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1. The overlap with metabolic dysfunction‐associated steatotic liver disease negatively affects outcomes of primary biliary cholangitis.

Author

Hernández‐Pérez, María, Riado, Daniel, Pena, Eva, Méndez, Carmen, Pinedo, Fernando, Ramos, Paloma, Castillo, Pilar, Romero, Miriam, Fernández‐Rodríguez, Conrado, and Olveira, Antonio

Subjects
*LIVER diseases, *URSODEOXYCHOLIC acid, *MEDICAL research, *LIVER transplantation, *PROGNOSIS
Abstract

Summary: Background and Aims: The relationship between primary biliary cholangitis (PBC) and metabolic dysfunction‐associated steatotic liver disease, and its impact on treatment response and prognosis, remains underexplored. Methods: Patient cohort from two centres comprising long‐term follow‐up data. All patients had histologically confirmed PBC. Biopsies were classified according to Non‐Alcoholic Steatohepatitis Clinical Research Network. Diagnosis of metabolic dysfunction‐associated steatotic liver disease was established when steatosis exceeded 5%, along with at least one metabolic risk factor. Patients with specific aetiologies of steatosis, other liver diseases, incomplete results and inadequate treatment with ursodeoxycholic acid were excluded. Data from patients initiating second‐line treatment were censored. Treatment response was assessed using the Toronto, Paris II and AST‐to‐platelet at 12‐month criteria. The UK PBC and Globe scores, and liver events were utilized as outcome measures. Results: The study included 129 patients, 36 showing histologically confirmed overlap between PBC and steatosis. Patients with overlap showed worse prognosis according to Paris II (61.1% vs. 33.3%, p = 0.004), Toronto (52.5% vs. 24.7%, p = 0.002), AST‐to‐platelet 12‐month >0.54 (36.1% vs. 17.2%, p = 0.021), Globe >0.30 (49.2% vs. 29.2%, p = 0.033) and UK PBC at 5, 10 and 15 years (p ≤ 0.001). Liver‐related mortality and liver transplant were more prevalent in the overlap group (p = 0.001). In the multivariate analysis, steatosis, dyslipidaemia and advanced fibrosis were independently associated to worse outcomes. Conclusions: Our findings suggest that metabolic dysfunction‐associated steatotic liver disease worsens the prognosis of PBC. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications

Author

Faura, Júlia, Bustamante, Alejandro, Reverté, Silvia, García-Berrocoso, Teresa, Millán, Mónica, Castellanos, Mar, Lara-Rodríguez, Blanca, Zaragoza, Josep, Ventura, Oriol, Hernández-Pérez, María, van Eendenburg, Cecile, Cardona, Pere, López-Cancio, Elena, Cánovas, David, Serena, Joaquín, Rubiera del Fueyo, Marta A., Dávalos, Antoni, Montaner, Joan, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Faura J, García-Berrocoso T, Ventura O, Montaner J] Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Bustamante A] Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Stroke Unit Hospital Universitari Germans Trias i Pujol Barcelona Spain. [Reverté S] Stroke Unit Hospital Universitari Verge de la Cinta de Tortosa Tortosa Spain. [Castellanos M] Department of Neurology Complejo Hospitalario Universitario A Coruña, A Coruña Biomedical Research Institute Spain. [Rubiera M] Unitat d’Ictus, Servei de Neurologia, Vall d'Hebron Hospital Universitari, Barcelona Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Male, Acute decompensated heart failure, Cerebrovascular diseases, 030204 cardiovascular system & hematology, Brain Ischemia, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], 0302 clinical medicine, Risk Factors, Malalties - Complicacions, Malalties - Factors de risc, Natriuretic Peptide, Brain, Early prediction, Prospective Studies, Cerebrovascular disease, Respiratory Tract Infections, Stroke, Original Research, Aged, 80 and over, Respiratory tract infections, Biochemical markers, Prognosis, Infeccions, 3. Good health, Marcadors bioquímics, Biomarker (medicine), Female, Cardiology and Cardiovascular Medicine, Malalties cerebrovasculars, medicine.medical_specialty, enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular [ENFERMEDADES], técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Infections, Fibrin Fibrinogen Degradation Products, stroke‐associated infection, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, ADHF, Protein Precursors, Stroke-associated infection, Aged, Ischemic Stroke, Heart Failure, business.industry, biomarkers, medicine.disease, Peptide Fragments, Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke [DISEASES], Infecctions, Early Diagnosis, ROC Curve, Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], business, Biomarkers, 030217 neurology & neurosurgery, Other subheadings::Other subheadings::/complications [Other subheadings], Follow-Up Studies
Abstract

Biomarkers; Stroke; Stroke‐associated infection Biomarcadors; Ictus; Infecció associada a un ictus Biomarcadores; Ictus; Infección asociada a un ictus Background Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life‐threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission. Methods and Results Nine hundred thirty‐eight patients experiencing ischemic stroke were prospectively recruited in the Stroke‐Chip study. Post‐stroke complications during hospitalization were retrospectively evaluated. Blood samples were drawn within 6 hours after stroke onset, and 14 biomarkers were analyzed by immunoassays. Biomarker values were normalized using log‐transformation and Z score. PanelomiX algorithm was used to select panels with the best accuracy for predicting ADHF and RTI. Logistic regression models were constructed with the clinical variables and the biomarker panels. The additional predictive value of the panels compared with the clinical model alone was evaluated by receiver operating characteristic curves. An internal validation through a 10‐fold cross‐validation with 3 repeats was performed. ADHF and RTI occurred in 19 (2%) and 86 (9.1%) cases, respectively. Three‐biomarker panels were developed as predictors: vascular adhesion protein‐1 >5.67, NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) >4.98 and d‐dimer >5.38 (sensitivity, 89.5%; specificity, 71.7%) for ADHF; and interleukin‐6 >3.97, von Willebrand factor >3.67, and d‐dimer >4.58 (sensitivity, 82.6%; specificity, 59.8%) for RTI. Both panels independently predicted stroke complications (panel for ADHF: odds ratio [OR] [95% CI], 10.1 [3–52.2]; panel for RTI: OR, 3.73 [1.95–7.14]) after adjustment by clinical confounders. The addition of the panel to clinical predictors significantly improved areas under the curve of the receiver operating characteristic curves in both cases. Conclusions Blood biomarkers could be useful for the early prediction of ADHF and RTI. Future studies should assess the usefulness of these panels in front of patients experiencing stroke with respiratory symptoms such as dyspnea. This project received funding from Instituto de Salud Carlos III (ISCIII) [DTS14/00004, PI17/02130], co‐financed by the European Regional Development Fund (FEDER), and from Fundació La Marató de TV3 [201706] and the European Union's Horizon 2020 research and innovation program [754517]. Neurovascular Research Laboratory takes part into the Spanish stroke research network INVICTUS+ (RD16/0019/0021). The funders had no role in the study design and conduction.

Published
2021
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3. Long-term antibiotic therapy in patients with surgery-indicated not undergoing surgery infective endocarditis

Author

Vallejo Camazon, Nuria, Mateu, Lourdes, Cediel, Germán, Escolà-Vergé, Laura, Fernández-Hidalgo, Nuria, Gurguí, Mercè, Pérez Rodriguez, María Teresa, Cuervo, Guillermo, Núñez Aragón, Raquel, Llibre, Cinta, Sopena, Nieves, Quesada, María Dolores, Berastegui García, Elisabet, Teis, Albert, López Ayerbe, Jorge, Juncà Puig, Gladys, Gual, Francisoc, Ferrer Sistach, Elena, Vivero, Ainhoa, Reynaga, Esteban, Hernández Pérez, María, Muñoz Guijosa, Christian, Pedro-Botet, Lluïsa, Bayés-Genís, Antoni, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Vallejo Camazon N] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Department of Medicine, CIBERCV, Autonomous University of Barcelona, Barcelona, Spain. [Mateu L] Unitat Malalties Infeccioses, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Cediel G] Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. [Escolà-Vergé L, Fernández-Hidalgo N] Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gurgui Ferrer M] Unitat de Malalties Infeccioses, Hospital Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Male, medicine.medical_specialty, Referral, medicine.drug_class, Antibiotics, Bacterial Infections and Mycoses::Bacterial Infections::Endocarditis, Bacterial [DISEASES], Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Antibiòtics, acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos [COMPUESTOS QUÍMICOS Y DROGAS], Clinical Cardiology, Other subheadings::Other subheadings::/drug therapy [Other subheadings], infecciones bacterianas y micosis::infecciones bacterianas::endocarditis bacteriana [ENFERMEDADES], surgery, Antibiotic therapy, medicine.artery, Ascending aorta, medicine, Medicaments antibacterians - Ús terapèutic, Humans, Endocarditis, In patient, Other subheadings::/therapeutic use [Other subheadings], Aged, Retrospective Studies, Cirurgia, Otros calificadores::/uso terapéutico [Otros calificadores], business.industry, infective endocarditis, Endocarditis, Bacterial, General Medicine, Prognosis, medicine.disease, Anti-Bacterial Agents, Surgery, Multicenter study, Infective endocarditis, suppressive antibiotic treatment, Endocarditis bacteriana - Tractament, Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [CHEMICALS AND DRUGS], Female, Cardiology and Cardiovascular Medicine, business
Abstract

Edocarditis infecciosa; Tractament antibiòtic supressiu; Cirurgia Endocarditis infecciosa; Tratamiento antibiótico supresor: Cirugía Infective endocarditis; Suppressive antibiotic treatment; Surgery Background: To date, there is little information regarding management of patients with infective endocarditis (IE) that did not undergo an indicated surgery. Therefore, we aimed to evaluate prognosis of these patients treated with a long-term antibiotic treatment strategy, including oral long term suppressive antibiotic treatment in five referral centres with a multidisciplinary endocarditis team. Methods: This retrospective, multicenter study retrieved individual patient-level data from five referral centres in Spain. Among a total of 1797, 32 consecutive patients with IE were examined (median age 72 years; 78% males) who had not undergone an indicated surgery, but received long-term antibiotic treatment (LTAT) and were followed by a multidisciplinary endocarditis team, between 2011 and 2019. Primary outcomes were infection relapse and mortality during follow-up. Results: Among 32 patients, 21 had IE associated with prostheses. Of the latter, 8 had an ascending aorta prosthetic graft. In 24 patients, a switch to long-term oral suppressive antibiotic treatment (LOSAT) was considered. The median duration of LOSAT was 277 days. Four patients experienced a relapse during follow-up. One patient died within 60 days, and 12 patients died between 60 days and 3 years. However, only 4 deaths were related to IE. Conclusions: The present study results suggest that a LTAT strategy, including LOSAT, might be considered for patients with IE that cannot undergo an indicated surgery. After hospitalization, they should be followed by a multidisciplinary endocarditis team. Antoni Bayes-Genis was supported by grants from the Ministerio de Educación y Ciencia (SAF2014–59892), Fundació La MARATÓ de TV3 (201502, 201516), CIBER Cardiovascular (CB16/11/00403), and AdvanceCat 2014. María Hernández Pérez is supported by a Juan Rodes research contract (JR17/00006) from Instituto de Salud Carlos III.

Published
2021

4. Neuroimagen en el ictus agudo: búsqueda de nuevos biomarcadores subrogados del pronóstico clínico

Author

Hernández Pérez, María, Dávalos, Antoni, and Universitat Autònoma de Barcelona. Departament de Medicina

Subjects
Ischemic stroke, 616.8, Ictus isquémico, Pronóstico, Neuroimaging, Prognòstic, Neuroimagen, Prognosis, Ictus isquèmic, Ciències de la Salut, Neuroimatge
Abstract

Objetivos: 1. Adaptar y validar una nueva secuencia de angiografía dinámica por resonancia magnética (dMRA) para el estudio de la oclusión arterial y la calidad de la colateralidad en el ictus agudo; 2. Deteminar el valor del volumen de calcificación en las arterias carótidas intracraneales en la resistencia a la recanalización arterial y en el pronóstico funcional de los pacientes tratados mediante trombectomía mecánica (TM); 3. Estudiar la relación entre la reperfusión alcanzada inmediatamente después de la TM evaluada según los grados angiográficos Thrombolysis in Cerebral Ischemia (TICI) y según la RM de perfusión y determinar el valor de la reperfusión como marcador subrogado del pronóstico funcional de los pacientes sometidos a TM. Métodos: Para los experimentos 1 y 2 seleccionamos pacientes de la base prospectiva de ictus agudo del Hospital Germans Trias, mientras que para el experimento 3 se diseñó un estudio prospectivo de neuroimagen seriada en pacientes sometidos a TM. Los datos clínicos se registraron de forma prospectiva. Los estudios de neuroimagen fueron anonimizados y evaluados por dos investigadores cegados a los datos clínicos y resto de datos radiológicos. Para el experimento 1 se evaluó la RM inicial incluyendo las secuencias de dMRA y la angioRM TOF; para el experimento 2 se calculó la cantidad de calcio en la pared arterial de la carótida intracraneal en el TC craneal a la llegada al hospital; para el experimento 3 se evaluaron los grados angiográficos de revascularización TICI y se valoraron las secuencias de RM de perfusión antes y después de la intervención para el cálculo del índice de reperfusión (IR) Resultados: 1. Experimento 1: Inclusión de 25 pacientes; la dRMA detectó 3 oclusiones en tándem y 3 oclusiones arteriales incompletas que no había sido halladas por la angioRM TOF. El llenado colateral completo en dMRA (n=12, 48%) se asoció con menor volumen de lesión en DWI (p=0.039), menor volumen de hipoperfusión (p=0.018) y menor ratio de intensidad de la hipoperfusión (0.018). Los pacientes con un drenaje venoso simétrico (52%) presentaron con mayor frecuencia un llenado colateral completo (p=0.015). 2. Experimento 2: Inclusión de 194 pacientes. Un mayor volumen de calcio en la pared carotídea intracraneal se asoció con revascularización arterial incompleta (OR ajustada 0.73 [Intervalo de confianza 95%, 0-57-0.93]) y con un peor pronóstico funcional (OR ajustada 1.31 [Intervalo de confianza 95% 1.04-1.66]). 3. Experimento 3: Se estudiaron 53 pacientes. Los grados TICI y la reperfusión evaluada en RM se asociaron de forma que a mayor grado TICI; menor área cerebral hipoperfundida y mayor IR (p90% para el IR. El IR>90% presentó la mayor precisión global como predictor del pronóstico clínico seguido del TICI 2b-3, pero el TICI 2b-3 fue más factible. Conclusiones: 1. La dMRA fue factible y fiable en pacientes con un ictus agudo. Permitió una mejor evaluación del lugar de la oclusión y de la presencia de flujo anterógrado a través del trombo que las técnicas de angioRM convencionales y posibilitó la evaluación dinámica de la colateralidad arterial y del drenaje venoso. 2. Una mayor cantidad de calcio en la pared de la arteria carótida intracraneal se asoció de forma independiente a una mayor resistencia a la recanalización arterial y a un peor pronóstico funcional en pacientes con un ictus agudo que fueron tratados mediante TM. 3. Los grados angiográficos TICI y la reperfusión evaluada mediante RM estuvieron estrechamente relacionados. El grado angiográfico TICI2b-3 fue el mejor marcador subrogado de pronóstico clínico al combinar un alto valor pronóstico y una gran factibilidad., Objectives: 1. To adapt and to validate a new sequence of dynamic magnetic resonance angiography (dMRA) in order to study arterial occlusion location, collateral status and venous drainage in acute stroke patients. 2. To examine the relation of the burden of intracranial carotid artery wall calcification with arterial revascularization and functional outcome in acute stroke patients treated with mechanical thrombectomy (MT). 3. To study the associations between the degree of reperfusion achieved immediately after MT according to the angiographic Thrombolysis in Cerebral Ischemia (TICI) grading system and according to perfusion MRI and to determine the value of reperfusion as a surrogate marker of functional prognosis in patients undergoing MT. Methods: For experiments 1 and 2 we selected subjects from the prospective database of acute stroke patients of Germans Trias Hospital, while for the experiment 3 we designed a prospective study of serial neuroimaging in patients undergoing MT. Clinical data were prospectively recorded. Neuroimaging studies were anonymized and evaluated by two investigators blinded to clinical and other radiological data. For the experiment 1 baseline MR was evaluated including dMRA and angioRM TOF sequences; for experiment 2, the amount of calcium in the arterial wall of the intracranial carotid CT was calculated on the baseline CT. Regarding experiment 3 we evaluated both TICI grades on conventional angiography and perfusion MRI sequences before and after the intervention. We calculated reperfusion index (RI) as (TMax6s pre-MT xTMax6s post-MT)/TMax6s pre-MT. Results: 1. Experiment 1: Inclusion of 25 patients; dRMA detected 3 tandem occlusions and 3 incomplete arterial occlusions that were not identified by TOF MRI. Complete collateral filling (n=12, 48%) was associated with smaller diffusion weighted imaging lesion volume (p = 0.039), smaller hypoperfused volume (p = 0.018) and lower hypoperfusion intensity ratio (0.018). Patients with symmetrical venous clearance (52%) were more likely to have complete collateral filling (p = 0.015). 2. Experiment 2: Inclusion of 194 patients. Larger volumes of calcium in the intracranial carotid wall were associated with incomplete arterial revascularization (adjusted OR 0.73 [95% confidence Interval, 0-57-0.93]) and with a poorer functional outcome (adjusted OR 1.31 [95%confidence interval, 1.04-1.66]). 3. Experiment 3: We studied 53 patients. A higher post-procedural TICI grade was correlated with a smaller post-procedural hypoperfusion volume and a lower value of RI (p 90% had the highest global accuracy for predicting clinical outcome followed by TICI 2b-3, but TICI 2b-3 was more feasible. Conclusions: 1. dMRA was feasible and reliable in patients with acute stroke. It allowed a better evaluation of the site of occlusion and the presence of anterograde flow through thrombus than conventional angioRM techniques and enabled the dynamic evaluation of arterial input and venous drainage. 2. A larger amount of calcium in the intracranial carotid artery before MT in acute stroke patients was an indicator of worse postprocedural arterial revascularization and poorer functional outcome. 3. TICI angiographic grades and MR reperfusion were closely related. TICI2b-3 was the best surrogate of clinical prognosis by combining global accuracy and feasibility.

Published
2017

5. Natural History of Acute Stroke due to Occlusion of the Middle Cerebral Artery and Intracranial Internal Carotid Artery.

Author

Hernández‐Pérez, María, Pérez de la Ossa, Natalia, Aleu, Aitziber, Millán, Mònica, Gomis, Meritxell, Dorado, Laura, López‐Cancio, Elena, Jovin, Tudor, and Dávalos, Antoni

Subjects
*STROKE, *ANTERIOR cruciate ligament, *ARTERIES, *CAROTID artery, *DEATH (Biology)
Abstract

ABSTRACT BACKGROUND AND PURPOSE The natural history of acute ischemic stroke (AIS) due to anterior circulation large artery occlusion is not well established. This information is essential for assessment of clinical benefit derived from recanalization therapies. METHODS Patients with AIS due to anterior circulation large artery occlusion not treated with reperfusion therapies admitted from January 2005 to September 2010 were consecutively selected. Site of occlusion was assessed with transcranial duplex according to Thrombolysis in Brain Infarction (TIBI) grades. Poor outcome was considered as a modified Rankin Scale>2 at 90 days. RESULTS A total of 120 patients were studied. Site of occlusion was terminal internal carotid artery (TICA) in 13 (10.8%), proximal middle cerebral artery (MCA) in 69 (57.5%), and distal MCA in 38 (31.7%) patients. Overall, 74.2% of patients had poor outcome. There were significant differences in poor outcome between patients with TICA, proximal MCA, and distal MCA occlusion (92%, 87%, 47%, P < .001) and mortality at 90 days (23%, 12%, 3%, P = .001). CONCLUSIONS Outcome of AIS patients with anterior circulation large artery occlusion not treated with reperfusion therapies is extremely poor in TICA and proximal MCA occlusions with better outcomes noted in distal MCA occlusions. These findings are relevant for estimation of treatment effect of reperfusion therapies according to occlusion location. [ABSTRACT FROM AUTHOR]

Published
2014
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6. Prestroke Physical Activity Is Associated with Good Functional Outcome and Arterial Recanalization after Stroke due to a Large Vessel Occlusion.

Author

Ricciardi, ana Clara, López-Cancio, Elena, Pérez de la Ossa, Natalia, Sobrino, Tomás, Hernández-Pérez, María, Gomis, Meritxell, Munuera, Josep, Muñoz, Lucía, Dorado, Laura, Millán, Mónica, Dávalos, antonio, and arenillas, Juan F.

Subjects
STROKE, PHYSICAL activity, ARTERIAL disease treatment, ARTERIAL diseases, ARTERIAL occlusions, DISEASE risk factors, PHYSIOLOGY
Abstract

Background: Although multiple studies and meta-analyses have consistently suggested that regular physical activity (PhA) is associated with a decreased stroke risk and recurrence, there is limited data on the possible preconditioning effect of prestroke PhA on stroke severity and prognosis. We aimed to study the association of prestroke PhA with different outcome variables in patients with acute ischemic stroke due to an anterior large vessel occlusion. Methods: The Prestroke Physical Activity and Functional Recovery in Patients with Ischemic Stroke and Arterial Occlusion trial is an observational and longitudinal study that included consecutive patients with acute ischemic stroke admitted to a single tertiary stroke center. Main inclusion criteria were: anterior circulation ischemic stroke within 12 h from symptom onset; presence of a confirmed anterior large vessel occlusion, and functional independence previous to stroke. Prestroke PhA was evaluated with the International Physical Activity Questionnaire and categorized into mild, moderate and high levels by means of metabolic equivalent (MET) minutes per week thresholds. The primary outcome measure was good functional outcome at 3 months (modified Rankin scale ≤2). Secondary outcomes were severity of stroke at admission, complete early recanalization, early dramatic neurological improvement and final infarct volume. Results: During the study period, 159 patients fulfilled the above criteria. The mean age was 68 years, 62% were men and the baseline NIHSS score was 17. Patients with high levels of prestroke PhA were younger, had more frequently distal occlusions and had lower levels of blood glucose and fibrinogen at admission. After multivariate analysis, a high level of prestroke PhA was associated with a good functional outcome at 3 months. Regarding secondary outcome variables and after adjustment for relevant factors, a high level of prestroke PhA was independently associated with milder stroke severity at admission, early dramatic improvement, early arterial recanalization after intravenous thrombolysis and lower final infarct volume. The beneficial association of prestroke PhA with stroke outcomes was already present with a cutoff point of 1,000 MET min/week, a level of PhA easily achieved by walking 1 h/day during 5 days or by doing a vigorous aerobic activity 1 h/day twice a week. Conclusions: Prestroke PhA is independently associated with favorable stroke outcomes after a large vessel occlusion. Future research on the underlying mechanisms is needed to understand this neuroprotective effect of PhA. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2014
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