25,516 results match your criteria Transient Ischemic Attack


Toward neuroimaging-based network biomarkers for transient ischemic attack.

Hum Brain Mapp 2019 Apr 19. Epub 2019 Apr 19.

Institute for Brain Research and Rehabilitation, Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.

Stroke is associated with topological disruptions of large-scale functional brain networks. However, whether these disruptions occur in transient ischemic attack (TIA), an important risk factor for stroke, remains largely unknown. Combining multimodal MRI techniques, we systematically examined TIA-related topological alterations of functional brain networks, and tested their reproducibility, structural, and metabolic substrates, associations with clinical risk factors and abilities as diagnostic and prognostic biomarkers. Read More

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http://dx.doi.org/10.1002/hbm.24602DOI Listing

Utilization and safety of extracranial-intracranial bypass surgery in symptomatic steno-occlusive disorders.

Brain Circ 2019 Jan-Mar;5(1):32-35. Epub 2019 Mar 27.

Department of Neurology, UT Health McGovern School of Medicine, Houston, Texas, USA.

Objective: The objective of this study was to investigate patterns of utilization and safety of extracranial-intracranial (EC-IC) bypass in patients with symptomatic cerebrovascular steno-occlusive disorders.

Methods: Patients with one of the steno-occlusive conditions (defined as symptomatic intracranial stenosis, extracranial stenosis, and moyamoya disease) were identified using all nonfederal hospitalizations in New York (2005-2014) and Florida (2005-2015). EC-IC bypass surgery was defined using the corresponding procedure codes. Read More

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http://dx.doi.org/10.4103/bc.bc_33_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458777PMC

Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):207-211

Department of Radiodiagnosis, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India.

Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Read More

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http://www.ruralneuropractice.com/text.asp?2019/10/2/207/254
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http://dx.doi.org/10.4103/jnrp.jnrp_362_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454959PMC
April 2019
2 Reads

Medium-term results of undersized angioplasty and stenting for symptomatic high-grade intracranial atherosclerotic stenosis with Enterprise.

Interv Neuroradiol 2019 Apr 16:1591019919832244. Epub 2019 Apr 16.

1 Department of Radiology, University of Health Sciences, Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Purpose: The aim of this retrospective study is to evaluate medium-term results of undersized balloon angioplasty and stenting for symptomatic high-grade (70-99%) stenosis of a major intracranial artery with Enterprise stent.

Methods: This study included 68 consecutive symptomatic (recurrent transient ischemic attack (TIA) or ischemic stroke under dual antiplatelet treatment) patients with high-grade (70-99%) stenosis of a major intracranial artery who were endovascularly treated with undersized balloon angioplasty and Enterprise stent deployment between July 2012 and December 2017. Primary outcomes were any stroke or death within 30 days after procedure. Read More

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http://dx.doi.org/10.1177/1591019919832244DOI Listing

Long-Term Stroke Recurrence after Transient Ischemic Attack: Implications of Etiology.

J Stroke 2019 Apr 17. Epub 2019 Apr 17.

Department of Neurology, Hospital del Mar, Barcelona, Spain.

Background And Purpose: To analyze long-term stroke recurrence (SR) characteristics after transient ischemic attack (TIA) according to initial etiological classification.

Methods: A prospective cohort of 706 TIA patients was followed up in a single tertiary stroke center. Endpoint was SR. Read More

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http://dx.doi.org/10.5853/jos.2018.03601DOI Listing

[Predictors for development of major cardiovascular events in elderly patients with severe and extremely severe chronic obstructive pulmonary disease in combination with early stages of chronic kidney disease].

Kardiologiia 2019 Apr 13;59(3S):52-60. Epub 2019 Apr 13.

State Budgetary Institution of Health Care, Territorial Clinical Hospital #2, Krasnykh Partizan 6, k. 2, Krasnodar, Russia 350012.

Aim: To study the structure of major cardiovascular events (MCVE) and to identify their independent predictors in elderly patients with severe and extremely severe chronic obstructive pulmonary disease (COPD) in combination with early stages of chronic kidney disease (CKD).

Materials And Methods: The study included 172 elderly patients with stage 3-4 COPD associated with stage 1-2 CKD. Initially, risk factors for MCVE were identified and levels of vitamin D (25 (ОН) D) were measured for all patients. Read More

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http://dx.doi.org/10.18087/cardio.2539DOI Listing
April 2019
2 Reads

Stroke and thromboembolic events in men with prostate cancer treated with definitive radiation therapy with or without androgen deprivation therapy.

Prostate Cancer Prostatic Dis 2019 Apr 15. Epub 2019 Apr 15.

VA San Diego Health Care System, La Jolla, CA, USA.

Background: There is conflicting evidence regarding the association between androgen deprivation therapy (ADT) for prostate cancer (PC) and the risk of developing stroke and thromboembolic events. Our study evaluated the association between ADT use and development of stroke, transient ischemic attack (TIA), deep vein thrombosis (DVT), and pulmonary embolism (PE) in a homogenous group of men with PC treated with definitive radiation therapy (RT) after controlling for multiple sources of confounding.

Methods: Observational cohort study of patients diagnosed with PC at the US Department of Veterans Affairs between 1 January 2001 and October 31, 2015 and treated with definitive RT. Read More

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http://dx.doi.org/10.1038/s41391-019-0150-5DOI Listing
April 2019
1 Read

Management of transient ischemic attack or nondisabling stroke related to extracranial internal carotid artery stenosis.

CMAJ 2019 Apr;191(15):E418-E422

Division of Vascular Surgery (Kapila), William Osler Health System, Brampton, Ont.; Division of Vascular Surgery (Jetty), University of Ottawa, Ottawa, Ont.; Division of Neurology, Mackenzie Health System (Basile), Vaughan, Ont.; Division of Vascular Surgery (Dubois), Western University, London, Ont.

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http://dx.doi.org/10.1503/cmaj.180735DOI Listing

Racial/ethnic disparities in patients undergoing transcatheter aortic valve replacement: Insights from the healthcare cost and utilization project's national inpatient sample.

Cardiovasc Revasc Med 2019 Apr 9. Epub 2019 Apr 9.

Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Phoenix, AZ, USA.

Purpose: To identify racial/ethnic disparities in utilization rates, in-hospital outcomes and health care resource use among Non-Hispanic Whites (NHW), African Americans (AA) and Hispanics undergoing transcatheter aortic valve replacement (TAVR) in the United States (US).

Methods And Results: The National Inpatient Sample database was queried for patients ≥18 years of age who underwent TAVR from 2012 to 2014. The primary outcome was all-cause in hospital mortality. Read More

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http://dx.doi.org/10.1016/j.carrev.2019.04.005DOI Listing
April 2019
2 Reads

Long-Term Outcome of Symptomatic Patients Undergoing Hybrid Revascularisation for Extracranial Carotid Artery Tandem Stenosis.

Eur J Vasc Endovasc Surg 2019 Apr 12. Epub 2019 Apr 12.

Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht University, the Netherlands. Electronic address:

Objectives: Carotid tandem lesions are a multilevel significant (>50%) atherosclerotic disease involving both the internal carotid artery (ICA) and either the ipsilateral common carotid artery (CCA) or the innominate artery (IA). These lesions may be challenging to treat. Current guidelines offer no definitive recommendation on the optimal treatment algorithm. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10785884183086
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http://dx.doi.org/10.1016/j.ejvs.2018.11.016DOI Listing
April 2019
2 Reads

Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD2 score combined with the position of intracranial vascular stenosis.

Medicine (Baltimore) 2019 Apr;98(15):e15081

This study aims to investigate the value of the ABCD score combined with the position of the offending vessel stenosis in predicting the risk of transient ischemic attack (TIA) to develop into cerebral infarction.The ABCD score and head magnetic resonance imaging + magnetic resonance angiography (MRA) results of 192 patients with TIA were retrospectively analyzed. With the 7th day as the endpoint time, these patients were divided into 3 groups, according to ABCD scores: low-risk group (n = 105), moderate-risk group (n = 60), and high-risk group (n = 27). Read More

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http://dx.doi.org/10.1097/MD.0000000000015081DOI Listing

Magnetic resonance angiography of hypoplastic A1 segment of anterior cerebral artery at 3.0-Tesla in Andhra Pradesh population of India.

Anat Cell Biol 2019 Mar 29;52(1):43-47. Epub 2019 Mar 29.

Department of Neurology, Narayana Medical College, Nellore, India.

Pre-communicating or A1 segment of anterior cerebral artery (A1ACA) hypoplasia can negotiate the anterior cerebral circulation. Not many studies have been examined the association of hypoplastic A1ACA and cerebral ischemic stroke (CIS). In this study the authors' want to accomplish the relationship between hypoplastic A1ACA and outcomes among the patients with CIS in Andhra Pradesh population of India. Read More

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https://synapse.koreamed.org/DOIx.php?id=10.5115/acb.2019.52
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http://dx.doi.org/10.5115/acb.2019.52.1.43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449583PMC
March 2019
1 Read

Trial of atorvastatin for the primary prevention of cardiovascular events in patients with rheumatoid arthritis (TRACE RA): A multicenter, randomized, placebo controlled trial.

Arthritis Rheumatol 2019 Apr 15. Epub 2019 Apr 15.

Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester.

Objective: Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVE in RA patients. Read More

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http://dx.doi.org/10.1002/art.40892DOI Listing
April 2019
1 Read

Effect of Dual versus Mono Antiplatelet Therapy on Recurrent Stroke Modulated by Activated Partial Thromboplastin Time.

Eur J Neurol 2019 Apr 10. Epub 2019 Apr 10.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: The efficacy of dual antiplatelet treatment may be modified by many factors. We aimed to assess whether the effect of clopidogrel plus aspirin versus aspirin alone on recurrent stroke would be affected by admission activated partial thromboplastin time (aPTT).

Methods: Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Read More

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http://dx.doi.org/10.1111/ene.13961DOI Listing
April 2019
1 Read

Prognostic value of left atrial strain in patients with moderate asymptomatic mitral regurgitation.

Int J Cardiovasc Imaging 2019 Apr 10. Epub 2019 Apr 10.

Department of Cardiovascular Diseases, University of Siena, Viale Bracci 1, Siena, Italy.

For patients with asymptomatic mitral regurgitation (MR), the criteria identifying the groups at higher-risk and their clinical outcome are still uncertain. Therefore, in these patients, optimal time of surgery remains controversial. The purpose of this study was to compare left atrial (LA) strain to other echocardiographic left ventricular (LV) and LA parameters for the prediction of cardiovascular outcomes in patients with moderate asymptomatic MR. Read More

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http://dx.doi.org/10.1007/s10554-019-01598-6DOI Listing
April 2019
1 Read

Six-Month Outcome of Transient Ischemic Attack and Its Mimics.

Front Neurol 2019 27;10:294. Epub 2019 Mar 27.

Department of Neurology, Geisinger Medical Center, Danville, PA, United States.

Although the risk of recurrent cerebral ischemia is higher after a transient ischemic attack (TIA), there is limited data on the outcome of TIA mimics. The goal of this study is to compare the 6-month outcome of patients with negative and positive diffusion-weighted imaging (DWI) TIAs (DWI-neg TIA vs. DWI-pos TIA) and also TIA mimics. Read More

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http://dx.doi.org/10.3389/fneur.2019.00294DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445867PMC
March 2019
4 Reads

Postoperative ischemic events in patients undergoing carotid artery stenting using algorithmic selection for embolic protection.

Neuroradiol J 2019 Apr 11:1971400919839644. Epub 2019 Apr 11.

2 Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, Japan.

Purpose: Carotid artery stenting (CAS) is a valuable alternative to carotid endarterectomy, especially in high-risk patients. However, the reported incidences of perioperative stroke and death remain higher than for carotid endarterectomy, even when using embolic protection devices (EPDs) during CAS. Our purpose was to evaluate 30-day major adverse events after CAS when selecting the most appropriate EPD. Read More

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http://dx.doi.org/10.1177/1971400919839644DOI Listing
April 2019
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Symptomatic Carotid Plaques Demonstrate Less Leaky Plaque Microvasculature Compared With the Contralateral Side: A Dynamic Contrast-Enhanced Magnetic Resonance Imaging Study.

J Am Heart Assoc 2019 Apr;8(8):e011832

1 Department of Radiology and Nuclear Medicine Maastricht University Medical Centre Maastricht The Netherlands.

Background Rupture of a vulnerable carotid atherosclerotic plaque is an important underlying cause of ischemic stroke. Increased leaky plaque microvasculature may contribute to plaque vulnerability. These immature microvessels may facilitate entrance of inflammatory cells into the plaque. Read More

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http://dx.doi.org/10.1161/JAHA.118.011832DOI Listing
April 2019
1 Read

A Lack of Decline in Major Nontraumatic Amputations in Texas: Contemporary Trends, Risk Factor Associations, and Impact of Revascularization.

Diabetes Care 2019 Apr 9. Epub 2019 Apr 9.

Division of Cardiology, Department of Medicine, The University of Texas Health Science Center at San Antonio (UT Health San Antonio), San Antonio, TX

Objective: Nontraumatic major lower extremity amputations (LEAs) have been reported to be declining nationally; however, trends in Texas have been less well described. We evaluated demographic and clinical risk factors and revascularization associations for LEAs by using inpatient hospital discharge data in Texas from 2005 to 2014.

Research Design And Methods: Inpatient hospital discharge data were obtained from the Texas Center for Health Statistics. Read More

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http://dx.doi.org/10.2337/dc19-0078DOI Listing
April 2019
1 Read

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack.

Cochrane Database Syst Rev 2019 Apr 9;4:CD011427. Epub 2019 Apr 9.

NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, St Luke's Campus, South Cloisters (Room 3.09), Exeter, Devon, UK, EX1 2LU.

Background: Rapid and accurate detection of stroke by paramedics or other emergency clinicians at the time of first contact is crucial for timely initiation of appropriate treatment. Several stroke recognition scales have been developed to support the initial triage. However, their accuracy remains uncertain and there is no agreement which of the scales perform better. Read More

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http://dx.doi.org/10.1002/14651858.CD011427.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455894PMC
April 2019
2 Reads

The influence of mean arterial pressure on the efficacy and safety of dual antiplatelet therapy in minor stroke or transient ischemic attack patients.

J Clin Hypertens (Greenwich) 2019 Apr 7. Epub 2019 Apr 7.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Mean arterial pressure (MAP) is the strongest predictor of stroke. The combination of clopidogrel and aspirin within 24 hours after onset has been suggested by the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) study to be superior to aspirin alone. However, it is not clear whether poststroke blood pressure has an influence on the efficacy and safety of dual antiplatelet treatment. Read More

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http://dx.doi.org/10.1111/jch.13527DOI Listing
April 2019
1 Read

Atheroma of the Innominate Artery Presenting as a Transient Ischemic Attack.

Cureus 2019 Jan 25;11(1):e3961. Epub 2019 Jan 25.

Internal Medicine, Oak Hill Hospital, Brooksville, USA.

Supra-aortic atherosclerotic lesions, including innominate artery atheromas, are an uncommon but established cause of transient ischemic attacks, stroke, upper extremity ischemia, and vertebrobasilar insufficiency. We present a patient with a transient ischemic attack admitted with right hemispheric symptoms who was found to have a severe ulcerated innominate artery atheroma. The patient underwent an aortic arch angiogram with stenting of the innominate artery. Read More

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http://dx.doi.org/10.7759/cureus.3961DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436674PMC
January 2019
1 Read

Prothrombotic State in Atrial Fibrillation Patients With One Additional Risk Factor of the CHADS-VASc Score (Beyond Sex).

Can J Cardiol 2019 Jan 30. Epub 2019 Jan 30.

Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland. Electronic address:

Background: It is unclear whether a prothrombotic state occurs in atrial fibrillation (AF) with low stroke risk.

Methods: We studied 118 patients with AF with the Congestive Heart Failure, Hypertension, Age (≥ 75 years), Diabetes, Stroke/Transient Ischemic Attack/Systemic Embolism, Vascular Disease, Age (65-74 years), Sex (Female) (CHADS-VASc) score of 1 in men or 2 in women vs 52 patients with AF with the CHADS-VASc score of 0 in men or 1 in women. Plasma clot permeability (K), a measure of fibrin clot density, and clot lysis time (CLT), endogenous thrombin potential (ETP), von Willebrand factor antigen, and plasminogen activator inhibitor-1 were evaluated in nonanticoagulated subjects. Read More

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http://dx.doi.org/10.1016/j.cjca.2019.01.014DOI Listing
January 2019
4 Reads

Analysis of Vascular Event Risk After Herpes Zoster From 2007 to 2014 US Insurance Claims Data.

Mayo Clin Proc 2019 Apr 5. Epub 2019 Apr 5.

Department of Family Medicine and Community Health, University of Minnesota, Minneapolis.

Objective: To estimate the risk of transient ischemic attack (TIA), stroke, and myocardial infarction in periods covering 4 weeks before to 52 weeks after herpes zoster (HZ) diagnosis in US adults.

Patients And Methods: This retrospective study (GSK study identifier: HO-15-15771) with matched cohorts used the Truven Health MarketScan Commercial and Medicare claims data set linked with obesity and smoking status information. Patients 18 years and older at the date of HZ diagnosis and 1-year pre- and post-HZ diagnosis continuous insurance enrollment (from January 1, 2007, through December 31, 2014) were propensity score matched to controls in terms of demographic characteristics, risk factors for vascular events, other comorbid disorders, general health, obesity, and smoking status. Read More

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http://dx.doi.org/10.1016/j.mayocp.2018.12.025DOI Listing
April 2019
2 Reads

Cardiovascular and cerebrovascular safety of testosterone replacement therapy among aging men with low testosterone levels: a cohort study.

Am J Med 2019 Apr 3. Epub 2019 Apr 3.

Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Québec, Canada. Electronic address:

Purpose: We assessed the risk of ischemic stroke, transient ischemic attack, and myocardial infarction associated with testosterone replacement therapy (TRT) among aging men with low testosterone levels.

Methods: Using the UK Clinical Practice Research Datalink (CPRD), we formed a cohort of men aged 45years or older with low testosterone levels and no evidence of hypogonadotropic or testicular disease, between 1995 and 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) of a composite of ischemic stroke/transient ischemic attack and myocardial infarction were estimated using time-dependent Cox proportional hazards models, comparing current use of TRT with nonuse. Read More

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http://dx.doi.org/10.1016/j.amjmed.2019.03.022DOI Listing
April 2019
5 Reads

A Systematic Review of Direct Cardiovascular Event Costs: An International Perspective.

Pharmacoeconomics 2019 Apr 4. Epub 2019 Apr 4.

School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.

Introduction: There is a lack of comprehensive cost information for cardiovascular events since 2013.

Objective: A systematic review on the contemporary cost of cardiovascular events was therefore undertaken.

Methods: Methods complied with those recommended by the Cochrane Collaboration and the Centre for Reviews and Dissemination. Read More

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http://dx.doi.org/10.1007/s40273-019-00795-4DOI Listing
April 2019
1 Read

'My watch kept on alarming all night about my heart rate': diagnosis of asymptomatic atrial fibrillation with fast ventricular response in a patient with a recent TIA as the result of a smartwatch alarm.

Authors:
Immo Weichert

Oxf Med Case Reports 2019 Mar 29;2019(3):omz014. Epub 2019 Mar 29.

Department of Acute Medicine, Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust, Ipswich IP4 5PD, Suffolk, UK.

Atrial fibrillation is a leading cause of stroke and early detection and treatment of the condition are critical. Paroxysmal atrial fibrillation is often asymptomatic and may go undetected and untreated in the routine management of patients with ischaemic strokes or transient ischaemic attacks. Prolonged monitoring does increase the diagnosis rate of atrial fibrillation after an ischaemic cerebrovascular event. Read More

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http://dx.doi.org/10.1093/omcr/omz014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440268PMC
March 2019
3 Reads

Utility of routine transesophageal echocardiography in patients with stroke or transient ischemic attack.

Proc (Bayl Univ Med Cent) 2018 Oct 11;31(4):401-403. Epub 2018 Sep 11.

Division of Cardiology, Baylor University Medical CenterDallasTexas.

In several series of patients with presumed stroke, transesophageal echocardiography (TEE) has seemed advantageous over transthoracic echocardiography (TTE) in that it improves detection of cardiac sources and can lead to changes in the methods of treatment. We hypothesized that the real-world application of TEE in our institution produced results at variance from those previously reported. Our study of 219 patients, referred for TEE for an indication of stroke or transient ischemic attack, found few relevant findings that would have indicated a new diagnosis or required a change in treatment. Read More

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https://www.tandfonline.com/doi/full/10.1080/08998280.2018.1
Publisher Site
http://dx.doi.org/10.1080/08998280.2018.1471935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413983PMC
October 2018
4 Reads

Ischaemic stroke as a complication of cardiac catheterisation. Clinical and radiological characteristics, progression, and therapeutic implications.

Neurologia 2019 Apr 1. Epub 2019 Apr 1.

Departamento de Neurociencias, Hospital Germans Trias i Pujol, Badalona, Barcelona, España. Electronic address:

Introduction: Ischaemic stroke is the most common neurological complication of cardiac catheterisation. This study aims to analyse the clinical and prognostic differences between post-catheterisation stroke code (SC) and all other in-hospital and prehospital SC.

Methods: We prospectively recorded SC activation at our centre between March 2011 and April 2016. Read More

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http://dx.doi.org/10.1016/j.nrl.2018.12.012DOI Listing

Relation of Cardiovascular Events and Deaths to Low-Density Lipoprotein Cholesterol Level Among Statin-Treated Patients With Atherosclerotic Cardiovascular Disease.

Am J Cardiol 2019 Mar 8. Epub 2019 Mar 8.

Amgen, Inc., Thousand Oaks, California.

This study describes subsequent cardiovascular events and deaths by low-density lipoprotein cholesterol (LDL-C) level in patients with atherosclerotic cardiovascular disease (ASCVD) receiving moderate- to high-intensity statins. Olmsted County, Minnesota residents with index ASCVD (myocardial infarction, unstable angina, coronary revascularization, ischemic stroke or transient ischemic attack) occurring between 2005 and 2012 were identified, and those with a prescription for a moderate- or high-intensity statin and an LDL-C measurement in the 90days after index were included. Cox regression models were used to examine associations between LDL-C, modeled as a time-dependent variable, and a composite outcome of subsequent cardiovascular events or all-cause death. Read More

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http://dx.doi.org/10.1016/j.amjcard.2019.02.043DOI Listing
March 2019
3 Reads

Effect of a Multifaceted Quality Improvement Intervention on the Prescription of Evidence-Based Treatment in Patients at High Cardiovascular Risk in Brazil: The BRIDGE Cardiovascular Prevention Cluster Randomized Clinical Trial.

JAMA Cardiol 2019 Apr 3. Epub 2019 Apr 3.

HCor Research Institute, Hospital do Coração, São Paulo, São Paulo, Brazil.

Importance: Studies have found that patients at high cardiovascular risk often fail to receive evidence-based therapies in community practice.

Objective: To evaluate whether a multifaceted quality improvement intervention can improve the prescription of evidence-based therapies.

Design, Setting, And Participants: In this 2-arm cluster randomized clinical trial, patients with established atherothrombotic disease from 40 public and private outpatient clinics (clusters) in Brazil were studied. Read More

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http://dx.doi.org/10.1001/jamacardio.2019.0649DOI Listing
April 2019
5 Reads

There Is Selective Increase in Pro-thrombotic Circulating Extracellular Vesicles in Acute Ischemic Stroke and Transient Ischemic Attack: A Study of Patients From the Middle East and Southeast Asia.

Front Neurol 2019 19;10:251. Epub 2019 Mar 19.

The Stroke Program, The Neuroscience Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.

Stroke attacks were found to be present at a younger age in patients from Southeast Asia (SE) and the Middle East (ME) resident in the state of Qatar. Extracellular vesicles (EVs), which are small membrane vesicles with pro-thrombotic properties, may contribute to the high risk of stroke in this population. Thus, total and cell-specific medium size EVs were counted by flow cytometry in platelet-free plasma from healthy volunteers and patients with transient ischemic attacks (TIA) and acute ischemic stroke (AIS) from SE and ME. Read More

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http://dx.doi.org/10.3389/fneur.2019.00251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434679PMC
March 2019
4 Reads

Evaluating Real-World Clinical Outcomes in Atrial Fibrillation Patients Receiving the WATCHMAN Left Atrial Appendage Closure Technology.

Circ Arrhythm Electrophysiol 2019 Apr;12(4):e006841

Department of Cardiology, Cardiologicum, Hamburg, Germany (M.W.B.).

Background: Left atrial appendage occlusion with WATCHMAN has emerged as viable alternative to vitamin K antagonists in randomized controlled trials. Evaluating real-life clinical outcomes in atrial fibrillation patients receiving the WATCHMAN left atrial appendage closure technology was designed to collect prospective multicenter outcomes of thromboembolic events, bleeding, and mortality for patients implanted with a WATCHMAN in routine daily practice.

Methods: One thousand twenty patients with a WATCHMAN implant procedure were prospectively followed in 47 centers. Read More

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http://dx.doi.org/10.1161/CIRCEP.118.006841DOI Listing
April 2019
3 Reads

Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke.

Br J Surg 2019 Apr 2. Epub 2019 Apr 2.

Division of Surgery and Interventional Science, University College London, London, UK.

Background: Carotid stenosis is a common cause of ischaemic stroke and transient ischaemic attack (TIA). Despite rising recognition and centralization of stroke services there has been a decline in interventions for carotid stenosis in recent years. The aim of this study was to determine the current prevalence and management of carotid stenosis in the UK. Read More

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http://dx.doi.org/10.1002/bjs.11136DOI Listing

Cerebral blood flow territory instability in patients with atherosclerotic intracranial stenosis.

J Magn Reson Imaging 2019 Apr 2. Epub 2019 Apr 2.

Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Background: Stroke risk stratification in patients with symptomatic intracranial atherosclerotic arterial disease (ICAD) remains an important clinical objective owing to the high 14-19% recurrent stroke rate in these patients on standard-of-care medical management. There thus remains a need for hemodynamic markers that may allow for the selection of personalized therapies for high-risk symptomatic patients.

Purpose: To determine if shifting of cerebral blood flow (CBF) territories in response to changes in cerebral perfusion pressure (CPP) may provide a marker for stroke risk in ICAD patients. Read More

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http://dx.doi.org/10.1002/jmri.26737DOI Listing
April 2019
2 Reads

Atrial Fibrillation: An Underestimated Cause of Ischemic Monocular Visual Loss?

J Stroke Cerebrovasc Dis 2019 Mar 29. Epub 2019 Mar 29.

Hyperacute Stroke Unit, University College London Hospital, United Kingdom.

Introduction: Atrial fibrillation (AF) is a major cause of ischemic stroke and Transient Ischemic Attack (TIA) and investigation for paroxysmal AF is recommended following an embolic brain event. In contrast, retinal ischemic monocular blindness is traditionally considered most linked to carotid artery disease (CAS) and investigating for AF is less vigilant. We aimed to determine the prevalence of AF in patients with ischemic monocular blindness. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.03.017DOI Listing

Association between illness representation and psychological distress in stroke patients: A systematic review and meta-analysis.

Int J Nurs Stud 2019 Feb 8;94:42-50. Epub 2019 Feb 8.

Department of Nursing, Chung-Shan Medical University Hospital, Taiwan, ROC. Electronic address:

Aims: This paper aims to systematically review the illness perceptions of stroke patients and to examine the association between illness representation and psychological distress in empirical research studies.

Background: Patients' perceptions of health threats determine their coping behavior. Several recent studies have focused on illness belief and distress in stroke patients. Read More

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http://dx.doi.org/10.1016/j.ijnurstu.2019.01.015DOI Listing
February 2019
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Coronary atheroma regression and adverse cardiac events: A systematic review and meta-regression analysis.

Atherosclerosis 2019 Mar 11;284:194-201. Epub 2019 Mar 11.

Division of Cardiology, University of British Columbia, Vancouver, B.C, Canada. Electronic address:

Background And Aims: The relationship between plaque regression induced by dyslipidemia therapies and occurrence of major adverse cardiovascular events (MACE) is controversial. We performed a systematic review and meta-regression of dyslipidemia therapy studies reporting MACE and intravascular ultrasound (IVUS) measures of change in coronary atheroma.

Methods: Prospective studies of dyslipidemia therapies reporting percent atheroma volume (PAV) measured by IVUS and reporting death, myocardial infarction, stroke, unstable angina or transient ischemic attack (MACE) were included. Read More

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http://dx.doi.org/10.1016/j.atherosclerosis.2019.03.005DOI Listing
March 2019
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Risk factors for thromboembolic and bleeding events in anticoagulated patients with atrial fibrillation: the prospective, multicentre observational PREvention oF thromboembolic events - European Registry in Atrial Fibrillation (PREFER in AF).

BMJ Open 2019 Mar 30;9(3):e022478. Epub 2019 Mar 30.

University of Birmingham Institute of Cardiovascular Sciences, University of Birmingham, UHB and SWBH NHS Trusts, Birmingham, UK.

Objectives: We identified factors associated with thromboembolic and bleeding events in two contemporary cohorts of anticoagulated patients with atrial fibrillation (AF), treated with either vitamin K antagonists (VKA) or non-VKA oral anticoagulants (NOACs).

Design: Prospective, multicentre observational study.

Setting: 461 centres in seven European countries. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022478DOI Listing
March 2019
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Outpatient and inpatient readmission rates of 3- and 4-level anterior cervical discectomy and fusion surgeries.

J Neurosurg Spine 2019 03 29:1-6. Epub 2019 Mar 29.

2Chicago Medical School, North Chicago, Illinois.

OBJECTIVE With the costs related to the United States medical system constantly rising, efforts are being made to turn traditional inpatient procedures into outpatient same-day surgeries. In this study the authors looked at the various comorbidities and perioperative complications and their impact on readmission rates of patients undergoing outpatient versus inpatient 3- and 4-level anterior cervical discectomy and fusion (ACDF). METHODS This was a retrospective study of 337 3- and 4- level ACDF procedures in 332 patients (5 patients had both primary and revision surgeries that were included in this total of 337 procedures) between May 2012 and June 2017. Read More

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http://dx.doi.org/10.3171/2019.1.SPINE181019DOI Listing
March 2019
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Revascularization and functional outcomes after mechanical thrombectomy for acute ischemic stroke in elderly patients.

J Neurosurg 2019 03 29:1-8. Epub 2019 Mar 29.

2Department of Neurological Surgery and.

OBJECTIVE Mechanical thrombectomy (MT) is now the standard of care for acute ischemic stroke (AIS) secondary to large-vessel occlusion, but there remains a question of whether elderly patients benefit from this procedure to the same degree as the younger populations enrolled in the seminal trials on MT. The authors compared outcomes after MT of patients 80–89 and ≥ 90 years old with AIS to those of younger patients. METHODS The authors retrospectively analyzed records of patients undergoing MT at their institution to examine stroke severity, comorbid conditions, medical management, recanalization results, and clinical outcomes. Read More

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http://dx.doi.org/10.3171/2018.12.JNS182399DOI Listing
March 2019
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Different influence of cardiac hemodynamics on thromboembolic events in patients with paroxysmal and non-paroxysmal atrial fibrillation.

PLoS One 2019 29;14(3):e0214743. Epub 2019 Mar 29.

Arrhythmia Center, Korea University Medical Center Anam Hospital, Seoul, Republic of Korea.

Blood stasis in left atrium (LA) or LA appendage (LAA) is thought to be the main cause of thrombus formation and systemic embolism in atrial fibrillation (AF) patients. Paroxysmal and non-paroxysmal AF differ significantly in various aspects. Impact of cardiac hemodynamics on systemic embolism might also differ between the 2 distinct AF entities. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214743PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440630PMC
March 2019
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Left atrial volume index and left ventricular global longitudinal strain predict new-onset atrial fibrillation in patients with transient ischemic attack.

Int J Cardiovasc Imaging 2019 Mar 28. Epub 2019 Mar 28.

Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Odense, Denmark.

This study aimed to investigate different echocardiographic parameters for predicting atrial fibrillation (AF) in patients with transient ischemic attack (TIA). Echocardiography was performed in 110 patients (median age 65.8 years, 53% males) with TIA and no history of stroke or AF. Read More

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http://dx.doi.org/10.1007/s10554-019-01586-wDOI Listing
March 2019
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Comparison of hemodynamic changes and prognosis between stenting and standardized medical treatment in patients with symptomatic moderate to severe vertebral artery origin stenosis.

Medicine (Baltimore) 2019 Mar;98(13):e14899

Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, Jiangsu 215000, China.

This study aimed to compare the clinical efficacy of stenting compared with standardized medical treatment in patients with moderate to severe vertebral artery origin stenosis (VAOS).Patients diagnosed with moderate to severe VAOS and indicated to undergo vertebral artery stenting were enrolled. Patients were divided into stenting group and standardized medical treatment group. Read More

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http://dx.doi.org/10.1097/MD.0000000000014899DOI Listing
March 2019
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Incident Atrial Fibrillation, Dementia and the Role of Anticoagulation: A Population-Based Cohort Study.

Thromb Haemost 2019 Mar 27. Epub 2019 Mar 27.

Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt, Germany.

Introduction:  Atrial fibrillation (AF) is associated with dementia. Anticoagulation may modify this relationship, but it is unclear if this is due to stroke reduction alone.

Methods:  Age- and sex-matched individuals from the U. Read More

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http://dx.doi.org/10.1055/s-0039-1683429DOI Listing
March 2019
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Small vessel occlusion is a high-risk etiology for early recurrent stroke after transient ischemic attack.

Int J Stroke 2019 Mar 27:1747493019840931. Epub 2019 Mar 27.

1 Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.

Background: Recent prospective registration studies of transient ischemic attack in Western countries demonstrated that large artery atherosclerosis is the highest risk etiology for early stroke recurrence under urgent evaluation and treatment. On the other hand, some limited transient ischemic attack studies from East Asian countries showed transient ischemic attack patients due to small vessel occlusion were at a higher early stroke risk.

Aims: We aimed to assess the risk for early stroke in small vessel occlusion-transient ischemic attack patients in a Japanese large transient ischemic attack registry. Read More

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http://dx.doi.org/10.1177/1747493019840931DOI Listing
March 2019
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Brief Educational Intervention Improves Emergency Medical Services Stroke Recognition.

Stroke 2019 Mar 28:STROKEAHA118023885. Epub 2019 Mar 28.

Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, MI (M.J.R.).

Background and Purpose- Recognition of stroke symptoms and hospital prenotification by emergency medical services (EMS) facilitate rapid stroke treatment; however, one-third of patients with stroke are unrecognized by EMS. To promote stroke recognition and quality measure compliant prehospital stroke care, we deployed a 30-minute online EMS educational module coupled with a performance feedback system in a single Michigan county. Methods- During a 24-month study period, a registry of consecutive EMS-transported suspected or unrecognized stroke cases was utilized to perform an interrupted time series analysis of the impact of the EMS education and feedback intervention. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.023885DOI Listing
March 2019
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The Impact of Transient Ischemic Attack (TIA) on Brain and Behavior.

Front Behav Neurosci 2019 11;13:44. Epub 2019 Mar 11.

Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.

Transient ischemic attack (TIA) was originally defined as self-resolving focal cerebral ischemia with symptoms lasting <24 h. The newer definition also added the limitation that there should be no evidence of acute brain tissue infarction, to recognize that acute injury to the brain can result from ischemia of <24-h duration. However, several recent findings suggest that having a TIA correlates with deficits that can persist far beyond the resolution of clinical symptoms, even in the absence of imaging evidence of ischemic tissue injury. Read More

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http://dx.doi.org/10.3389/fnbeh.2019.00044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421333PMC