48,381 results match your criteria outcomes stroke

Cost Burden and Cost-Effective Analysis of the Nationwide Implementation of the Quality in Acute Stroke Care Protocol in Australia.

J Stroke Cerebrovasc Dis 2021 Jun 19;30(8):105931. Epub 2021 Jun 19.

School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address:

Objectives: The Quality in Acute Stroke Care (QASC) protocol is a multidisciplinary approach to implement evidence-based treatment after acute stroke that reduces death and disability. This study sought to evaluate the cost-effectiveness of implementing the QASC protocol across Australia, from a healthcare and a societal perspective.

Materials And Methods: A decision-analytic model was constructed to reflect one-year outcomes post-stroke, aligned with the stroke severity categories of the modified Rankin scale (mRS). Read More

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TEVAR and periscope graft technique to treatment of huge aneurysm of aortic isthmus: Case report.

Int J Surg Case Rep 2021 Jun 19;84:106129. Epub 2021 Jun 19.

Vascular Surgery Unit - AOmUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.

Introduction: Thoracic endovascular aortic repair (TEVAR) has revolutionized the treatment of thoracic aortic aneurysms. Innovative techniques as chimney and periscope grafts can improve the outcomes of procedure. Herein, we report a case in emergency of huge Thoracic aortic aneurism. Read More

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Reducing stroke burden through a targeted self-management intervention for reducing stroke risk factors in high-risk Ugandans: A protocol for a randomized controlled trial.

PLoS One 2021 22;16(6):e0251662. Epub 2021 Jun 22.

Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.

Introduction: Stroke burden is rapidly increasing globally. Modifiable risk factors offer an opportunity to intervene, and targeting hypertension is a key actionable target for stroke risk reduction in sub-Saharan Africa. This 3-site planned randomized controlled trial builds on promising preliminary data. Read More

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Outcomes of mechanical circulatory support for acute myocardial infarction complicated by cardiogenic shock.

Catheter Cardiovasc Interv 2021 Jun 22. Epub 2021 Jun 22.

Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.

Background: Mechanical circulatory support (MCS) with the Impella device (Abiomed, Danvers, MA) has been associated with higher in-hospital mortality than intra-aortic balloon pump (IABP) in the Premier Healthcare Database and National Cardiovascular Data Registry.

Methods: The objective of this retrospective cohort study was to describe trends and outcomes of Impella usage in acute myocardial infarction complicated by cardiogenic shock (AMICS) treated with MCS (Impella or IABP) using real-world observational data from the National Inpatient Sample (NIS) including hospitalizations for AMICS managed with MCS between January 2012 to December 2017. The primary outcomes included in-hospital mortality, transfusion, acute kidney injury, stroke, total costs, and length of stay. Read More

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Transcatheter Treatment of Valvular Heart Disease: A Review.

JAMA 2021 Jun;325(24):2480-2494

Bluhm Cardiovascular Institute and Departments of Medicine and Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Importance: More than 40 million people are living with either mitral or aortic valve disease worldwide, and more than 180 000 heart valve replacement surgeries are performed each year in the US. Transcatheter valve repair has emerged as an important therapeutic option for patients who are candidates for heart valve replacement.

Observations: All transcatheter valve therapies involve a multidisciplinary team of interventional cardiologists, cardiothoracic surgeons, radiologists, echocardiographers, nurses, and social workers, termed the heart team, to determine the optimal approach for managing each patient. Read More

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AIM2 deletion enhances blood-brain barrier integrity in experimental ischemic stroke.

CNS Neurosci Ther 2021 Jun 22. Epub 2021 Jun 22.

Department of Neurology, Drum Tower Hospital, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.

Aims: Ischemic stroke is a life-threatening disease with limited therapeutic strategies. Blood-brain barrier (BBB) disruption is a critical pathological process that contributes to poor outcomes in ischemic stroke. We previously showed that the microglial inhibition of the inflammasome sensor absent in melanoma 2 (AIM2) suppressed the inflammatory response and protected against ischemic stroke. Read More

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Temporal Trends and Drivers of Heart Team Utilization in Transcatheter Aortic Valve Replacement: A Population-Based Study in Ontario, Canada.

J Am Heart Assoc 2021 Jun 22:e020741. Epub 2021 Jun 22.

Schulich Heart Program Division of Cardiology Sunnybrook Health Sciences Centre University of Toronto Ontario Canada.

Background The multidisciplinary Heart Team (HT) is recommended for management decisions for transcatheter aortic valve replacement (TAVR) candidates, and during TAVR procedures. Empiric evidence to support these recommendations is limited. We aimed to explore temporal trends, drivers, and outcomes associated with HT utilization. Read More

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Apixaban in Patients with Atrial Fibrillation and Severe Renal Dysfunction: Findings from a National Registry.

Isr Med Assoc J 2021 Jun;23(6):353-358

Heart Research Follow-Up Program, University of Rochester Medical Center, Rochester, NY, USA.

Background: Real-world information regarding the use of direct oral anticoagulants therapy and the outcome in patients with renal dysfunction is limited.

Objectives: To evaluate the clinical characteristics and outcomes of patients with atrial fibrillation (AF) and severe renal dysfunction who are treated with apixaban.

Methods: A sub-analysis was conducted within a multicenter prospective cohort study. Read More

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Newly diagnosed diabetes has high risk for cardiovascular outcome in ischemic stroke patients.

Sci Rep 2021 Jun 21;11(1):12929. Epub 2021 Jun 21.

Department of Neurology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

We investigated cardiovascular outcomes in ischemic stroke patients with newly diagnosed diabetes mellitus (DM) compared with those of patients with previously known DM and no DM using the glycosylated hemoglobin (HbA1c) criteria. The relationship between new DM diagnosis and cardiovascular risk remains unclear to date. We performed post hoc analysis using the data of participants from the Prevention of Cardiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage (PICASSO) trial. Read More

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Impact of lung function on cardiovascular diseases and cardiovascular risk factors: a two sample bidirectional Mendelian randomisation study.

Thorax 2021 Jun 21. Epub 2021 Jun 21.

School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Adminstrative Region, China.

Introduction: Observational studies suggested lung function is inversely associated with cardiovascular disease (CVD) although these studies could be confounded. We conducted a two sample Mendelian randomisation study using summary statistics from genome-wide association studies (GWAS) to clarify the role of lung function in CVD and its risk factors, and conversely the role of CVD in lung function.

Methods: We obtained genetic instruments for forced expiratory volume in 1 s (FEV: 260) and forced vital capacity (FVC: 320) from publicly available UK Biobank summary statistics (n=421 986) and applied to GWAS summary statistics for coronary artery disease (CAD) (n=184 305), stroke (n=446 696), atrial fibrillation (n=1 030 836) and heart failure (n=977 320) and cardiovascular risk factors. Read More

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Outcomes of transulnar and transradial percutaneous coronary intervention using ultrasound guided access in patients selected based on an ultrasound algorithm.

Indian Heart J 2021 May-Jun;73(3):362-364. Epub 2021 Mar 17.

Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, TX, 79905, USA.

We performed a prospective observational study of 215 patients (58 ± 11 years) and compared the outcomes of ultrasound guided ulnar (n = 98, 45.6%) vs. radial (n = 117, 54. Read More

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Single-center experience of 105-minimalistc transfemoral transcatheter aortic valve replacement and its outcome.

Indian Heart J 2021 May-Jun;73(3):301-306. Epub 2021 Feb 3.

Cardiology, Eternal Hospital, Jaipur, India.

Introduction: Transcatheter aortic valve replacement (TAVR) increases worldwide, and indications expand from high-risk aortic stenosis patients to low-risk aortic stenosis. Studies have shown that minimalistic TAVR done under conscious sedation is safe and effective. We report single-operator, the single-center outcome of 105 minimalist transfemoral, conscious sedation TAVR patients, analyzed retrospectively. Read More

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February 2021

Association of statin use in older people primary prevention group with risk of cardiovascular events and mortality: a systematic review and meta-analysis of observational studies.

BMC Med 2021 Jun 22;19(1):139. Epub 2021 Jun 22.

Head Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz (MUL), Lodz, Poland.

Background: Current evidence from randomized controlled trials on statins for primary prevention of cardiovascular disease (CVD) in older people, especially those aged > 75 years, is still lacking. We conducted a systematic review and meta-analysis of observational studies to extend the current evidence about the association of statin use in older people primary prevention group with risk of CVD and mortality.

Methods: PubMed, Scopus, and Embase were searched from inception until March 18, 2021. Read More

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Endoluminal flow diverters in the treatment of sidewall and bifurcation aneurysm: A systematic review and meta-analysis of complications and angiographic outcomes.

Interv Neuroradiol 2021 Jun 22:15910199211026713. Epub 2021 Jun 22.

Department of Radiology, Mayo Clinic, Rochester, MN, USA.

Background And Aim: The use of endoluminal flow diversion in bifurcation aneurysms has been questioned due to the potential for complications and lower occlusion rates. In this study we assessed outcomes of endovascular treatment of intracranial sidewall and bifurcation aneurysms with flow diverters.

Methods: In July 2020, a literature search for all studies utilizing endoluminal flow diverter treatment for sidewall or bifurcation aneurysms was performed. Read More

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Central Triage of Acute Stroke Patients Across a Distributive Stroke Network Is Safe and Reduces Transfer Denials.

Stroke 2021 Jun 22:STROKEAHA120033018. Epub 2021 Jun 22.

Department of Neurology, Washington University School of Medicine, St. Louis, MO. (D.H., J.A.G., J.-M.L., A.L.F.).

Background And Purpose: Mechanical thrombectomy has dramatically increased patient volumes transferred to comprehensive stroke centers (CSCs), resulting in transfer denials for patients who need higher level of care only available at a CSC. We hypothesized that a distributive stroke network (DSN), triaging low severity acute stroke patients to a primary stroke center (PSC) upon initial telestroke consultation, would safely reduce transfer denials, thereby providing additional volume to treat severe strokes at a CSC.

Methods: In 2017, a DSN was implemented, in which mild stroke patients were centrally triaged, via telestroke consultation, to a PSC based upon a simple clinical severity algorithm, while higher acuity/severity strokes were triaged to the CSC. Read More

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Disparities between Asian and Non-Asian Thrombolyzed Acute Ischemic Stroke Patients in the Enhanced Control of Hypertension and Thrombolysis Stroke Trial.

Cerebrovasc Dis 2021 Jun 21:1-7. Epub 2021 Jun 21.

The George Institute for Global Health, Faculty of Medicine, UNSW, Sydney, New South Wales, Australia.

Background And Purpose: As outcomes for acute ischemic stroke (AIS) vary according to clinical profile and management approaches, we aimed to determine disparities in clinical outcomes between Asian and non-Asian participants of the international, Enhanced Control of Hypertension and Thrombolysis Stroke study (ENCHANTED).

Methods: ENCHANTED was a multicenter, prospective, partial-factorial, randomized, open trial of low-dose (0.6 mg/kg) versus standard-dose (0. Read More

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Lyme neuroborreliosis-associated cerebrovascular events in the Finnish endemic area.

J Neurol Sci 2021 Jun 17;427:117544. Epub 2021 Jun 17.

Departments of Neurology, University of Helsinki and Helsinki University Hospital, Finland.

Objectives: Neuroborreliosis is a rare cause of cerebral vasculitis and stroke. The incidence of Lyme borreliosis in Finland has been increasing in the last 20 years, so we expect that Lyme neuroborreliosis-associated vasculitis can be a more common cause of stroke in the future.

Materials & Methods: We have retrospectively identified all adult patients (>16 years old) diagnosed with borreliosis (A69. Read More

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Low-dose tirofiban is associated with reduced in-hospital mortality in cardioembolic stroke patients treated with endovascular thrombectomy.

J Neurol Sci 2021 Jun 15;427:117539. Epub 2021 Jun 15.

Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address:

Background And Purpose: Whether tirofiban is safe and effective in cardioembolic stroke patients treated with endovascular thrombectomy (EVT) remains unknown; this study evaluated the safety and efficacy of low-dose tirofiban in this patients population.

Methods: This study was a prospective registry study. Patients with cardioembolic stroke undergoing EVT from January 2013 to December 2020 were treated with EVT alone or EVT plus low-dose tirofiban. Read More

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Maximum intravenous alteplase dose for obese stroke patients is not associated with greater likelihood of worse outcomes.

Thromb Res 2021 Jun 7;204:76-80. Epub 2021 Jun 7.

Miami Neuroscience Institute, Baptist Health South Florida, 8900 North Kendall Drive, 2 Clarke Pavilion, Miami, FL 33176, USA. Electronic address:

Background: IV alteplase is a primary treatment for acute ischemic stroke (AIS) at a weight-based dose (WBD) of 0.9 mg/kg and maximum dose (MD) of 90 mg. There are conflicting data regarding outcomes for those weighing ≥100 kg. Read More

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Spontaneous Subarachnoid Haemorrhage in Spinal Hemangioblastoma: Illustrative Case and Discussion of a Pathophysiological Hypothesis.

J Stroke Cerebrovasc Dis 2021 Jun 18;30(8):105925. Epub 2021 Jun 18.

Department of Neurologic Surgery, Azienda Ospedaliero-Universitaria, Parma, Italy.

Spontaneous non-aneurysmal subarachnoid haemorrhage (naSAH) is an unusual finding that could be burdened by significant mortality and morbidity rates. Rare pathologies and delayed diagnosis could be advocated as responsible of unfavourable outcomes. Herein, we describe an exceedingly rare giant lumbar spinal hemangioblastoma (80 × 23 mm) presenting as an intracranial naSAH. Read More

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Cost-Effectiveness Analysis of Percutaneous Patent Foramen Ovale Closure Preventing Secondary Ischemic Stroke in Japan.

J Stroke Cerebrovasc Dis 2021 Jun 18;30(8):105884. Epub 2021 Jun 18.

Department of Cardiovascular Medicine, Okayama University, Okayama, Japan.

Objectives: Patent foramen ovale is a hemodynamically insignificant interatrial communication that may cause ischemic stroke. Percutaneous patent foramen ovale closure reduces the risk for recurrent ischemic stroke in patients with a history of cryptogenic ischemic stroke. This study evaluated the cost-effectiveness of patent foramen ovale closure against medical therapy in patients after their first cryptogenic ischemic stroke in Japan. Read More

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Analysis of Medicare Payments and Patient Outcomes with Pre-Operative Imaging for Carotid Endarterectomy.

Ann Vasc Surg 2021 Jun 18. Epub 2021 Jun 18.

Division of Vascular Surgery, Department of Surgery, Stanford University, Stanford, CA.

Objective: The use of radiographic evaluation of carotid disease may vary, and current guidelines do not strongly recommend the use of cross-sectional imaging (CSI) prior to surgical intervention. We sought to describe the trends in pre-operative carotid imaging and evaluate the associated clinical outcomes and Medicare payments for patients undergoing carotid endarterectomy (CEA) for asymptomatic carotid disease.

Methods: We used a 20% Medicare sample from 2006-2014 identifying patients undergoing CEA for asymptomatic disease. Read More

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Laser in situ Fenestration in Thoracic Endovascular Aortic Repair: A Single-Center Analysis.

Ann Vasc Surg 2021 Jun 18. Epub 2021 Jun 18.

Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425, United States of America. Electronic address:

Introduction And Objectives: Laser in situ fenestration (LISF) is an expanding technique for arch vessel revascularization in thoracic endovascular aortic repair (TEVAR). We present a single center's early and midterm outcomes using adjunctive LISF with TEVAR for treatment of various arch pathologies.

Methods: 24 patients underwent TEVAR with LISF (2017 - 2020). Read More

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A Systematic Review Supporting the Society for Vascular Surgery Guidelines on the Management of Carotid Artery Disease.

J Vasc Surg 2021 Jun 18. Epub 2021 Jun 18.

Evidence-Based Practice Research Program, Mayo Clinic, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, MN, USA. Electronic address:

Background: To support the development of guidelines on the management of carotid disease, a writing committee from the Society for Vascular Surgery has commissioned this systematic review.

Methods: We searched multiple data bases for studies addressing 5 questions: medical management vs. carotid revascularization (CEA) in asymptomatic patients, CEA vs. Read More

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Neonatal presentation of genetic epilepsies: Early differentiation from acute provoked seizures.

Epilepsia 2021 Jun 21. Epub 2021 Jun 21.

Department of Pediatrics, Saint-Luc University Hospital, Catholic University of Louvain, Brussels, Belgium.

Objective: Although most seizures in neonates are due to acute brain injury, some represent the first sign of neonatal onset genetic epilepsies. Delay in recognition and lack of expert assessment of neonates with epilepsy may result in worse developmental outcomes. As in older children and adults, seizure semiology in neonates is an essential determinant in diagnosis. Read More

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Association of metabolic syndrome with cardiovascular outcomes in hypertensive patients: a systematic review and meta-analysis.

J Endocrinol Invest 2021 Jun 21. Epub 2021 Jun 21.

Department of General Practice, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.

Purpose: The association between metabolic syndrome (MetS) and cardiovascular outcomes in patients with hypertension is still controversial. This meta-analysis sought to evaluate the association of MetS with cardiovascular outcomes in hypertensive patients.

Methods: Two authors comprehensively searched PubMed and Embase databases from their inception to April 18, 2020 for the longitudinal studies that evaluated the association of MetS with cardiovascular outcomes in patients with hypertension. Read More

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Distribution, management and outcomes of AMI according to principal diagnosis priority during inpatient admission.

Int J Clin Pract 2021 Jun 21:e14554. Epub 2021 Jun 21.

Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, UK.

Background: In recent years, there has been a growing interest in outcomes of patients with acute myocardial infarction (AMI) using large administrative datasets. The present study was designed to compare the characteristics, management strategies and acute outcomes between patients with primary and secondary AMI diagnoses in a national cohort of patients.

Methods: All hospitalizations of adults (≥18 years) with a discharge diagnosis of AMI in the US National Inpatient Sample between January 2004 and September 2015 were included, stratified by primary or secondary AMI. Read More

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European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke.

Eur J Neurol 2021 Jun 21. Epub 2021 Jun 21.

RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania.

Background And Purpose: Early pharmacological support for post-stroke neurorehabilitation has seen an abundance of mixed results from clinical trials, leaving practitioners at a loss regarding the best options to improve patient outcomes. The objective of this evidence-based guideline is to support clinical decision-making of healthcare professionals involved in the recovery of stroke survivors.

Methods: This guideline was developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Read More

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Is hybrid coronary revascularization really beneficial in the long term?

Eur J Cardiothorac Surg 2021 Jun 21. Epub 2021 Jun 21.

Objectives: This analysis aimed to compare both short- and long-term outcomes of hybrid coronary revascularization (HCR) with different techniques and coronary artery bypass grafting (CABG).

Methods: Twenty-three studies were included, covering 10 468 different patients, among whom 2403 patients underwent HCR with either simultaneous or staged method and 8065 patients underwent CABG.

Results: Compared with CABG, HCR had a statistically significant lower risk of stroke [odds ratio (OR) = 0. Read More

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Remote ischemic conditioning with exercise (RICE) promotes functional rehabilitation following ischemic stroke.

Neurol Res 2021 Jun 20:1-10. Epub 2021 Jun 20.

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA.

: Exercise is an essential rehabilitative strategy after stroke butits implementation is limited as its very early use can exacerbate damage and is restricted by patient disability. Remote Ischemic Conditioning (RIC) is a safe alternative for post-stroke neuroprotetion. The present study investigated the neurorehabilitative benefits of early RIC followed by exercise (RICE) therapy. Read More

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