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6. Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials

Author

Klug, Didier, Casolla, Barbara, Puy, Laurent, Coffee, Morgane, Kuchcinski, Grégory, Labreuche, Julien, van Nieuwenhuizen, Koen M., Algra, Ale, van Gelder, Isabelle C., Kappelle, L. Jaap, Rinkel, Gabriel J.E., Schutgens, Roger E.G., Khatri, Pooja, Conwit, Robin, Falcone, Guido, Elm, Jordan, Anderson, Craig S., Song, Lili, Pandian, Jeyaraj, Hart, Robert G., Sharma, Mukul, Aref, Hany, Tarhuni, Wadea, Fabregas, Joan Marti, Diener, Hans-Christoph, Endres, Matthias, Lemmens, Robin, Kwon, Sun U., Lee, Byung-Chul, Ameriso, Sebastian, Milling, Truman J., Kasner, Scott E., Mikulik, Robert, Xavier, Denis, Beer, Ronny, Toni, Danilo, Eckstein, Jens, Seiffge, David, Ferro, Jose M., Tsivgoulis, Georgios, Sharma, Sanjib K., Wei-Liou, Chia, Hohnloser, Stefan H., Katsanos, Aristeidis, Bosch, Jackie, Healey, Jeff, Eikelboom, John, Khaw, Alexander, Gladstone, David, Pikula, Aleksandra, Coutts, Shelagh, Smith, Eric E., Butcher, Ken, Field, Thalia, Gioia, Laura, Stapf, Christian, Halse, Omid, Ringleb, Peter, Enzinger, Christian, Sibon, Igor, Montaner, Joan, Caso, Valeria, Heuschmann, Peter, Lip, Gregory Y.H., Haefeli, Walter, Debette, Stefanie, Dennis, Martin S., Wyller, Torgeir Bruun, Rønning, Ole M., Eilertsen, Helle, Ihle-Hansen, Hege, Sandset, Else Charlotte, Pennlert, Johanna, Glader, Eva-Lotta, Kruuse, Christina, Wester, Per, Carlsson, Maria, Forfang, Elisabeth, Al-Shahi Salman, Rustam, Stephen, Jacqueline, Tierney, Jayne F, Lewis, Steff C, Newby, David E, Parry-Jones, Adrian R, White, Philip M, Connolly, Stuart J, Benavente, Oscar R, Dowlatshahi, Dar, Cordonnier, Charlotte, Viscoli, Catherine M, Sheth, Kevin N, Kamel, Hooman, Veltkamp, Roland, Larsen, Kristin T, Hofmeijer, Jeannette, Kerkhoff, Henk, Schreuder, Floris H B M, Shoamanesh, Ashkan, Klijn, Catharina J M, and van der Worp, H Bart

Published
2023
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13. Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) study protocol: a stepped wedge randomised trial of stroke screening using the National Institutes of Health Stroke Scale in the ambulance

Author

Bugge, Helge Fagerheim, Guterud, Mona, Bache, Kristi C. G., Braarud, Anne-Cathrine, Eriksen, Erik, Fremstad, Kjell Otto, Ihle-Hansen, Hege, Ingebretsen, Svein Håkon, Kramer-Johansen, Jo, Larsen, Karianne, Røislien, Jo, Thorsen, Kjetil, Toft, Mathias, Sandset, Else Charlotte, and Hov, Maren Ranhoff

Published
2022
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20. Sleep Duration and Cognitive Function: The Akershus Cardiac Examination 1950 Study.

Author

Ihle-Hansen, Hege, Einvik, Gunnar, Hagberg, Guri, Thommessen, Bente, Rønning, Ole Morten, Vigen, Thea, Lyngbakken, Magnus Nakrem, Berge, Trygve, Røsjø, Helge, Tveit, Arnljot, and Ihle-Hansen, Håkon

Subjects
*COGNITION disorder risk factors, *SELF-evaluation, *RISK assessment, *CROSS-sectional method, *COGNITIVE testing, *RESEARCH funding, *DESCRIPTIVE statistics, *SLEEP duration, *LONGITUDINAL method, *MEMORY, *AGING, *NEUROPSYCHOLOGICAL tests, *MIDDLE age, *OLD age
Abstract

Introduction: Sleep duration is proposed as a lifestyle-related risk factor for cognitive impairment. We investigated the association between sleep duration and cognitive function in a large population-based cohort aged 62–65 years. Methods: Cross-sectional analyses from the Akershus Cardiac Examination 1950 Study. Linear and nonlinear models were conducted to explore the association between self-reported sleep duration and cognitive function, adjusted for established risk factors for cognitive impairment. Results: We included 3,348 participants, mean age (SD) was 63.9 ± 0.6 years, 48.2% were women, and 47.9% had education >12 years. Mean sleep duration (SD) was 7.0 ± 1.0 h, and 10.2% had abnormal sleep duration (<6 or >8 h). Individuals reporting <6 h or >8 h of sleep scored significantly lower on MoCA test and delayed recall trial in adjusted analysis. Conclusions: Sleep duration showed an inverted U-shaped association with global cognitive function and memory, suggesting that both shortened and prolonged sleep are related to adverse brain health. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Balance and Gait After First Minor Ischemic Stroke in People 70 Years of Age or Younger: A Prospective Observational Cohort Study

Author

Hamre, Charlotta, Fure, Brynjar, Helbostad, Jorunn L., Wyller, Torgeir B., Ihle-Hansen, Hege, Vlachos, Georgios, Ursin, Marie, and Tangen, Gro Gujord

Subjects
United States. National Institutes of Health, Medical research, Ischemia, Stroke patients, Disabilities, Health
Abstract

Stroke is a major health challenge. It is the second most common cause of death and the third most common cause of disability worldwide. (1) Traditionally, stroke has been a [...], Background. Two-thirds of patients with stroke experience only mild impairments in the acute phase, and the proportion of patients Objective. The objective of this study was to explore balance and gait in the acute phase and after 3 and 12 months in patients [less than or equal to]70 years with minor ischemic stroke (National Institutes of Health Stroke Scale score [less than or equal to]3). This study also explored factors predicting impaired balance after 12 months. Design. This study was designed as an explorative longitudinal cohort study. Methods. Patients were recruited consecutively from 2 stroke units. Balance and gait were assessed with the Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go, and preferred gait speed. Predictors for impaired balance were explored using logistic regression. Results. This study included 101 patients. Mean (SD) age was 55.5 (11.4) years, 20% were female, and mean (SD) National Institutes of Health Stroke Scale score was 0.6 (0.9) points. The Mini-BESTest, gait speed, and Timed Up and Go improved significantly from the acute phase to 3 months, and gait speed also improved from 3 to 12 months. At 12 months, 26% had balance impairments and 33% walked slower than 1.0 m/s. Poor balance in the acute phase (odds ratio = 0.92, 95% confidence interval = 0.85-0.95) was the only predictor of balance impairments (Mini-BESTest score [less than or equal to]22) at 12 months poststroke. Limitations. Limitations include lack of information about pre-stroke balance and gait impairment and poststroke exercise. Few women limited the generalizability. Conclusion. This study observed improvements in both balance and gait during the follow-up; still, about one-third had balance or gait impairments at 12 months poststroke. Balance in the acute phase predicted impaired balance at 12 months.

Published
2020
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29. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial

Author

Logallo, Nicola, Novotny, Vojtech, Assmus, Jörg, Kvistad, Christopher E, Alteheld, Lars, Rønning, Ole Morten, Thommessen, Bente, Amthor, Karl-Friedrich, Ihle-Hansen, Hege, Kurz, Martin, Tobro, Håkon, Kaur, Kamaljit, Stankiewicz, Magdalena, Carlsson, Maria, Morsund, Åse, Idicula, Titto, Aamodt, Anne Hege, Lund, Christian, Næss, Halvor, Waje-Andreassen, Ulrike, and Thomassen, Lars

Published
2017
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36. Adherence to a Long-Term Physical Activity and Exercise Program After Stroke Applied in a Randomized Controlled Trial

Author

Gunnes, Mari, Langhammer, Birgitta, Aamot, Inger-Lise, Lydersen, Stian, Ihle-Hansen, Hege, Indredavik, Bent, Reneflot, Kristine H., Schroeter, Walburga, and Askim, Torunn

Subjects
Care and treatment, Patient outcomes, Health aspects, Stroke patients -- Care and treatment -- Patient outcomes, Patient compliance -- Patient outcomes, Exercise -- Health aspects, Physical therapy -- Patient outcomes
Abstract

Background. Persistent physical activity is important to maintain motor function across all stages after stroke. Objective. The objective of this study was to investigate adherence to an 18-month physical activity [...]

Published
2019
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38. Efficacy and Safety of Individualized Coaching After Stroke: the LAST Study (Life After Stroke): A Pragmatic Randomized Controlled Trial

Author

Askim, Torunn, Langhammer, Birgitta, Ihle-Hansen, Hege, Gunnes, Mari, Lydersen, Stian, Indredavik, Bent, Engstad, Torgeir, Magnussen, Jon, Hansen, Anne, Schjørlien, Rune, Engen, Stian, Osmundnes, Randi Moxnes, Olerud, Anne-Britt, Knudsen, Camilla, Hansen, Trine, Schroeter, Walburga, Fjelldal, Gro Stensrud, Hovde, Kristin, Reneflot, Kristine Helen, Wennberg, Lisa, Norvang, Ole Petter, Phan, Ailan, Storvoll, John Bjørn, Ørjaset, Brede, Syvertsen, Marianne, Berger, Ingvild, Dahl, Anne Eitrem, Sandø, Christine Lundemo, Kjølstad, Veronica, Hansen, Alexander, Vileid, Helene Kværne, Giddal, Maren Hjelle, Bernhardt, Julie, and Langhorne, Peter

Published
2018
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40. Atrial fibrillation in cryptogenic stroke and TIA patients in the nordic atrial fibrillation and stroke The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study: Main results

Author

Ratajczak-Tretel, Barbara, Lambert, Anna Tancin, Al-Ani, R., Arntzen, Kathrine Grønning, Bakkejord, G.K., Bekkeseth, H.M.O., Bjerkeli, Vigdis, Eldøen, Guttorm, Gulsvik, Anne Kristine, Halvorsen, Bente, Høie, G.A., Ihle-Hansen, Håkon, Ihle-Hansen, Hege, Ingebrigtsen, S., Johansen, H, Kremer, C., Krogseth, S.B., Kruuse, C., Kurz, Friedrich Martin Wilhelm, Nakstad, Ingvild, Novotny, Vojtech, Næss, Halvor, Qazi, Rehman Ul-Haq, Rezaj, M.K., Rørholt, Dag Marius Nitschke, Steffensen, Linn Hofsøy, Sømark, Jesper, Tobro, Håkon, Truelsen, T.C., Wassvik, L., Ægidius, K.L., Atar, Dan, and Aamodt, Anne Hege

Abstract

Introduction: Secondary stroke prevention depends on proper identification of the underlying etiology and initiation of optimal treatment after the index event. The aim of the NOR-FIB study was to detect and quantify underlying atrial fibrillation (AF) in patients with cryptogenic stroke (CS) or transient ischaemic attack (TIA) using insertable cardiac monitor (ICM), to optimise secondary prevention, and to test the feasibility of ICM usage for stroke physicians. Patients and methods: Prospective observational international multicenter real-life study of CS and TIA patients monitored for 12 months with ICM (Reveal LINQ) for AF detection. Results: ICM insertion was performed in 91.5% by stroke physicians, within median 9 days after index event. Paroxysmal AF was diagnosed in 74 out of 259 patients (28.6%), detected early after ICM insertion (mean 48 ± 52 days) in 86.5% of patients. AF patients were older (72.6 vs 62.2; p

Published
2022

41. Use of Drugs With Risk of Heart Rate-Related Problems is Common in Norwegian Dementia Patients Treated With Acetylcholinesterase Inhibitors: A Prevalence Study Based on the Norwegian Prescription Database

Author

Efjestad, Anne Sverdrup, Ihle-Hansen, Hege, Hjellvik, Vidar, Engedal, Knut, and Blix, Hege Salvesen

Subjects
Pharmacology, Pharmacology (medical)
Abstract

Background: Drugs commonly prescribed for heart rate control may induce adverse drug reactions in Alzheimer patients treated with acetylcholinesterase inhibitors (AChEIs). We have studied use of drugs with a known risk of Torsades de pointes (TdP) and drugs used to treat behavioral and psychological symptoms of dementia, as well as a combination of drugs with a known risk of TdP and drugs with a known heart rate-lowering effect, before and after initiating treatment with AChEIs.Methods: The study applied data from the Norwegian Prescription Database for the period 2004–2016. Prescriptions of concomitant use of drugs in persistent users of AChEIs was studied in a follow-up period from 4 years before to 2 years after AChEI initiation in men and women of two age groups: 37–80 and 81–88 years.Results: A small number of patients were prescribed haloperidol (∼1.5% The second year after AChEI initiation), digoxin/digitoxin (∼3%), and verapamil (∼1.3%), while a substantial proportion of the patients were prescribed betablockers (∼28%) and citalopram/escitalopram (∼17%). During follow-up, up to 6% of the study population were prescribed both betablockers and citalopram/citalopram in addition to AChEIs, a combination that increased over the follow-up period and was observed most frequently in women in the oldest age group.Conclusions: A large proportion (∼44%) of patients treated with AChEIs were prescribed drugs that could cause bradycardic and prolonged time from the start of the Q wave to the end of the T wave (QT interval). Thus, action should be taken to reduce the combination of drugs with risk of bradycardia and prolonged QT interval. Medication review on a regular basis could be an option as an important risk-reducing intervention.

Published
2022

42. Predictors of cognitive and emotional symptoms 12 months after first-ever mild stroke.

Author

Vlachos, Georgios, Ihle-Hansen, Hege, Wyller, Torgeir Bruun, Brækhus, Anne, Mangset, Margrete, Hamre, Charlotta, and Fure, Brynjar

Subjects
*APATHY, *STROKE, *COGNITIVE processing speed, *LOGISTIC regression analysis, *EXECUTIVE function, *COGNITION disorders
Abstract

Even mild strokes may affect the patients' everyday life by impairing cognitive and emotional functions. Our aim was to study predictors of such impairments one year after first-ever mild stroke. We included cognitively healthy patients ≤ 70 years with acute mild stroke. Vascular risk factors, sociodemographic factors and stroke classifications were recorded. At one-year post-stroke, different domains related to cognitive and emotional function were assessed with validated instruments. Logistic regression analyses were performed to identify predictors of cognitive and emotional outcome. Of 117 patient assessed at follow-up, only 21 patients (18%) scored within the reference range on all cognitive and emotional assessments. Younger age, multiple infarcts, and being outside working life at stroke onset were independent predictors of cognitive impairments (psychomotor speed, attention, executive and visuospatial function, memory). Female gender and a higher National Institutes of Health Stroke Scale (NIHSS) score at discharge were significantly associated with emotional impairments (anxiety, depressive symptoms, fatigue, apathy, emotional lability) after one year, but these associations were only seen in the unadjusted models. In conclusion, patients in working age may profit from a follow-up during the post-stroke period, with extra focus on cognitive and emotional functions. [ABSTRACT FROM AUTHOR]

Published
2023
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43. Biomarkers predictive of atrial fibrillation in patients with cryptogenic stroke. Insights from the Nordic Atrial Fibrillation and Stroke (NOR‐FIB) study.

Author

Tancin Lambert, Anna, Ratajczak‐Tretel, Barbara, Al‐Ani, Riadh, Arntzen, Kathrine, Bakkejord, Grete Kristin, Bekkeseth, Hanna Marie Otterholt, Bjerkeli, Vigdis, Eldøen, Guttorm, Gulsvik, Anne Kristine, Halvorsen, Bente, Høie, Gudrun Anette, Ihle‐Hansen, Hege, Ihle‐Hansen, Håkon, Ingebrigtsen, Susanne, Johansen, Henriette, Kremer, Christine, Krogseth, Siv Bohne, Kruuse, Christina, Kurz, Martin, and Nakstad, Ingvild

Subjects
ISCHEMIC stroke, ATRIAL fibrillation, BRAIN natriuretic factor, TRANSIENT ischemic attack, RECEIVER operating characteristic curves
Abstract

Background and purpose: There are currently no biomarkers to select cryptogenic stroke (CS) patients for monitoring with insertable cardiac monitors (ICMs), the most effective tool for diagnosing atrial fibrillation (AF) in CS. The purpose of this study was to assess clinically available biomarkers as predictors of AF. Methods: Eligible CS and cryptogenic transient ischaemic attack patients underwent 12‐month monitoring with ICMs, clinical follow‐up and biomarker sampling. Levels of cardiac and thromboembolic biomarkers, taken within 14 days from symptom onset, were compared between patients diagnosed with AF (n = 74) during monitoring and those without AF (n = 185). Receiver operating characteristic curves were created. Biomarkers reaching area under the receiver operating characteristic curve ≥ 0.7 were dichotomized by finding optimal cut‐off values and were used in logistic regression establishing their predictive value for increased risk of AF in unadjusted and adjusted models. Results: B‐type natriuretic peptide (BNP), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), creatine kinase, D‐dimer and high‐sensitivity cardiac troponin I and T were significantly higher in the AF than non‐AF group. BNP and NT‐proBNP reached the predefined area under the curve level, 0.755 and 0.725 respectively. Optimal cut‐off values were 33.5 ng/l for BNP and 87 ng/l for NT‐proBNP. Regression analysis showed that NT‐proBNP was a predictor of AF in both unadjusted (odds ratio 7.72, 95% confidence interval 3.16–18.87) and age‐ and sex‐adjusted models (odds ratio 4.82, 95% confidence interval 1.79–12.96). Conclusion: Several clinically established biomarkers were associated with AF. NT‐proBNP performed best as AF predictor and could be used for selecting patients for long‐term monitoring with ICMs. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Cognitive impairment in people with physical frailty using the phenotype model: A systematic review and meta analysis.

Author

Vahedi, Ali, Eriksdotter, Maria, Ihle‐Hansen, Hege, Wyller, Torgeir Bruun, Øksengård, Anne Rita, and Fure, Brynjar

Abstract

Objective: We performed a systematic review and meta‐analysis to study the relationship between cognitive functioning and phenotypic frailty status. Methods: We searched Pubmed, Cochrane Library and Epistemonikos from 2000 until March 2022, and used the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Samples included both sexes, age ≥55 years, assessed with standardized measures of the different cognitive domains and the frailty phenotype model and analyzing the relationship between the frailty subtypes pre‐frail, frail and robust and specific cognitive function. Results: Eleven studies published from 2008 until March 2022 fulfilled the inclusion criteria, and 10 were included in our meta‐analyses. Sample sizes varied from 104 to 4649 individuals. Mean Mini‐Mental State Examination (MMSE) scores ranged from 17.0 to 27.6, with mean difference (MD) of −2.55 (95% confidence interval [CI] −3.32, −1.78) in frail compared to robust, MD −1.64 (95% CI −2.21, −1.06) in frail compared to prefrail and MD −0.68 (95% CI −0.94, −0.43) in prefrail compared to robust. In subgroup analyses, frail persons had lower scores in the memory domain with standardized mean difference (SMD) −1.01 (95% CI −1.42, −0.59). Conclusion: MMSE scores were significantly lower in frail compared to robust and prefrail persons and in prefrail compared to robust persons. Subgroup analysis of memory revealed significantly poorer scores in frail compared to robust. The results indicate a strong relationship between physical frailty and cognitive impairment suggesting incorporation of cognitive function in frailty assessments. Key points: Global cognitive function, as examined through Mini‐Mental State Examination, shows poorer scores in frail compared to prefrail and robust persons.Frail persons also score poorer in cognitive domains memory, visuospatial function, executive function and psychomotor speed.The results indicate a strong relationship between physical frailty and cognitive impairment.Since both cognitive and physical frailty usually are present, frailty models which include both cognitive and physical functions should be used in clinical practice. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Subclinical Carotid Artery Atherosclerosis and Cognitive Function: A Mini-Review.

Author

Ihle-Hansen, Håkon, Ihle-Hansen, Hege, Sandset, Else Charlotte, and Hagberg, Guri

Subjects
COGNITIVE ability, CAROTID artery, COGNITION disorders, ATHEROSCLEROSIS, COGNITION
Abstract

Carotid artery atherosclerosis, the result of a multitude of vascular risk factors, is a promising marker for use in risk stratification. Recent evidence suggests that carotid artery atherosclerosis affects cognitive function and is an independent risk factor for the development of cognitive impairment. Both atherosclerosis and cognitive impairment develop over a prolonged period (years), and due to the aging population, markers to identify persons at risk are needed. Carotid artery atherosclerosis can easily be visualized using non-invasive ultrasound, potentially enabling early and intensified risk factor management to preserve cognitive function or delay further decline. However, the burden of atherosclerosis and temporal exposure required to pose a risk of cognitive impairment is unclear. This mini-review aims to explore the available evidence on the association between carotid atherosclerosis and cognition, and furthermore identify the remaining gaps in knowledge. [ABSTRACT FROM AUTHOR]

Published
2021
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50. Pressor therapy in acute ischaemic stroke: an updated systematic review.

Author

Strømsnes, Torbjørn Austveg, Kaugerud Hagen, Truls Jørgen, Ouyang, Menglu, Wang, Xia, Chen, Chen, Rygg, Silje-Emilie, Hewson, David, Lenthall, Rob, McConachie, Norman, Izzath, Wazim, Bath, Philip M, Dhillon, Permesh Singh, Podlasek, Anna, England, Timothy, Sprigg, Nikola, Robinson, Thompson G, Advani, Rajiv, Ihle-Hansen, Hege, Sandset, Else Charlotte, and Krishnan, Kailash

Published
2022
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