scholarly journals Impact of Diabetes Mellitus on 1867 Acute Ischemic Stroke Patients. A Bergen NORSTROKE Study

2015 ◽  
pp. 1-11 ◽  
Author(s):  
Aliona Nacu ◽  
◽  
Lars Thomassen ◽  
Annette Fromm ◽  
Anna Bjerkreim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients

scholarly journals KORELASI KADAR LAJU ENDAP DARAH DENGAN NILAI ASPECTS PADA PASIEN STROKE ISKEMIK

2015 ◽  
Vol 38 (1) ◽  
pp. 26
Author(s):  
Ratih Ismiranti Murni ◽  
Dwi Pudjonarko ◽  
Bambang Satoto ◽  
Sukma Imawati
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
Clinical Manifestations ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Emergency Imaging ◽  
Brain Ct Scan ◽  
Relationship Of

AbstrakStroke adalah penyebab utama ke-3 kematian di Amerika Serikat. Stroke iskemik adalah kondisi kompleks dengan etiologi dan manifestasi klinis bervariasi. CT Scan kepala adalah pencitraan darurat stroke membedakan dengan perdarahan intrakranial. Beberapa peneliti mengemukakan adanya korelasi independent dan hubungan pemeriksaan rutin biomarkers pada pasien stroke iskemik akut termasuk di dalamnya parameter inflamasi yang berperan pada patofisiologi iskemia otak. Tujuan penelitian ini mengetahui korelasi kadar LED dengan penilaian ASPECTS pada pasien stroke iskemik. Penelitian ini merupakan penelitian observasional analitik belah lintang dari catatan rekam medik. Selama periode Desember 2012 - Oktober 2014. Didapatkan 16 sampel yang memenuhi kriteria inklusi dan ekslusi. Dengan beberapa karakteristik subyek penelitian meliputi usia, jenis kelamin, hipertensi, diabetes mellitus, dislipidemia, kadar LED 1 dan 2, awitan stroke iskemik akut. Uji statistik Rank Spearman’s,dan uji bivariat maupun multivariat. Didapatkan hasil tidak ada korelasi antara nilai ASPECTS dengan kadar LED dan faktor yang mempengaruhi nilai ASPECTS.AbstractStroke is the third major cause of death in United States. Ischemic stroke results from complex conditions with various etiologies and clinical manifestations. Brain CT Scan is a stroke emergency imaging to differentiate intracranial hemorrhage. Several studies claimed there were independent correlation and relationship of biomarker in routine examination of acute ischemic stroke patients including inflammation parameters that contribute to the pathophysiology of brain ischemic. The purpose in this study was to identify correlation between ESR level and ASPECTS in ischemic stroke patients. The method of study was analytical observational cross sectional taken from medical record. It was performed in 16 patients that fulfill the inclusion and exclusion criteria during December 2012- October 2014. Several characteristics of subject that affecting ASPECTS included age, gender, hypertention, diabetes mellitus, dyslipidemia, ESR level 1 and 2, and onset of acute ischemic stroke were assessed. Analytical test was performed by Rank spearman’s test and multivariate test. There was no correlation between ASPECTS with ESR level and factors that affect ASPECTS.

scholarly journals Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus

Stroke ◽  
2019 ◽  
Vol 50 (6) ◽  
pp. 1497-1503 ◽  
Author(s):  
Matthew E. Ehrlich ◽  
Li Liang ◽  
Haolin Xu ◽  
Andrzej S. Kosinski ◽  
Adrian F. Hernandez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Type ◽  
Stroke Patients ◽  
Tissue Type Plasminogen Activator ◽  
Type Plasminogen Activator ◽  
History Of

Abstract MP41: Acute Ischemic Stroke and Coronavirus Disease 2019: An Analysis of 27,676 Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
William Baskett ◽  
Wei Huang ◽  
Daniel Shyu ◽  
Danny Myers ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Relative Risk ◽  
Confidence Interval ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Healthcare Facilities

Background and Purpose: Acute ischemic stroke may occur in patients with Coronavirus disease 2019 but risk factors, in hospital events, and outcomes are not well studied in large cohorts. We identified risk factors, co-morbidities, and outcomes in patients with Coronavirus disease 2019 with or without acute ischemic stroke and compared with patients without Coronavirus disease 2019 and acute ischemic stroke. Methods: We analyzed the data from 54 healthcare facilities using the Cerner de-identified Coronavirus disease 2019 dataset. The dataset included patients with an emergency department or inpatient encounter with a discharge diagnoses codes that could be associated to suspicion of or exposure to Coronavirus disease 2019, or confirmed Coronavirus disease 2019. Results: A total of 103 (1.3%) patients developed acute ischemic stroke among 8,163 patients with Coronavirus disease 2019. Among all Coronavirus disease 2019 patients, the proportion of patients with hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk 2.1, 95% confidence interval 1.7-2.4, p<.0001) after adjusting for potential confounders. A total of 199 (1.0%) patients developed acute ischemic stroke among 19,513 patents without Coronavirus disease 2019. Among all ischemic stroke patients, Coronavirus disease 2019 was associated with discharge to destination other than home or death (relative risk 1.2, 95% confidence interval 1.0-1.3, p=.03) after adjusting for potential confounders. Conclusions: Acute ischemic stroke was infrequent in patients with Coronavirus disease 2019 and usually occurs in presence of other cardiovascular risk factors. The risk of discharge to destination other than home or death increased two folds with occurrence of acute ischemic stroke in patients with Coronavirus disease 2019.

scholarly journals Who will benefit more from low-dose alteplase in acute ischemic stroke?

2019 ◽  
Vol 15 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Xia Wang ◽  
Keon-Joo Lee ◽  
Tom J Moullaali ◽  
Beom Joon Kim ◽  
Qiang Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Low Dose ◽  
Standard Dose ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Lower Systolic Blood Pressure ◽  
Intravenous Alteplase

Objectives Controversy persists over the benefits of low-dose versus standard-dose intravenous alteplase for the treatment of acute ischemic stroke. We sought to determine individual patient factors that contribute to the risk–benefit balance of low-dose alteplase treatment. Methods Observational study using data from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED), an international, randomized, open-label, blinded-endpoint trial that assessed low-dose (0.6 mg/kg) versus standard-dose (0.9 mg/kg) intravenous alteplase in acute ischemic stroke patients. Logistic regression models were used to estimate the benefit of good functional outcome (scores 0 or 1 on the modified Rankin scale at 90 days) and risk (symptomatic intracerebral hemorrhage), under both regimens for individual patients. The net advantage for low-dose, relative to standard-dose, alteplase was calculated by dividing excess benefit by excess risk according to a combination of patient characteristics. The algorithms were externally validated in a nationwide acute stroke registry database in South Korea. Results Patients with an estimated net advantage from low-dose alteplase, compared with without, were younger (mean age of 66 vs. 75 years), had lower systolic blood pressure (148 vs. 160 mm Hg), lower National Institute of Health Stroke Scale score (median of 8 vs. 16), and no atrial fibrillation (10.3% vs. 97.4%), diabetes mellitus (19.2% vs. 22.4%), or premorbid symptoms (defined by modified Rankin scale = 1) (16.3% vs. 37.8%). Conclusion Use of low-dose alteplase may be preferable in acute ischemic stroke patients with a combination of favorable characteristics, including younger age, lower systolic blood pressure, mild neurological impairment, and no atrial fibrillation, diabetes mellitus, or premorbid symptoms.

scholarly journals Ethnicity and Other Determinants of Quality of Functional Outcome in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 588-593
Author(s):  
Xiaoying Chen ◽  
Xia Wang ◽  
Candice Delcourt ◽  
Jingwei Li ◽  
Hisatomi Arima ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Large Vessel ◽  
Poor Hrqol ◽  
Stroke Patients ◽  
Quality Of Life Scale ◽  
Life Scale

Background and Purpose— Patient-centered outcomes are important. We aimed to determine predictors of health-related quality of life (HRQoL) and develop utility-weighted modified Rankin Scale (mRS) scores in thrombolyzed acute ischemic stroke patients from both arms of ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). Methods— ENCHANTED was an international quasi-factorial clinical trial of different doses of intravenous alteplase and intensities of blood pressure control in acute ischemic stroke patients, with outcomes on the 5-Dimensional European Quality of Life Scale and mRS assessed at 90 days post-randomization. Logistic regression models were used to identify baseline predictors of poor HRQoL (≤mean 5-Dimensional European Quality of Life Scale utility scores). Ordinary least squares regression derived utility-weighted mRS scores. Results— In 4016 acute ischemic stroke patients with complete 5-Dimensional European Quality of Life Scale and mRS data, independent predictors of poor HRQoL were older age (odds ratio, 1.19 [95% CI, 1.12–1.27], per 10-year increase), non-Asian ethnicity (1.91 [1.61–2.27]), greater stroke severity on the National Institutes of Health Stroke Scale (1.11 [1.09–1.12]), diabetes mellitus (1.41 [1.18–1.69]), premorbid disability (mRS score 1 versus 0; 1.62 [1.33–1.97]), large vessel atheromatous pathogenesis (1.32 [1.12–1.54]), and proxy respondent (2.35 [2.01–2.74]). Sensitivity analyses indicate the ethnicity influence on HRQoL was driven by the high proportion of Chinese (62.9% of Asian) participants with better HRQoL compared with non-Chinese or other Asian groups. Derived utility values across mRS scores 0 to 5 were 0.977, 0.885, 0.748, 0.576, 0.194, and −0.174, respectively. Correlations between mRS and 5-Dimensional European Quality of Life Scale scores were stronger in Asians. Conclusions— HRQoL is worse after thrombolyzed acute ischemic stroke in the elderly, non-Asians, with greater initial severity, diabetes mellitus, premorbid disability, due to large vessel atheroma, and proxy assessment. The broader significance of better HRQoL in Asians is tempered by Chinese participants dominating analyses. From utility-weighted mRS scores indicating the greatest steps in mRS scores are between 5 and 3, treatments to avoid major disability provide the greatest benefits for patients. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT01422616.

Abstract T MP90: Relationship Between Daily Blood Glucose Variability and Neurological Outcome in Acute Ischemic Stroke Patients With Diabetes Mellitus

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Satoshi Kubo ◽  
Naohisa Hosomi ◽  
Takeshi Yoshimoto ◽  
Syuichiro Neshige ◽  
Takahiro Himeno ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Blood Glucose ◽  
Acute Ischemic Stroke ◽  
Glucose Variability ◽  
Unfavorable Outcome ◽  
Stroke Patients ◽  
Stroke Outcomes ◽  
Blood Glucose Variability ◽  
Patients With Diabetes

BACKGROUND: Although hyperglycemia in acute stroke is associated with poor stroke outcomes, it remains unclear whether blood glucose variability are also associated with stroke outcomes. In this study, we examined the relationships between daily blood glucose variability and early neurological outcome in acute ischemic stroke patients with diabetes mellitus. METHODS: Subjects were a total of 329 acute ischemic stroke patients (216 male, 70.9 ± 9.6 years) who were either already undergoing treatment for diabetes or had a hemoglobin A1c level of >5.8% at admission from July 2006 to June 2009. The consecutive morning fasting blood glucose (BG) levels were evaluated during 7 days from admission and described as mean and successive variation (SV). The unfavorable outcome was defined by a modified Rankin Scale score of 4 to 6 at discharge. RESULTS: The patients with unfavorable outcome (n=86) were older (75.7 ± 10.5 vs. 69.2 ± 8.6 years, p<0.001), more frequently female (47.7% vs. 29.6%, p=0.003), less commonly had dyslipidemia (40.7% vs. 60.9%, p=0.001), less commonly took oral hypoglycemic agents (30.2% vs. 53.5%, p<0.001), and had higher NIHSS scores (median 9 vs. 3, p<0.001) than those without. The mean BG levels and SV levels in patients with unfavorable outcome were higher than those in patients without (163.3 ± 39.0 vs. 147.9 ± 34.0 mg/dl; p<0.001 and 33.7 ± 24.9 vs. 23.2 ± 15.3 mg/dl; p<0.001, respectively). SV levels was independently associated with unfavorable outcome (OR 1.023, 95%CI 1.004-1.042, p=0.015) using logistic regression analysis controlling age, sex hypertension systolic blood pressure, NIHSS score at admission and insulin use during hospitalization, which are selected using stepwise method. However mean BG levels did not remained as factor, which associated with unfavorable outcome with step wise method. CONCLUSION: Increased blood glucose variability, but not mean BG, was independently related to unfavorable outcome at discharge in acute ischemic stroke patients with diabetes mellitus.

Thrombolysis outcomes in acute ischemic stroke patients with prior stroke and diabetes mellitus

Neurology ◽  
2011 ◽  
Vol 77 (21) ◽  
pp. 1866-1872 ◽  
Author(s):  
N. K. Mishra ◽  
N. Ahmed ◽  
A. Davalos ◽  
H. K. Iversen ◽  
T. Melo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Prior Stroke
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