracranial Carotid Arterial Calcification In Acute Ischemic Stroke

SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A330-A330
Author(s):  
Kwang Ik Yang ◽  
Ho Geol Wo ◽  
Jo Sung Jung ◽  
Se Won Oh ◽  
Seung Cheol Lee ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Ischemic Stroke ◽  
Sleep Apnea ◽  
High Risk ◽  
Acute Ischemic Stroke ◽  
Arterial Calcification ◽  
Obstructive Sleep ◽  
Carotid Arterial

Abstract TMP58: A Simple Score to Assess the Risk of Paroxysmal Atrial Fibirillation in Acute Ischemic Stroke Patients

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kotaro Yoshioka ◽  
Kosuke Watanabe ◽  
Masaki Hidume ◽  
Toshiro Kanazawa ◽  
Satoru Ishibashi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
High Risk ◽  
Acute Ischemic Stroke ◽  
Demographic Data ◽  
Ecg Monitoring ◽  
Stroke Patients ◽  
Holter Ecg ◽  
Multiple Variable ◽  
History Of

Introduction: Paroxysmal atrial fibrillation (PAF) is an important risk factor for ischemic stroke and has similar risk to permanent atrial fibrillation (AF), but detecting PAF is challenging. Holter ECG has a low sensitivity. Continuous ECG monitoring and implanted event recorders are high cost and inconvenient for elderly patients. Identifying patients at a particularly high risk of PAF by using scores may represent a reasonable alternative. We aimed to elucidate a clinical profile of patients with PAF including those risk factors by multiple variable analysis and create a score to detect patients with PAF. Methods: Consecutive patients with acute ischemic strokes from 2010 to 2011 were prospectively analyzed. We excluded patients with permanent AF. All patients without permanent AF had 24-hour Holter ECG and ECG monitoring on the ward within 7 days. Collected data included demographic data, clinical data including history of irregular rhythm or antiarrhythmic agent and transthoracic echocardiography data. PAF was documented by review of medical history, baseline ECG, ECG monitoring and Holter ECG. Results: We studied 197 stroke patients and excluded 45 (23%) patients with permanent AF. Thirty-five (23%) of 152 patients had PAF. Univariate analyses revealed that older age (p = 0.008), arrhythmia history (p <0.0001), higher brain natriuretic peptide (BNP) (p <0.0001) and left atrial dilatation (p = 0.007) were significantly associated with documented PAF more than without documented AF. Arrhythmia history (OR 11.4, 95% CI 2.4-54.0), BNP ≥ 85 pg/ml (OR 24.2, 95% CI 6.8-86.1) and left atraial (LA) diameter ≥ 40 mm (OR 3.3, 95% CI 1.1-9.5) were significantly independent predictive factors of PAF by logistic regression analysis. We calculated a score (BNP [≥ 150 pg/ml:3 point, 149-85 pg/ml:2], arrhythmia history[yes:2] and dilatation of LA [≥ 40 mm:1]. The area under the ROC curve for the documented PAF group was 0.908 and a total score ≥ 3 had a sensitivity of 83% and a specificity of 87%. Conclusions: In acute ischemic stroke patients without permanent AF, patients with documented PAF had significantly more history of arrhythmia, higher BNP and LA dilatation than those without documented AF. The new score can be useful to identify individuals at high risk of PAF.

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