30 results on '"Dittrich, Tolga D'
Search Results
2. Association between ischaemic stroke aetiology and leptomeningeal collateral status: a retrospective cohort study
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Lina Sojak, Anna M. Toebak, Camilla Gallino, Tennessee von Streng, Salome Rudin, Lilian F. Kriemler, Annaelle Zietz, Benjamin Wagner, Henrik Gensicke, Raoul Sutter, Christian H. Nickel, Mira Katan, Leo H. Bonati, Marios Psychogios, Tolga D. Dittrich, and Gian Marco De Marchis
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Medicine - Abstract
INTRODUCTION: There is limited understanding of the pathomechanistic relationship between leptomeningeal collateral formation and ischaemic stroke aetiology. We aimed to assess the association of leptomeningeal collateral status and ischaemic stroke aetiology, using the widely recognised “Trial of Org 10172 in Acute Stroke Treatment” (TOAST) classification categorising strokes into five distinct aetiologies. METHODS: Retrospective study of consecutively admitted adult ischaemic stroke patients at a Swiss stroke centre. Leptomeningeal collateral status was assessed on admission with single-phase CT-angiographies using a validated 4-point score. Patients were categorised into large-artery atherosclerosis (LAA), cardioembolic (CE), small-vessel disease (SVD) and cryptogenic (CG) according to the TOAST classification. We performed ordinal and binary (poor [collaterals filling ≤50% of the occluded territory] vs good [collaterals filling >50% of the occluded territory] collateralisation) logistic regression to evaluate the impact of TOAST aetiology on collateral status. RESULTS: Among 191 patients, LAA patients had better collateral status compared to non-LAA aetiology (LAA: 2 vs CE: 2 vs SVD: 3 vs CG: 2, pLAA vs non-LAA = 0.04). In weighted multivariate logistic regression, LAA and SVD independently predicted better collateral status (binary models [adjusted odds ratio; aOR]: LAA: 3.72 [1.21–11.44] and SVD: 4.19 [1.21–14.52]; ordinal models [adjusted common odds ratio; acOR]: LAA: 2.26 [95% CI: 1.23–4.15] and SVD: 1.94 [1.03–3.66]), while CE predicted worse collateral status (binary models [aOR]: CE: 0.17 [0.07–0.41]; ordinal models [acOR]: CE: 0.24 [0.11–0.51]). CONCLUSION: The aetiology of ischaemic stroke is associated with leptomeningeal collateral status on single-phase CT-angiography, with LAA and SVD predicting better and CE predicting worse collateral status.
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- 2024
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3. Translation of patients’ advance directives in intensive care units: are we there yet?
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Sira M. Baumann, Natalie J. Kruse, Paulina S. C. Kliem, Simon A. Amacher, Sabina Hunziker, Tolga D. Dittrich, Fabienne Renetseder, Pascale Grzonka, and Raoul Sutter
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Advance directives ,Patients’ will ,Intensive care ,Neurocritical illness ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Objectives This review examined studies regarding the implementation and translation of patients’ advance directives (AD) in intensive care units (ICUs), focusing on practical difficulties and obstacles. Methods The digital PubMed and Medline databases were screened using predefined keywords to identify relevant prospective and retrospective studies published until 2022. Results Seventeen studies from the United States, Europe, and South Africa (including 149,413 patients and 1210 healthcare professionals) were identified. The highest prevalence of ADs was described in a prospective study in North America (49%), followed by Central Europe (13%), Asia (4%), Australia and New Zealand (4%), Latin America (3%), and Northern and Southern Europe (2.6%). While four retrospective studies reported limited effects of ADs, four retrospective studies, one survey and one systematic review indicated significant effects on provision of intensive care, higher rates of do-not-resuscitate orders, and care withholding in patients with ADs. Four of these studies showed shorter ICU stays, and lower treatment costs in patients with ADs. One prospective and two retrospective studies reported issues with loss, delayed or no transmission of ADs. One survey revealed that 91% of healthcare workers did not regularly check for ADs. Two retrospective studies and two survey revealed that the implementation of directives is further challenged by issues with their applicability, phrasing, and compliance by the critical care team and family members. Conclusions Although ADs may improve intensive- and end-of-life care, insufficient knowledge, lack of awareness, poor communication between healthcare providers and patients or surrogates, lack of standardization of directives, as well as ethical and legal concerns challenge their implementation.
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- 2023
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4. Translation of patients’ advance directives in intensive care units: are we there yet?
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Baumann, Sira M., Kruse, Natalie J., Kliem, Paulina S. C., Amacher, Simon A., Hunziker, Sabina, Dittrich, Tolga D., Renetseder, Fabienne, Grzonka, Pascale, and Sutter, Raoul
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- 2023
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5. Lipoprotein(a) as a blood marker for large artery atherosclerosis stroke etiology: validation in a prospective cohort from a swiss stroke center
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Salome Rudin, Lilian Kriemler, Tolga D. Dittrich, Annaelle Zietz, Juliane Schweizer, Markus Arnold, Nils Peters, Filip Barinka, Simon Jung, Marcel Arnold, Katharina Rentsch, Mirjam Christ-Crain, Mira Katan, and Gian Marco De Marchis
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Medicine - Abstract
BACKGROUND: Lipoprotein (a) [Lp(a)] serum levels are highly genetically determined and promote atherogenesis. High Lp(a) levels are associated with increased cardiovascular morbidity. Serum Lp(a) levels have recently been associated with large artery atherosclerosis (LAA) stroke. We aimed to externally validate this association in an independent cohort. METHODS: This study stems from the prospective multicentre CoRisk study (CoPeptin for Risk Stratification in Acute Stroke patients [NCT00878813]), conducted at the University Hospital Bern, Switzerland, between 2009 and 2011, in which Lp(a) plasma levels were measured within the first 24 hours after stroke onset. We assessed the association of Lp(a) with LAA stroke using multivariable logistic regression and performed interaction analyses to identify potential effect modifiers. RESULTS: Of 743 patients with ischaemic stroke, 105 (14%) had LAA stroke aetiology. Lp(a) levels were higher for LAA stroke than non-LAA stroke patients (23.0 nmol/l vs 16.3 nmol/l, p = 0.01). Multivariable regression revealed an independent association of log10 Lp(a) with LAA stroke aetiology (aOR 1.47 [95% CI 1.03–2.09], p = 0.03). The interaction analyses showed that Lp(a) was not associated with LAA stroke aetiology among patients with diabetes. CONCLUSIONS: In a well-characterised cohort of patients with ischaemic stroke, we validated the association of higher Lp(a) levels with LAA stroke aetiology, independent of traditional cardiovascular risk factors. These findings may inform randomised clinical trials investigating the effect of Lp(a) lowering agents on cardiovascular outcomes. The CoRisk (CoPeptin for Risk Stratification in Acute Patients) study is registered on ClinicalTrials.gov. Registration number: NCT00878813.
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- 2024
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6. Biomarker, Imaging, and Clinical Factors Associated With Overt and Covert Stroke in Patients With Atrial Fibrillation
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De Marchis, Gian Marco, Krisai, Philipp, Werlen, Laura, Sinnecker, Tim, Aeschbacher, Stefanie, Dittrich, Tolga D., Polymeris, Alexandros A., Coslovksy, Michael, Blum, Manuel R., Rodondi, Nicolas, Reichlin, Tobias, Moschovitis, Giorgio, Wuerfel, Jens, Lyrer, Philippe A., Fischer, Urs, Conen, David, Kastner, Peter, Ziegler, André, Osswald, Stefan, Kühne, Michael, and Bonati, Leo H.
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- 2023
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7. Absent leptomeningeal collateralization is associated with greatest benefit from mechanical thrombectomy in the 6-24 hour time window.
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Dittrich, Tolga D, von Streng, Tennessee, Toebak, Anna M, Zietz, Annaelle, Wagner, Benjamin, Hänsel, Martin, Sutter, Raoul, Katan, Mira, Peters, Nils, Michels, Lars, Kulcsár, Zsolt, Karwacki, Grzegorz M, Pileggi, Marco, Cereda, Carlo W, Wegener, Susanne, Bonati, Leo H, Psychogios, Marios, and De Marchis, Gian Marco
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- 2024
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8. Blood Biomarkers in the Diagnosis of Acute Stroke
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De Marchis, Gian Marco, Dittrich, Tolga D., Fonseca, Ana Catarina, editor, and Ferro, José M., editor
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- 2021
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9. Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study
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Dittrich, Tolga D., Sporns, Peter B., Kriemler, Lilian F., Rudin, Salome, Nguyen, Anh, Zietz, Annaelle, Polymeris, Alexandros A., Tränka, Christopher, Thilemann, Sebastian, Wagner, Benjamin, Altersberger, Valerian L., Piot, Ines, Barinka, Filip, Müller, Susanne, Hänsel, Martin, Gensicke, Henrik, Engelter, Stefan T., Lyrer, Philippe A., Sutter, Raoul, Nickel, Christian H., Katan, Mira, Peters, Nils, Kulcsár, Zsolt, Karwacki, Grzegorz M., Pileggi, Marco, Cereda, Carlo, Wegener, Susanne, Bonati, Leo H., Fischer, Urs, Psychogios, Marios, and De Marchis, Gian Marco
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- 2023
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10. Statin Therapy in Ischemic Stroke Patients with Atrial Fibrillation: Efficacy and Safety Outcomes
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Marvardi, Michele, primary, Ferrante, Mario, additional, Paciaroni, Maurizio, additional, Abdul-Rahim, Azmil H, additional, Tsivgoulis, Georgios, additional, Seiffge, David J, additional, Engelter, Stefan T, additional, Lyrer, Philippe A., additional, Polymeris, Alexandros A, additional, Dittrich, Tolga D, additional, Cancelloni, Virginia, additional, Zietz, Annaelle, additional, De Marchis, Gian Marco, additional, Putaala, Jukka, additional, Strbian, Daniel, additional, Tomppo, Liisa, additional, Michel, Patrik, additional, Strambo, Davide, additional, Salerno, Alexander, additional, Vanacker, Peter, additional, Zuurbier, Susanna M., additional, Yperzeele, Laetitia, additional, Loos, Caroline MJ, additional, Cappellari, Manuel, additional, Emiliani, Andrea, additional, Zedde, Marialuisa, additional, Becattini, Cecilia, additional, Pascarella, Rosario, additional, Dawson, Jesse, additional, Cronshaw, Robert, additional, Schirinzi, Erika, additional, Del Sette, Massimo, additional, Stretz, Christoph, additional, Kala, Narendra Sharma, additional, Schomer, Ashley, additional, Mac Grory, Brian, additional, Jayaraman, Mahesh V, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Masotti, Luca, additional, Grifoni, Elisa, additional, Toni, Danilo, additional, Risitano, Angela, additional, Falcou, Anne A, additional, Petraglia, Luca, additional, Lotti, Enrico Maria, additional, Pavolucci, Lucia, additional, Lochner, Piergiorgio, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Alberti, Andrea, additional, Venti, Michele, additional, Leone De Magistris, Ilaria, additional, Mosconi, Maria Giulia, additional, Giustozzi, Michela, additional, Kargiotis, Odysseas, additional, Rocco, Alessandro, additional, Diomedi, Marina, additional, Marcheselli, Simona, additional, Antonenko, Kateryna, additional, Rota, Eugenia, additional, Tassinari, Tiziana, additional, Saia, Valentina, additional, Palmerini, Francesco, additional, Aridon, Paolo, additional, Arnao, Valentina, additional, Monaco, Serena, additional, Cottone, Salvatore, additional, Baldi, Antonio, additional, D'Amore, Cataldo, additional, Ageno, Walter, additional, Pegoraro, Samuela, additional, Ntaios, George, additional, Adamou, Anastasia, additional, Sagris, Dimitrios, additional, Giannopoulos, Sotirios, additional, Kosmidou, Maria, additional, Ntais, Evangelos, additional, Romoli, Michele, additional, Pantoni, Leonardo, additional, Rosa, Silvia, additional, Bertora, Pierluigi, additional, Chiti, Alberto, additional, Canavero, Isabella, additional, Saggese, Carlo Emanuele, additional, Plocco, Maurizio, additional, Giorli, Elisa, additional, Palaiodimou, Lina, additional, Bakola, Eleni, additional, Bandini, Fabio, additional, Gasparro, Antonio, additional, Terruso, Valeria, additional, Mannino, Marina, additional, Pezzini, Alessandro, additional, Ornello, Raffaele, additional, Sacco, Simona, additional, Popovic, Nemanja, additional, Scoditti, Umberto, additional, Genovese, Antonio, additional, Flomin, Yuriy, additional, Mancuso, Michelangelo, additional, D'agliano, Roberto, additional, Baldini, Marco, additional, Ulivi, Leonardo, additional, Giannini, Nicola, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrysoula, additional, Chondrogianni, Maria, additional, Halvatsiotis, Panagiotis, additional, Karagkiozi, Efstathia, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, lanari, alessia, additional, Tatlisumak, Turgut, additional, Acciarresi, Monica, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Sohn, Sung-Il, additional, Mumoli, Nicola, additional, Cararra, Davide, additional, Maccarrone, Miriam, additional, Galati, Franco, additional, Gourbali, Vanessa, additional, Orlandi, Giovanni, additional, Giuntini, Martina, additional, Corea, Francesco, additional, Bellesini, Marta, additional, Karapanayiotides, Theodore, additional, Csiba, Laszlo, additional, Szabo, Lilla, additional, Imberti, Davide, additional, Pieroni, Alessio, additional, Barlinn, Kristian, additional, Pallesen, Lars-Peder, additional, Barlinn, Jessica, additional, Doronin, Boris, additional, Volodina, Vera Alexandrovna, additional, Agnelli, Giancarlo, additional, Deleu, Dirk, additional, Bonetti, Bruno, additional, Gentile, Luana, additional, Reale, Giuseppe, additional, Caliandro, Pietro, additional, Morotti, Andrea, additional, Vannucchi, Vieri, additional, Padroni, Marina, additional, Letteri, Federica, additional, Magoni, Mauro, additional, Tiseo, Cindy, additional, Rigatelli, Alberto, additional, Zauli, Aurelia, additional, Bossi, Francesco, additional, and Caso, Valeria, additional
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- 2024
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11. Lipoprotein(a) as a blood marker for large artery atherosclerosis stroke etiology: validation in a prospective cohort from a swiss stroke center
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Rudin, Salome, primary, Kriemler, Lilian, additional, Dittrich, Tolga D., additional, Zietz, Annaelle, additional, Schweizer, Juliane, additional, Arnold, Markus, additional, Peters, Nils, additional, Barinka, Filip, additional, Jung, Simon, additional, Arnold, Marcel, additional, Rentsch, Katharina, additional, Christ-Crain, Mirjam, additional, Katan, Mira, additional, and De Marchis, Gian Marco, additional
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- 2024
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12. Diagnostic yield of cerebrospinal fluid analysis in status epilepticus: an 8-year cohort study
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Dittrich, Tolga D., Baumann, Sira M., Semmlack, Saskia, De Marchis, Gian Marco, Hunziker, Sabina, Rüegg, Stephan, Marsch, Stephan, Tschudin-Sutter, Sarah, and Sutter, Raoul
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- 2021
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13. Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
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Benjamin Wagner, Lisa Hert, Alexandros A. Polymeris, Sabine Schaedelin, Johanna M. Lieb, David J. Seiffge, Christopher Traenka, Sebastian Thilemann, Joachim Fladt, Valerian L. Altersberger, Annaelle Zietz, Tolga D. Dittrich, Urs Fisch, Henrik Gensicke, Gian Marco De Marchis, Leo H. Bonati, Philippe A. Lyrer, Stefan T. Engelter, and Nils Peters
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stroke ,atrial fibrillation ,anticoagulation ,direct-acting oral anticoagulant ,cerebral microbleeds ,small vessel disease ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
BackgroundCerebral microbleeds (CMBs) may have a differential impact on clinical outcome in stroke patients with atrial fibrillation (AF) treated with different types of oral anticoagulation (OAC).MethodsObservational single-center study on AF-stroke-patients treated with OAC. Magnetic-resonance-imaging was performed to assess CMBs. Outcome measures consisted of recurrent ischemic stroke (IS), intracranial hemorrhage (ICH), death, and their combined analysis. Functional disability was assessed by mRS. Using adjusted logistic regression and Cox proportional-hazards models, we assessed the association of the presence of CMBs and OAC type (vitamin K antagonists [VKAs] vs. direct oral anticoagulants [DOACs]) with clinical outcome.ResultsOf 310 AF-stroke patients treated with OAC [DOACs: n = 234 (75%); VKAs: n = 76 (25%)], CMBs were present in 86 (28%) patients; of these, 66 (77%) received DOACs. In both groups, CMBs were associated with an increased risk for the composite outcome: VKAs: HR 3.654 [1.614; 8.277]; p = 0.002; DOACs: HR 2.230 [1.233; 4.034]; p = 0.008. Patients with CMBs had ~50% higher absolute rates of the composite outcome compared to the overall cohort, with a comparable ratio between treatment groups [VKAs 13/20(65%) vs. DOACs 19/66(29%); p < 0.01]. The VKA-group had a 2-fold higher IS [VKAs:4 (20%) vs. DOACs:6 (9%); p = 0.35] and a 10-fold higher ICH rate [VKAs: 3 (15%) vs. DOACs: 1 (1.5%); p = 0.038]. No significant interaction was observed between type of OAC and presence of CMBs. DOAC-patients showed a significantly better functional outcome (OR 0.40 [0.17; 0.94]; p = 0.04).ConclusionsIn AF-stroke patients treated with OAC, the presence of CMBs was associated with an unfavorable composite outcome for both VKAs and DOACs, with a higher risk for recurrent IS than for ICH. Strokes were numerically higher under VKAs and increased in the presence of CMBs.Clinical trial registrationhttp://www.clinicaltrials.gov, Unique identifier: NCT03826927.
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- 2022
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14. Causes, Manifestations, and Complications of Generalized Convulsive Status Epilepticus in Adults
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Sutter, Raoul, Dittrich, Tolga D., Kaplan, Peter W., Tarsy, Daniel, Series editor, Drislane, Frank W., editor, and Kaplan MBBS, Peter W., editor
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- 2018
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15. Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study
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Tolga D. Dittrich, Peter B. Sporns, Lilian F. Kriemler, Salome Rudin, Anh Nguyen, Annaelle Zietz, Alexandros A. Polymeris, Christopher Tränka, Sebastian Thilemann, Benjamin Wagner, Valerian L. Altersberger, Ines Piot, Filip Barinka, Susanne Müller, Martin Hänsel, Henrik Gensicke, Stefan T. Engelter, Philippe A. Lyrer, Raoul Sutter, Christian H. Nickel, Mira Katan, Nils Peters, Zsolt Kulcsár, Grzegorz M. Karwacki, Marco Pileggi, Carlo Cereda, Susanne Wegener, Leo H. Bonati, Urs Fischer, Marios Psychogios, and Gian Marco De Marchis
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: We assessed the efficacy and safety of mechanical thrombectomy (MT) in adult stroke patients with anterior circulation large vessel occlusion presenting in the late time window not fulfilling the DEFUSE-3 (Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging trial) and DAWN (Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct trial) inclusion criteria. Methods: Cohort study of adults with anterior circulation large vessel occlusion admitted between 6 and 24 hours after last-seen-well at 5 participating Swiss stroke centers between 2014 and 2021. Mismatch was assessed by computer tomography or magnetic resonance imaging perfusion with automated software (RAPID or OLEA). We excluded patients meeting DEFUSE-3 and DAWN inclusion criteria and compared those who underwent MT with those receiving best medical treatment alone by inverse probability of treatment weighting using the propensity score. The primary efficacy end point was a favorable functional outcome at 90 days, defined as a modified Rankin Scale score shift toward lower categories. The primary safety end point was symptomatic intracranial hemorrhage within 7 days of stroke onset; the secondary was all-cause mortality within 90 days. Results: Among 278 patients with anterior circulation large vessel occlusion presenting in the late time window, 190 (68%) did not meet the DEFUSE-3 and DAWN inclusion criteria and thus were included in the analyses. Of those, 102 (54%) received MT. In the inverse probability of treatment weighting analysis, patients in the MT group had higher odds of favorable outcomes compared with the best medical treatment alone group (modified Rankin Scale shift: acOR, 1.46 [1.02–2.10]; P =0.04) and lower odds of all-cause mortality within 90 days (aOR, 0.59 [0.37–0.93]; P =0.02). There were no significant differences in symptomatic intracranial hemorrhage (MT versus best medical treatment alone: 5% versus 2%, P =0.63). Conclusions: Two out of 3 patients with anterior circulation large vessel occlusion presenting in the late time window did not meet the DEFUSE-3 and DAWN inclusion criteria. In these patients, MT was associated with higher odds of favorable functional outcomes without increased rates of symptomatic intracranial hemorrhage. These findings support the enrollment of patients into ongoing randomized trials on MT in the late window with more permissive inclusion criteria.
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- 2023
16. New Avenues for Optimal Treatment of Atrial Fibrillation and Stroke Prevention
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De Marchis, Gian Marco, Sposato, Luciano A., Kühne, Michael, Dittrich, Tolga D., Bonati, Leo H., Fischer, Urs, and Chaturvedi, Seemant
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- 2021
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17. Genetic proxies for PCSK9 inhibition associate with lipoprotein(a): Effects on coronary artery disease and ischemic stroke
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Gian Marco De Marchis, Tolga D. Dittrich, Rainer Malik, Annaelle V. Zietz, Lilian F. Kriemler, Brian A. Ference, Martin Dichgans, and Marios K. Georgakis
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PCSK9 Inhibitors ,Humans ,Coronary Artery Disease ,Cholesterol, LDL ,Proprotein Convertase 9 ,Cardiology and Cardiovascular Medicine ,Lipoprotein(a) ,Ischemic Stroke - Abstract
Post hoc analyses of clinical trials show that PCSK9 inhibitors might lower lipoprotein(a), but whether this effect contributes to reductions in cardiovascular risk remains unknown. We aimed to assess whether genetically proxied PCSK9 inhibition influences lipoprotein(a) (Lp(a)), and whether any such effect could mediate its effects on coronary artery disease (CAD) and ischemic stroke (IS).To explore associations between the genetic proxies for PCSK9 inhibitors and Lp(a) levels, we used UK Biobank data (310,020 individuals). We identified 10 variants in the PCSK9 gene associated with lower PCSK9 and LDL-C levels as proxies for PCSK9 inhibition. We explored the effects of genetically proxied PCSK9 inhibition on Lp(a) levels, as well as on odds of CAD (60,801 cases, 184,305 controls) and IS (60,341 cases, 454,450 controls) in two-sample Mendelian randomization analyses. In mediation analyses, we assessed the effects of genetically proxied PCSK9 inhibition on CAD and IS mediated through reductions in Lp(a) levels.Genetically proxied PCSK9 inhibition (1-SD decrement in PCSK9 concentration; corresponding to 20.6 mg/dl decrement in LDL-C levels) was associated with a 4% decrease in log-Lp(a) levels (beta: -0.038, 95%CI: -0.053 to -0.023). We estimated a 0.8% reduction in the odds for CAD (OR: 0.992, 95%CI: 0.989-0.995) and a 0.5% reduction in the odds for atherosclerotic IS (OR: 0.995, 95%CI: 0.992-0.998) due to reductions in Lp(a) levels through genetically proxied PCSK9 inhibition, corresponding to 3.8% and 3.2% of the total effects, respectively.Genetic proxies for PCSK9 inhibition are associated with lower Lp(a) levels. However, Lp(a) lowering explains only a small proportion of the total effects of genetic proxies for PCSK9 inhibitors on risk of CAD and IS.
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- 2022
18. Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study
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Dittrich, Tolga D; https://orcid.org/0000-0002-9987-3631, Sporns, Peter B; https://orcid.org/0000-0002-3028-0539, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh; https://orcid.org/0000-0002-9343-8276, Zietz, Annaelle; https://orcid.org/0000-0002-4362-2497, Polymeris, Alexandros A; https://orcid.org/0000-0002-9475-2208, Tränka, Christopher, Thilemann, Sebastian; https://orcid.org/0000-0002-2735-0794, Wagner, Benjamin; https://orcid.org/0000-0001-9330-1790, Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Piot, Ines; https://orcid.org/0000-0001-8502-7453, Barinka, Filip; https://orcid.org/0000-0002-5823-0656, Müller, Susanne; https://orcid.org/0000-0002-5638-722X, Hänsel, Martin; https://orcid.org/0000-0001-9300-1130, Gensicke, Henrik; https://orcid.org/0000-0002-0949-2422, Engelter, Stefan T; https://orcid.org/0000-0003-3855-6234, Lyrer, Philippe A; https://orcid.org/0000-0002-1435-1114, Sutter, Raoul; https://orcid.org/0000-0002-6575-356X, Nickel, Christian H, Katan, Mira; https://orcid.org/0000-0002-9265-8066, Peters, Nils, Kulcsár, Zsolt; https://orcid.org/0000-0002-6805-5150, Karwacki, Grzegorz M; https://orcid.org/0000-0001-5963-6220, Pileggi, Marco; https://orcid.org/0000-0002-7691-8999, Cereda, Carlo; https://orcid.org/0000-0002-6479-1476, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Bonati, Leo H; https://orcid.org/0000-0003-1163-8133, Fischer, Urs; https://orcid.org/0000-0003-0521-4051, Psychogios, Marios; https://orcid.org/0000-0002-0016-414X, et al, Dittrich, Tolga D; https://orcid.org/0000-0002-9987-3631, Sporns, Peter B; https://orcid.org/0000-0002-3028-0539, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh; https://orcid.org/0000-0002-9343-8276, Zietz, Annaelle; https://orcid.org/0000-0002-4362-2497, Polymeris, Alexandros A; https://orcid.org/0000-0002-9475-2208, Tränka, Christopher, Thilemann, Sebastian; https://orcid.org/0000-0002-2735-0794, Wagner, Benjamin; https://orcid.org/0000-0001-9330-1790, Altersberger, Valerian L; https://orcid.org/0000-0002-0610-9328, Piot, Ines; https://orcid.org/0000-0001-8502-7453, Barinka, Filip; https://orcid.org/0000-0002-5823-0656, Müller, Susanne; https://orcid.org/0000-0002-5638-722X, Hänsel, Martin; https://orcid.org/0000-0001-9300-1130, Gensicke, Henrik; https://orcid.org/0000-0002-0949-2422, Engelter, Stefan T; https://orcid.org/0000-0003-3855-6234, Lyrer, Philippe A; https://orcid.org/0000-0002-1435-1114, Sutter, Raoul; https://orcid.org/0000-0002-6575-356X, Nickel, Christian H, Katan, Mira; https://orcid.org/0000-0002-9265-8066, Peters, Nils, Kulcsár, Zsolt; https://orcid.org/0000-0002-6805-5150, Karwacki, Grzegorz M; https://orcid.org/0000-0001-5963-6220, Pileggi, Marco; https://orcid.org/0000-0002-7691-8999, Cereda, Carlo; https://orcid.org/0000-0002-6479-1476, Wegener, Susanne; https://orcid.org/0000-0003-4369-7023, Bonati, Leo H; https://orcid.org/0000-0003-1163-8133, Fischer, Urs; https://orcid.org/0000-0003-0521-4051, Psychogios, Marios; https://orcid.org/0000-0002-0016-414X, and et al
- Abstract
Background: We assessed the efficacy and safety of mechanical thrombectomy (MT) in adult stroke patients with anterior circulation large vessel occlusion presenting in the late time window not fulfilling the DEFUSE-3 (Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging trial) and DAWN (Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct trial) inclusion criteria. Methods: Cohort study of adults with anterior circulation large vessel occlusion admitted between 6 and 24 hours after last-seen-well at 5 participating Swiss stroke centers between 2014 and 2021. Mismatch was assessed by computer tomography or magnetic resonance imaging perfusion with automated software (RAPID or OLEA). We excluded patients meeting DEFUSE-3 and DAWN inclusion criteria and compared those who underwent MT with those receiving best medical treatment alone by inverse probability of treatment weighting using the propensity score. The primary efficacy end point was a favorable functional outcome at 90 days, defined as a modified Rankin Scale score shift toward lower categories. The primary safety end point was symptomatic intracranial hemorrhage within 7 days of stroke onset; the secondary was all-cause mortality within 90 days. Results: Among 278 patients with anterior circulation large vessel occlusion presenting in the late time window, 190 (68%) did not meet the DEFUSE-3 and DAWN inclusion criteria and thus were included in the analyses. Of those, 102 (54%) received MT. In the inverse probability of treatment weighting analysis, patients in the MT group had higher odds of favorable outcomes compared with the best medical treatment alone group (modified Rankin Scale shift: acOR, 1.46 [1.02–2.10]; P=0.04) and lower odds of all-cause mortality within 90 days (aOR, 0.59 [0.37–0.93]; P=0.02). There were no significant differences in symptomatic intracranial hemorrhage (MT versus best medical treatment alone: 5% versus 2%, P=0.63). Conclusio
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- 2023
19. Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications – the PLEURA study
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Dittrich, Tolga D, primary, Aujesky, Mara, additional, Rudin, Salome, additional, Zietz, Annaelle, additional, Wagner, Benjamin, additional, Polymeris, Alexandros, additional, Altersberger, Valerian L, additional, Sinnecker, Tim, additional, Gensicke, Henrik, additional, Engelter, Stefan T, additional, Lyrer, Philippe, additional, Hess, Viviane, additional, Sutter, Raoul, additional, Nickel, Christian H, additional, Bonati, Leo H, additional, Fischer, Urs, additional, Psychogios, Marios, additional, Katan, Mira, additional, and De Marchis, Gian Marco, additional
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- 2023
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20. Causes, Manifestations, and Complications of Generalized Convulsive Status Epilepticus in Adults
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Sutter, Raoul, primary, Dittrich, Tolga D., additional, and Kaplan, Peter W., additional
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- 2017
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21. Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients
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Dittrich, Tolga D, primary, Sporns, Peter B, additional, Kriemler, Lilian F, additional, Rudin, Salome, additional, Nguyen, Anh, additional, Zietz, Annaelle, additional, Polymeris, Alexandros A, additional, Tränka, Christopher, additional, Thilemann, Sebastian, additional, Wagner, Benjamin, additional, Altersberger, Valerian L, additional, Piot, Ines, additional, Barinka, Filip, additional, Hänsel, Martin, additional, Gensicke, Henrik, additional, Engelter, Stefan T, additional, Lyrer, Philippe A, additional, Sutter, Raoul, additional, Nickel, Christian H, additional, Katan, Mira, additional, Peters, Nils, additional, Michels, Lars, additional, Kulcsár, Zsolt, additional, Karwacki, Grzegorz M, additional, Pileggi, Marco, additional, Cereda, Carlo, additional, Wegener, Susanne, additional, Bonati, Leo H, additional, Fischer, Urs, additional, Psychogios, Marios, additional, and De Marchis, Gian Marco, additional
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- 2022
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22. Genetic proxies for PCSK9 inhibition associate with lipoprotein(a): Effects on coronary artery disease and ischemic stroke
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De Marchis, Gian Marco, primary, Dittrich, Tolga D., additional, Malik, Rainer, additional, Zietz, Annaelle V., additional, Kriemler, Lilian F., additional, Ference, Brian A., additional, Dichgans, Martin, additional, and Georgakis, Marios K., additional
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- 2022
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23. sj-doc-2-eso-10.1177_23969873231151488 – Supplemental material for Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications – the PLEURA study
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Dittrich, Tolga D, Aujesky, Mara, Rudin, Salome, Zietz, Annaelle, Wagner, Benjamin, Polymeris, Alexandros, Altersberger, Valerian L, Sinnecker, Tim, Gensicke, Henrik, Engelter, Stefan T, Lyrer, Philippe, Hess, Viviane, Sutter, Raoul, Nickel, Christian H, Bonati, Leo H, Fischer, Urs, Psychogios, Marios, Katan, Mira, and De Marchis, Gian Marco
- Subjects
FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-doc-2-eso-10.1177_23969873231151488 for Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications – the PLEURA study by Tolga D Dittrich, Mara Aujesky, Salome Rudin, Annaelle Zietz, Benjamin Wagner, Alexandros Polymeris, Valerian L Altersberger, Tim Sinnecker, Henrik Gensicke, Stefan T Engelter, Philippe Lyrer, Viviane Hess, Raoul Sutter, Christian H Nickel, Leo H Bonati, Urs Fischer, Marios Psychogios, Mira Katan and Gian Marco De Marchis in European Stroke Journal
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- 2023
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24. sj-docx-1-eso-10.1177_23969873231151488 – Supplemental material for Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications – the PLEURA study
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Dittrich, Tolga D, Aujesky, Mara, Rudin, Salome, Zietz, Annaelle, Wagner, Benjamin, Polymeris, Alexandros, Altersberger, Valerian L, Sinnecker, Tim, Gensicke, Henrik, Engelter, Stefan T, Lyrer, Philippe, Hess, Viviane, Sutter, Raoul, Nickel, Christian H, Bonati, Leo H, Fischer, Urs, Psychogios, Marios, Katan, Mira, and De Marchis, Gian Marco
- Subjects
FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-docx-1-eso-10.1177_23969873231151488 for Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications – the PLEURA study by Tolga D Dittrich, Mara Aujesky, Salome Rudin, Annaelle Zietz, Benjamin Wagner, Alexandros Polymeris, Valerian L Altersberger, Tim Sinnecker, Henrik Gensicke, Stefan T Engelter, Philippe Lyrer, Viviane Hess, Raoul Sutter, Christian H Nickel, Leo H Bonati, Urs Fischer, Marios Psychogios, Mira Katan and Gian Marco De Marchis in European Stroke Journal
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- 2023
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25. Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients
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Tolga D Dittrich, Peter B Sporns, Lilian F Kriemler, Salome Rudin, Anh Nguyen, Annaelle Zietz, Alexandros A Polymeris, Christopher Tränka, Sebastian Thilemann, Benjamin Wagner, Valerian L Altersberger, Ines Piot, Filip Barinka, Martin Hänsel, Henrik Gensicke, Stefan T Engelter, Philippe A Lyrer, Raoul Sutter, Christian H Nickel, Mira Katan, Nils Peters, Lars Michels, Zsolt Kulcsár, Grzegorz M Karwacki, Marco Pileggi, Carlo Cereda, Susanne Wegener, Leo H Bonati, Urs Fischer, Marios Psychogios, and Gian Marco De Marchis
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Neurology - Abstract
Background: The DEFUSE-3 and DAWN trials showed that mechanical thrombectomy (MT) improves the outcome of selected patients with anterior circulation large vessel occlusions (LVO) up to 24 h after stroke onset. However, it is unknown whether only those patients fulfilling the trial inclusion criteria benefit, or whether benefit is seen in a broader range of patients presenting between 6 and 24 h. Aims: We determined whether fulfilling the DEFUSE-3 and DAWN selection criteria affects outcomes in MT patients in clinical practice. Methods: We reviewed adult patients with LVO treated with MT between 6 and 24 h after stroke onset at five Swiss stroke centers between 2014 and 2021. We compared two groups: (1) patients who satisfied neither DEFUSE-3 nor DAWN criteria (NDND) and (2) those who satisfied DEFUSE-3 or DAWN criteria (DOD). We used logistic regression to examine the impact of trial eligibility on two safety outcomes (symptomatic intracranial hemorrhage [sICH] and all-cause mortality at 3 months) and two efficacy outcomes (modified Rankin Score [mRS] shift toward lower categories and mRS of 0–2 at 3 months). Results: Of 174 patients who received MT, 102 (59%) belonged to the NDND group. Rates of sICH were similar between the NDND group and the DOD group (3% vs. 4%, p = 1.00). Multivariable regression revealed no differences in 3-month all-cause mortality (aOR 2.07, 95% CI 0.64–6.84, p = 0.23) or functional outcomes (mRS shift: acOR 0.81, 95% CI 0.37–1.79, p = 0.60; mRS 0–2: aOR 0.91, 95% CI 0.31–2.57, p = 0.85). Conclusion: Among adult patients with LVO treated with MT between 6 and 24 h, safety and efficacy outcomes were similar between DEFUSE-3/DAWN eligible and ineligible patients. Our data provide a compelling rationale for randomized trials with broader inclusion criteria for MT.
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- 2022
26. Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
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Wagner, Benjamin, primary, Hert, Lisa, additional, Polymeris, Alexandros A., additional, Schaedelin, Sabine, additional, Lieb, Johanna M., additional, Seiffge, David J., additional, Traenka, Christopher, additional, Thilemann, Sebastian, additional, Fladt, Joachim, additional, Altersberger, Valerian L., additional, Zietz, Annaelle, additional, Dittrich, Tolga D., additional, Fisch, Urs, additional, Gensicke, Henrik, additional, De Marchis, Gian Marco, additional, Bonati, Leo H., additional, Lyrer, Philippe A., additional, Engelter, Stefan T., additional, and Peters, Nils, additional
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- 2022
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27. Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients.
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Dittrich, Tolga D, Sporns, Peter B, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh, Zietz, Annaelle, Polymeris, Alexandros A, Tränka, Christopher, Thilemann, Sebastian, Wagner, Benjamin, Altersberger, Valerian L, Piot, Ines, Barinka, Filip, Hänsel, Martin, Gensicke, Henrik, Engelter, Stefan T, Lyrer, Philippe A, Sutter, Raoul, Nickel, Christian H, and Katan, Mira
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- *
THROMBECTOMY , *INTRACRANIAL hemorrhage , *STROKE , *TREATMENT effectiveness , *MORTALITY - Abstract
Background: The DEFUSE-3 and DAWN trials showed that mechanical thrombectomy (MT) improves the outcome of selected patients with anterior circulation large vessel occlusions (LVO) up to 24 h after stroke onset. However, it is unknown whether only those patients fulfilling the trial inclusion criteria benefit, or whether benefit is seen in a broader range of patients presenting between 6 and 24 h. Aims: We determined whether fulfilling the DEFUSE-3 and DAWN selection criteria affects outcomes in MT patients in clinical practice. Methods: We reviewed adult patients with LVO treated with MT between 6 and 24 h after stroke onset at five Swiss stroke centers between 2014 and 2021. We compared two groups: (1) patients who satisfied neither DEFUSE-3 nor DAWN criteria (NDND) and (2) those who satisfied DEFUSE-3 or DAWN criteria (DOD). We used logistic regression to examine the impact of trial eligibility on two safety outcomes (symptomatic intracranial hemorrhage [sICH] and all-cause mortality at 3 months) and two efficacy outcomes (modified Rankin Score [mRS] shift toward lower categories and mRS of 0–2 at 3 months). Results: Of 174 patients who received MT, 102 (59%) belonged to the NDND group. Rates of sICH were similar between the NDND group and the DOD group (3% vs. 4%, p = 1.00). Multivariable regression revealed no differences in 3-month all-cause mortality (aOR 2.07, 95% CI 0.64–6.84, p = 0.23) or functional outcomes (mRS shift: acOR 0.81, 95% CI 0.37–1.79, p = 0.60; mRS 0–2: aOR 0.91, 95% CI 0.31–2.57, p = 0.85). Conclusion: Among adult patients with LVO treated with MT between 6 and 24 h, safety and efficacy outcomes were similar between DEFUSE-3/DAWN eligible and ineligible patients. Our data provide a compelling rationale for randomized trials with broader inclusion criteria for MT. [ABSTRACT FROM AUTHOR]
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- 2023
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28. sj-docx-1-wso-10.1177_17474930221140793 – Supplemental material for Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients
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Dittrich, Tolga D, Sporns, Peter B, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh, Zietz, Annaelle, Polymeris, Alexandros A, Tränka, Christopher, Thilemann, Sebastian, Wagner, Benjamin, Altersberger, Valerian L, Piot, Ines, Barinka, Filip, Hänsel, Martin, Gensicke, Henrik, Engelter, Stefan T, Lyrer, Philippe A, Sutter, Raoul, Nickel, Christian H, Katan, Mira, Peters, Nils, Michels, Lars, Kulcsár, Zsolt, Karwacki, Grzegorz M, Pileggi, Marco, Cereda, Carlo, Wegener, Susanne, Bonati, Leo H, Fischer, Urs, Psychogios, Marios, and De Marchis, Gian Marco
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FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-docx-1-wso-10.1177_17474930221140793 for Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients by Tolga D Dittrich, Peter B Sporns, Lilian F Kriemler, Salome Rudin, Anh Nguyen, Annaelle Zietz, Alexandros A Polymeris, Christopher Tränka, Sebastian Thilemann, Benjamin Wagner, Valerian L Altersberger, Ines Piot, Filip Barinka, Martin Hänsel, Henrik Gensicke, Stefan T Engelter, Philippe A Lyrer, Raoul Sutter, Christian H Nickel, Mira Katan, Nils Peters, Lars Michels, Zsolt Kulcsár, Grzegorz M Karwacki, Marco Pileggi, Carlo Cereda, Susanne Wegener, Leo H Bonati, Urs Fischer, Marios Psychogios and Gian Marco De Marchis in International Journal of Stroke
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- 2022
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29. sj-docx-2-wso-10.1177_17474930221140793 – Supplemental material for Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients
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Dittrich, Tolga D, Sporns, Peter B, Kriemler, Lilian F, Rudin, Salome, Nguyen, Anh, Zietz, Annaelle, Polymeris, Alexandros A, Tränka, Christopher, Thilemann, Sebastian, Wagner, Benjamin, Altersberger, Valerian L, Piot, Ines, Barinka, Filip, Hänsel, Martin, Gensicke, Henrik, Engelter, Stefan T, Lyrer, Philippe A, Sutter, Raoul, Nickel, Christian H, Katan, Mira, Peters, Nils, Michels, Lars, Kulcsár, Zsolt, Karwacki, Grzegorz M, Pileggi, Marco, Cereda, Carlo, Wegener, Susanne, Bonati, Leo H, Fischer, Urs, Psychogios, Marios, and De Marchis, Gian Marco
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FOS: Clinical medicine ,Cardiology ,Medicine ,110904 Neurology and Neuromuscular Diseases - Abstract
Supplemental material, sj-docx-2-wso-10.1177_17474930221140793 for Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients by Tolga D Dittrich, Peter B Sporns, Lilian F Kriemler, Salome Rudin, Anh Nguyen, Annaelle Zietz, Alexandros A Polymeris, Christopher Tränka, Sebastian Thilemann, Benjamin Wagner, Valerian L Altersberger, Ines Piot, Filip Barinka, Martin Hänsel, Henrik Gensicke, Stefan T Engelter, Philippe A Lyrer, Raoul Sutter, Christian H Nickel, Mira Katan, Nils Peters, Lars Michels, Zsolt Kulcsár, Grzegorz M Karwacki, Marco Pileggi, Carlo Cereda, Susanne Wegener, Leo H Bonati, Urs Fischer, Marios Psychogios and Gian Marco De Marchis in International Journal of Stroke
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- 2022
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30. Association between ischaemic stroke aetiology and leptomeningeal collateral status: a retrospective cohort study.
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Sojak L, Toebak AM, Gallino C, Von Streng T, Rudin S, Kriemler LF, Zietz A, Wagner B, Gensicke H, Sutter R, Nickel CH, Katan M, Bonati LH, Psychogios M, Dittrich TD, and De Marchis GM
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- Humans, Retrospective Studies, Male, Female, Aged, Switzerland epidemiology, Middle Aged, Computed Tomography Angiography methods, Cerebral Angiography, Collateral Circulation, Ischemic Stroke complications, Ischemic Stroke etiology, Ischemic Stroke physiopathology, Ischemic Stroke diagnostic imaging, Meninges blood supply, Meninges diagnostic imaging, Meninges physiopathology
- Abstract
Introduction: There is limited understanding of the pathomechanistic relationship between leptomeningeal collateral formation and ischaemic stroke aetiology. We aimed to assess the association of leptomeningeal collateral status and ischaemic stroke aetiology, using the widely recognised "Trial of Org 10172 in Acute Stroke Treatment" (TOAST) classification categorising strokes into five distinct aetiologies., Methods: Retrospective study of consecutively admitted adult ischaemic stroke patients at a Swiss stroke centre. Leptomeningeal collateral status was assessed on admission with single-phase CT-angiographies using a validated 4-point score. Patients were categorised into large-artery atherosclerosis (LAA), cardioembolic (CE), small-vessel disease (SVD) and cryptogenic (CG) according to the TOAST classification. We performed ordinal and binary (poor [collaterals filling ≤50% of the occluded territory] vs good [collaterals filling >50% of the occluded territory] collateralisation) logistic regression to evaluate the impact of TOAST aetiology on collateral status., Results: Among 191 patients, LAA patients had better collateral status compared to non-LAA aetiology (LAA: 2 vs CE: 2 vs SVD: 3 vs CG: 2, pLAA vs non-LAA = 0.04). In weighted multivariate logistic regression, LAA and SVD independently predicted better collateral status (binary models [adjusted odds ratio; aOR]: LAA: 3.72 [1.21-11.44] and SVD: 4.19 [1.21-14.52]; ordinal models [adjusted common odds ratio; acOR]: LAA: 2.26 [95% CI: 1.23-4.15] and SVD: 1.94 [1.03-3.66]), while CE predicted worse collateral status (binary models [aOR]: CE: 0.17 [0.07-0.41]; ordinal models [acOR]: CE: 0.24 [0.11-0.51])., Conclusion: The aetiology of ischaemic stroke is associated with leptomeningeal collateral status on single-phase CT-angiography, with LAA and SVD predicting better and CE predicting worse collateral status.
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- 2024
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