scholarly journals Presence of Intracranial Artery Calcification Is Associated With Mortality and Vascular Events in Patients With Ischemic Stroke After Hospital Discharge

Stroke ◽  
2011 ◽  
Vol 42 (12) ◽  
pp. 3447-3453 ◽  
Author(s):  
Jean-Marc Bugnicourt ◽  
Claire Leclercq ◽  
Jean-Marc Chillon ◽  
Momar Diouf ◽  
Hervé Deramond ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Discharge ◽  
Intracranial Artery ◽  
Vascular Events ◽  
Intracranial Artery Calcification

Recurrent vascular events in patients with ischemic stroke/TIA and atrial fibrillation in relation to secondary prevention at hospital discharge

2004 ◽  
Vol 116 (24) ◽  
pp. 834-838 ◽  
Author(s):  
Susanne Tentschert ◽  
Silvia Parigger ◽  
Veronika Dorda ◽  
Kathrin Bittner ◽  
Daniel Unterbuchschachner ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Secondary Prevention ◽  
Hospital Discharge ◽  
Vascular Events

Intracranial Artery Calcification: A Newly Identified Risk Factor of Ischemic Stroke

2007 ◽  
Vol 17 (4) ◽  
pp. 300-303 ◽  
Author(s):  
Xiang-yan Chen ◽  
Wynnie Wai Man Lam ◽  
Ho Keung Ng ◽  
Yu-hua Fan ◽  
Ka Sing Wong
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Intracranial Artery ◽  
Intracranial Artery Calcification

Abstract P174: Effects of Immediate Blood Pressure Reduction on Death and Major Disability in Acute Ischemic Stroke Patients According to Time from Onset to Treatment

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tan Xu ◽  
Yonghong Zhang ◽  
Yingxian Sun ◽  
Chung-Shiuan Chen ◽  
Jing Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Hospital Discharge ◽  
Odds Ratio ◽  
Antihypertensive Treatment ◽  
Recurrent Stroke ◽  
Stroke Onset ◽  
Vascular Events

Introduction: Although elevated blood pressure (BP) is very common in patients with acute ischemic stroke, the management of hypertension among them remains controversial. Hypothesis: We tested the effects of immediate BP reduction on death and major disability at 14 days or hospital discharge and 3-month follow-up in patients with acute ischemic stroke according to time from stroke onset to initiation of antihypertensive treatment (<12, 12-23, and ≥24 hours). Methods: The China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) randomly assigned patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP) to receive antihypertensive treatment (N=2,038) or to discontinue all antihypertensive medications (N=2,033) during hospitalization. Study outcomes were assessed at 14 days or hospital discharge and 3-month post-treatment follow-up. The primary outcome was death and major disability (modified Rankin Scale score≥3), and secondary outcomes included recurrent stroke and vascular events. Results: Mean SBP was reduced 12.7% in the antihypertensive treatment group and 7.2% in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mmHg in the antihypertensive treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At 14 days or hospital discharge, the primary and secondary outcomes were not significantly different between treatment and control groups according to time from onset to treatment. At the 3-month follow-up, death or major disability (odds ratio 0.73, 95% CI 0.55-0.97, p=0.03), recurrent stroke (odds ratio 0.24, 95% CI 0.08-0.72, p=0.01), and vascular events (odds ratio 0.41, 95% CI 0.18-0.96, p=0.04) were significantly reduced in the antihypertensive treatment group among participants with time from stroke onset to treatment initiation ≥24 hours only. Conclusion: Among patients with acute ischemic stroke, BP reduction with antihypertensive medications might reduce 3-month death and major disability, recurrent stroke, and vascular events among those who initiated antihypertensive treatment after 24 hours from stroke onset.

STUDY ON THRIVE SCORE IN THE PROGNOSIS OF ISCHEMIC STROKE

2017 ◽  
pp. 22-24
Author(s):  
Thi Thao Nhi Tran ◽  
Dinh Toan Nguyen
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Regression Models ◽  
Cross Sectional Study ◽  
High Rate ◽  
Vascular Events ◽  
Cross Sectional ◽  
Key Words Ischemic Stroke ◽  
Outcome Mortality ◽  
Better Than

Background and Purpose: Stroke is the second cause of mortality and the leading cause of disability. Using the clinical scale to predict the outcome of the patient play an important role in clinical practice. The Totaled Health Risks in Vascular Events (THRIVE) score has shown broad utility, allowing prediction of clinical outcome and death. Methods: A cross-sectional study conducting on 102 patients with acute ischemic stroke using THRIVE score. The outcome of patient was assessed by mRankin in the day of 30 after stroke. Statistic analysis using SPSS 15.0. Results: There was 60.4% patient in the group with THRIVE score 0 – 2 points having a good outcome (mRS 0 - 2), patient group with THRIVE score 6 - 9 having a high rate of bad outcome and mortality. Having a positive correlation between THRIVE score on admission and mRankin score at the day 30 after stroke with r = 0.712. THRIVE score strongly predicts clinical outcome with ROC-AUC was 0.814 (95% CI 0.735 - 0.893, p<0.001), Se 69%, Sp 84% and the cut-off was 2. THRIVE score strongly predicts mortality with ROC-AUC was 0.856 (95% CI 0.756 - 0.956, p<0.01), Se 86%, Sp 77% and the cut-off was 3. Analysis of prognostic factors by multivariate regression models showed that THRIVE score was only independent prognostic factor for the outcome of post stroke patients. Conclusions: The THRIVE score is a simple-to-use tool to predict clinical outcome, mortality in patients with ischemic stroke. Despite its simplicity, the THRIVE score performs better than several other outcome prediction tools. Key words: Ischemic stroke, THRIVE, prognosis, outcome, mortality

scholarly journals Bypass Surgery for Ischemic Stroke Caused by Intracranial Artery Stenosis or Occlusion

2018 ◽  
Vol 4 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Ismatullah Soufiany ◽  
Khalil Ahmad Hijrat ◽  
Spina Soufiany ◽  
Lukui Chen
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Vegetative State ◽  
Superficial Temporal Artery ◽  
Case Series ◽  
Temporal Artery ◽  
Artery Stenosis ◽  
Intracranial Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

Surgical revascularization may be beneficial in patients with ischemic stroke caused by intracranial stenosis or occlusion who are ineligible for thrombolysis. Objective To evaluate the outcome of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in ischemic stroke caused by intracranial artery stenosis or occlusion. Methods We retrospectively studied successive case series of 19 patients who underwent surgical treatment between 2013–2017 of STA-MCA bypass. Surgical procedure was performed for the patients with acute ischemic stroke who were ineligible for thrombolysis. Results Of the 19 patients enrolled, symptom aggravation occurred during medical treatment, the patients were ineligible for thrombolysis despite being within 8 hours of symptom onset. Bypass significantly improved National Institutes of Health Stroke Scale scores, mean patient age was 78.05 years (range, 39–78 y). However, male 11 (57.95%) out of nineteen patients were presented with left-sided-lesions while female 8 (42%) had right-sided lesions with significant infarction growth by diffusion weighted imaging achieved, after surgical maneuver. No major complications occurred intraoperatively, in contrast to 2 (10.5%) minor manifestation were suffering minor complications probably they included the remote infarction (posterior cerebral artery territory). Pooled analysis with our patients showed a significant neurological improvement and a good outcome in 13 (68.4%) patients without hemorrhage or any other complication, 6 (31.6%) patients with unfavorable outcome (severe disability 2; vegetative state 4, non of them are died 0;). Conclusion STA-MCA bypass may be beneficial to patients with acute stroke or stenosis in progress who are ineligible for medical therapy. Furthermore, it appears safe when the infarction is small. These findings indicate that STA-MCA bypass could be considered as a treatment option in selected patients with ischemic stroke caused by intracranial stenosis or occlusion.

Impact of atrial fibrillation on inpatient cost for ischemic stroke in the USA

2018 ◽  
Vol 14 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Kumar Mukherjee ◽  
Khalid M Kamal
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Length Of Stay ◽  
Hospital Discharge ◽  
Significant Risk ◽  
Primary Diagnosis ◽  
Inpatient Cost ◽  
Targeted Interventions ◽  
Hospital Discharge Records ◽  
Hospital Characteristics

Background Atrial fibrillation is a significant risk factor for ischemic stroke and increases cost of treatment. Aims To estimate the incremental inpatient cost and length of stay due to atrial fibrillation among adults hospitalized with a primary diagnosis of ischemic stroke after controlling for sociodemographic, clinical, and hospital characteristics in a nationally representative discharge record of US population. Methods Hospital discharge records with a primary diagnosis of ischemic stroke were identified from the National Inpatient Sample data for the years 2010–2013. Generalized linear model with log link and least-square means were utilized to estimate the incremental inpatient cost and length of stay in ischemic stroke due to atrial fibrillation after controlling for sociodemographic, clinical, and hospital characteristics. Results Among 434,544 hospital discharge records with a primary diagnosis of ischemic stroke, 90,190 (20.76%) discharge records had a secondary diagnosis of atrial fibrillation. The average inpatient cost for all discharge records with a primary diagnosis of ischemic stroke was (mean = $13,072, median = $9270.87) significantly (p < 0.0001) higher compared to all discharge records without ischemic stroke (mean = $12,543.07, median = $7517.13). The mean length of stay for all records was 4.55 days (95% CI = 4.53–4.56). Among those identified with ischemic stroke, adjusted mean inpatient cost was higher by $2829 (95% CI = $2708–$2949) and mean length of stay was greater by 0.85 (95% CI = 0.81–0.89) for those with atrial fibrillation compared to those without. Conclusions The presence of atrial fibrillation was associated with increased inpatient cost and length of stay among patients diagnosed with ischemic stroke. Increased inpatient cost and length of stay call for a more comprehensive patient care approach including targeted interventions among adults diagnosed with ischemic stroke and atrial fibrillation, which could potentially reduce the overall cost in this population.

Predictors of mortality and the risk of recurrent vascular events in ischemic stroke patients

2017 ◽  
Vol 381 ◽  
pp. 997
Author(s):  
Y. Shojima ◽  
Y. Ueno ◽  
R. Tanaka ◽  
K. Yamashiro ◽  
N. Miyamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Patients ◽  
Vascular Events ◽  
Predictors Of Mortality

Predictors of Nasogastric Tube Removal Before Acute Hospital Discharge in First-Ever Ischemic Stroke Patients

2016 ◽  
Vol 97 (10) ◽  
pp. e49
Author(s):  
Yun-Shan Yen ◽  
Willy Chou ◽  
Ya-Fang Hsu ◽  
Mei-Ju Ko ◽  
Daniel Chiung Jui Su ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Discharge ◽  
Nasogastric Tube ◽  
Acute Hospital ◽  
Stroke Patients ◽  
Tube Removal

Abstract TP416: Comparative Effectiveness of Addition of Antiplatelet to Oral Anticoagulant in Acute Ischemic Stroke With Atrial Fibrillation

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Joon-tae Kim ◽  
Hee-Joon Bae ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Oral Anticoagulant ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards ◽  
Large Artery ◽  
Vascular Events ◽  
Nihss Score ◽  
Composite Events

Introduction: Atrial fibrillation (AF) and large artery diseases (LAD) share several risk factors and often coexist in the same patient. Optimal treatments for acute ischemic stroke (AIS) patients with concomitant AF and LAD have not been extensively studied so far. Objective: This study aimed to compare the effectiveness of the addition of antiplatelet (AP) to oral anticoagulant (OAC) with that of OAC alone in AIS with AF according to the LAD. Methods: Using a multicenter stroke registry, acute (within 48h of onset) and mild-to-moderate (NIHSS score ≤15) stroke patients with AF were identified. Propensity scores using IPTW were used to adjust baseline imbalances between the OAC+AP group and the OAC alone group in all patients and in each subgroup by LAD. The primary outcome was major vascular events, defined as the composite of recurrent stroke, MI, and all-cause mortality at up to 3 months after index stroke. Results: Among the 5469 patients (age, 72±10yrs; male, 54.9%; initial NIHSS score, 4 [2-9]), 79.0% (n=4323) received OAC alone, and 21.0% (n=1146) received OAC+AP. By weighted Cox proportional hazards analysis, a tendency of increasing the risk of 3-months primary composite events in the OAC+AP group vs the OAC alone (HR 1.36 [0.99-1.87], p=0.06), with significant interaction with treatments and LAD (Pint=0.048). Briefly, among patients with moderate-to-severe large artery stenosis, tendency of decrease in 3-months primary composite events of the OAC+AP group, compared with OAC alone group, was observed (HR 0.54 [0.17-1.70]), whereas among patients with complete occlusion, the OAC+AP group markedly increased the risk of 3-months composite events (HR 2.00 [1.27-3.15]), compared with the OAC alone group. No interaction between direct oral anticoagulant and warfarin on outcome was observed (Pint=0.35). Conclusion: In conclusion, treatment with addition of AP to OAC had a tendency to increase the risk of 3-months vascular events, compared with OAC alone in AIS with AF. However, the effects of antithrombotic treatment could be modified according to the LAD, with substantial benefits of OAC alone in subgroup of large artery occlusion. Our results address the need for the further study to tailor the optimal treatment in AIS with concomitant AF and LAD.

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