180 results on '"Ihle-Hansen H."'
Search Results
2. Underlying causes of cryptogenic stroke and TIA in the nordic atrial fibrillation and stroke (NOR-FIB) study – the importance of comprehensive clinical evaluation
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Ratajczak-Tretel, B., Lambert, A. Tancin, Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M.O., Bjerkeli, V., Eldøen, G., Gulsvik, A. K., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Naess, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., and Aamodt, A. H.
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- 2023
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3. Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial
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Parson, M, Valente, M, Chen, A, Sharobeam, A, Edwards, L, Blair, C, Christensen, L, Ægidius, K, Pihl, T, Fassel-Larsen, C, Wassvik, L, Folke, M, Rosenbaum, S, Gharehbagh, S S, Hansen, A, Preisler, N, Antsov, K, Mallene, S, Lill, M, Herodes, M, Vibo, R, Rakitin, A, Saarinen, J, Tiainen, M, Tumpula, O, Noppari, T, Raty, S, Sibolt, G, Nieminen, J, Niederhauser, J, Haritoncenko, I, Puustinen, J, Haula, T-M, Sipilä, J, Viesulaite, B, Taroza, S, Rastenyte, D, Matijosaitis, V, Vilionskis, A, Masiliunas, R, Ekkert, A, Chmeliauskas, P, Lukosaitis, V, Reichenbach, A, Moss, T T, Nilsen, H Y, Hammer-Berntzen, R, Nordby, L M, Weiby, T A, Nordengen, K, Ihle-Hansen, H, Stankiewiecz, M, Grotle, O, Nes, M, Thiemann, K, Særvold, I M, Fraas, M, Størdahl, S, Horn, J W, Hildrum, H, Myrstad, C, Tobro, H, Tunvold, J-A, Jacobsen, O, Aamodt, N, Baisa, H, Malmberg, V N, Rohweder, G, Ellekjær, H, Ildstad, F, Egstad, E, Helleberg, B H, Berg, H H, Jørgensen, J, Tronvik, E, Shirzadi, M, Solhoff, R, Van Lessen, R, Vatne, A, Forselv, K, Frøyshov, H, Fjeldstad, M S, Tangen, L, Matapour, S, Kindberg, K, Johannessen, C, Rist, M, Mathisen, I, Nyrnes, T, Haavik, A, Toverud, G, Aakvik, K, Larsson, M, Ytrehus, K, Ingebrigtsen, S, Stokmo, T, Helander, C, Larsen, I C, Solberg, T O, Seljeseth, Y M, Maini, S, Bersås, I, Mathé, J, Rooth, E, Laska, A-C, Rudberg, A-S, Esbjörnsson, M, Andler, F, Ericsson, A, Wickberg, O, Karlsson, J-E, Redfors, P, Jood, K, Buchwald, F, Mansson, K, Gråhamn, O, Sjölin, K, Lindvall, E, Cidh, Å, Tolf, A, Fasth, O, Hedström, B, Fladt, J, Dittrich, T D, Kriemler, L, Hannon, N, Amis, E, Finlay, S, Mitchell-Douglas, J, McGee, J, Davies, R, Johnson, V, Nair, A, Robinson, M, Greig, J, Halse, O, Wilding, P, Mashate, S, Chatterjee, K, Martin, M, Leason, S, Roberts, J, Dutta, D, Ward, D, Rayessa, R, Clarkson, E, Teo, J, Ho, C, Conway, S, Aissa, M, Papavasileiou, V, Fry, S, Waugh, D, Britton, J, Hassan, A, Manning, L, Khan, S, Asaipillai, A, Fornolles, C, Tate, M L, Chenna, S, Anjum, T, Karunatilake, D, Foot, J, VanPelt, L, Shetty, A, Wilkes, G, Buck, A, Jackson, B, Fleming, L, Carpenter, M, Jackson, L, Needle, A, Zahoor, T, Duraisami, T, Northcott, K, Kubie, J, Bowring, A, Keenan, S, Mackle, D, England, T, Rushton, B, Hedstrom, A, Amlani, S, Evans, R, Muddegowda, G, Remegoso, A, Ferdinand, P, Varquez, R, Davis, M, Elkin, E, Seal, R, Fawcett, M, Gradwell, C, Travers, C, Atkinson, B, Woodward, S, Giraldo, L, Byers, J, Cheripelli, B, Lee, S, Marigold, R, Smith, S, Zhang, L, Ghatala, R, Sim, C H, Ghani, U, Yates, K, Obarey, S, Willmot, M, Ahlquist, K, Bates, M, Rashed, K, Board, S, Andsberg, G, Sundayi, S, Garside, M, Macleod, M-J, Manoj, A, Hopper, O, Cederin, B, Toomsoo, T, Gross-Paju, K, Tapiola, T, Kestutis, J, Amthor, K-F, Heermann, B, Ottesen, V, Melum, T A, Kurz, M, Parsons, M, Roaldsen, Melinda B, Eltoft, Agnethe, Wilsgaard, Tom, Christensen, Hanne, Engelter, Stefan T, Indredavik, Bent, Jatužis, Dalius, Karelis, Guntis, Kõrv, Janika, Lundström, Erik, Petersson, Jesper, Putaala, Jukka, Søyland, Mary-Helen, Tveiten, Arnstein, Bivard, Andrew, Johnsen, Stein Harald, Mazya, Michael V, Werring, David J, Wu, Teddy Y, De Marchis, Gian Marco, Robinson, Thompson G, and Mathiesen, Ellisiv B
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- 2023
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4. Carotid plaque score for stroke and cardiovascular risk prediction in a middle-aged cohort from the general population: the akershus cardiac examination 1950 study
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Ihle-Hansen, H, primary, Vigen, T V, additional, Berge, T B, additional, Walle-Hansen, M W H, additional, Hagberg, G H, additional, Ihle-Hansen, H I H, additional, Thommessen, B T, additional, Ariansen, I A, additional, Rosjo, H R R, additional, Ronning, O M R, additional, Tveit, A T, additional, and Lyngbakken, M L, additional
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- 2023
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5. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission
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Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.
- Published
- 2023
6. Long-term effects on survival after a 1-year multifactorial vascular risk factor intervention after stroke or TIA: secondary analysis of a randomized controlled trial, a 7-year follow-up study
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Hagberg G, Fure B, Sandset EC, Thommessen B, Ihle-Hansen H, Øksengård AR, Nygård S, and Wyller TB
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Stroke ,cardiovascular risk ,risk factor management ,secondary prevention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Guri Hagberg,1,2 Brynjar Fure,3 Else Charlotte Sandset,4 Bente Thommessen,5 Håkon Ihle-Hansen,1,2 Anne Rita Øksengård,1 Ståle Nygård,6 Torgeir B Wyller,2,7 Hege Ihle-Hansen1,7 1Department of Internal Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Department of Internal Medicine, Karlstad Central Hospital and Institute of Public Health, University of Tromsoe, Tromsoe, Norway; 4Department of Neurology, Oslo University Hospital, Oslo, Norway; 5Department of Neurology, Akershus University Hospital, Lørenskog, Norway; 6Department of Informatics, The Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; 7Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway Background: Stroke and coronary heart disease share the same risk factors, and a multifactorial intervention after stroke may potentially result in the same reduction in cardiovascular mortality as seen after coronary events. We aimed to evaluate the effect on survival 7 years after a 1-year multifactorial risk factor intervention, and identify clinical predictors for long-term survival in a hospital-based cohort of patients with first-ever stroke or transient ischemic attack (TIA). Materials and methods: We performed a secondary analysis of a randomized controlled trial including patients between February 2007 and July 2008 comparing an intensive risk factor intervention vs usual care the first year poststroke to prevent cognitive impairment. From February 2014 to July 2016, all patients were invited to a follow-up. For patients dying throughout the follow-up period, date of death was obtained from the medical record. Examination at baseline and 1-year follow-up included extensive assessment of vascular risk factors and cognitive assessments. Results: A total of 195 patients were randomized. Mean (SD) age was 71.6 (12.5) years, 53.3% were male, mean (SD) body mass index (BMI) was 25.6 (4.1) kg/m². During follow-up, 35 patients in the intervention group and 41 in the control group died. Kaplan–Meier survival estimates show no significant difference in intention-to-treat (ITT) population or complete case (CC) population (log-rank P=0.29 vs log-rank P=0.07). In multivariable Cox proportional hazards regression analyses, lower age and higher BMI was independently associated with long-term survival, adjusted HR (95% CI) 1.08 (1.05–1.11) per year and 0.91 (0.85–0.97) per kg/m². Conclusion: In this post hoc analysis, we found no significant effect on survival after 7 years of a multifactorial risk factor program given during the first year after first-ever stroke or TIA. Higher BMI was an independent predictor for long-term survival in this cohort. Keywords: RCT, stroke, cardiovascular risk, risk factor management, secondary prevention
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- 2019
7. Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study: Main results
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Ratajczak-Tretel, B., Tancin Lambert, A., Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M. O., Bjerkeli, V., Eldøen, G., Gulsvik, A., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Johansen, H., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Næss, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., and Aamodt, A. H.
- Subjects
biomarkers ,atrial fibrillation ,Cryptogenic stroke ,Neurology (clinical) ,anticoagulation ,arrhythmia monitoring ,Cardiology and Cardiovascular Medicine ,insertable cardiac monitor ,secondary prevention - 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 Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
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- 2022
8. Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke:results from the NOR-FIB Study
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Ratajczak-Tretel, B., Lambert, A. Tancin, Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M. O., Bjerkeli, V., Eldøen, G., Gulsvik, A. K., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Næss, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., Aamodt, Anne Hege, Ratajczak-Tretel, B., Lambert, A. Tancin, Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M. O., Bjerkeli, V., Eldøen, G., Gulsvik, A. K., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Næss, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., and Aamodt, Anne Hege
- Abstract
Background: Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study. Method: The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers. The utility of the following AF-predicting scores was tested: AS5F, Brown ESUS-AF, CHA2DS2-VASc, CHASE-LESS, HATCH, HAVOC, STAF and SURF. Results: In univariate analyses increasing age, hypertension, left ventricle hypertrophy, dyslipidaemia, antiarrhythmic drugs usage, valvular heart disease, and neuroimaging findings of stroke due to intracranial vessel occlusions and previous ischemic lesions were associated with a higher likelihood of detected AF. In multivariate analysis, age was the only independent predictor of AF. All the AF-predicting scores showed significantly higher score levels for AF than non-AF patients. The STAF and the SURF scores provided the highest sensitivity and negative predictive values, while the AS5F and SURF reached an area under the receiver operating curve (AUC) > 0.7. Conclusion: Clinical risk scores may guide a personalized evaluation approach in CS patients. Increasing awareness of the usage of available AF-predicting scores may optimize the arrhythmia detection pathway in stroke units.
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- 2023
9. Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study:Main results
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Ratajczak-Tretel, B., Tancin Lambert, A., Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M. O., Bjerkeli, V., Eldøen, G., Gulsvik, A., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Johansen, H., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Næss, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., Aamodt, A. H., Ratajczak-Tretel, B., Tancin Lambert, A., Al-Ani, R., Arntzen, K., Bakkejord, G. K., Bekkeseth, H. M. O., Bjerkeli, V., Eldøen, G., Gulsvik, A., Halvorsen, B., Høie, G. A., Ihle-Hansen, H., Ingebrigtsen, S., Johansen, H., Kremer, C., Krogseth, S. B., Kruuse, C., Kurz, M., Nakstad, I., Novotny, V., Næss, H., Qazi, R., Rezaj, M. K., Rørholt, D. M., Steffensen, L. H., Sømark, J., Tobro, H., Truelsen, T. C., Wassvik, L., Ægidius, K. L., Atar, D., and Aamodt, A. H.
- 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 < 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p < 0.001) and admission NIHSS (median 2 vs 1; p = 0.001); and more often hypertension (p = 0.045) and dyslipidaemia (p = 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%. Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
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- 2023
10. Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial
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Roaldsen, Melinda B, primary, Eltoft, Agnethe, additional, Wilsgaard, Tom, additional, Christensen, Hanne, additional, Engelter, Stefan T, additional, Indredavik, Bent, additional, Jatužis, Dalius, additional, Karelis, Guntis, additional, Kõrv, Janika, additional, Lundström, Erik, additional, Petersson, Jesper, additional, Putaala, Jukka, additional, Søyland, Mary-Helen, additional, Tveiten, Arnstein, additional, Bivard, Andrew, additional, Johnsen, Stein Harald, additional, Mazya, Michael V, additional, Werring, David J, additional, Wu, Teddy Y, additional, De Marchis, Gian Marco, additional, Robinson, Thompson G, additional, Mathiesen, Ellisiv B, additional, Parson, M, additional, Valente, M, additional, Chen, A, additional, Sharobeam, A, additional, Edwards, L, additional, Blair, C, additional, Christensen, L, additional, Ægidius, K, additional, Pihl, T, additional, Fassel-Larsen, C, additional, Wassvik, L, additional, Folke, M, additional, Rosenbaum, S, additional, Gharehbagh, S S, additional, Hansen, A, additional, Preisler, N, additional, Antsov, K, additional, Mallene, S, additional, Lill, M, additional, Herodes, M, additional, Vibo, R, additional, Rakitin, A, additional, Saarinen, J, additional, Tiainen, M, additional, Tumpula, O, additional, Noppari, T, additional, Raty, S, additional, Sibolt, G, additional, Nieminen, J, additional, Niederhauser, J, additional, Haritoncenko, I, additional, Puustinen, J, additional, Haula, T-M, additional, Sipilä, J, additional, Viesulaite, B, additional, Taroza, S, additional, Rastenyte, D, additional, Matijosaitis, V, additional, Vilionskis, A, additional, Masiliunas, R, additional, Ekkert, A, additional, Chmeliauskas, P, additional, Lukosaitis, V, additional, Reichenbach, A, additional, Moss, T T, additional, Nilsen, H Y, additional, Hammer-Berntzen, R, additional, Nordby, L M, additional, Weiby, T A, additional, Nordengen, K, additional, Ihle-Hansen, H, additional, Stankiewiecz, M, additional, Grotle, O, additional, Nes, M, additional, Thiemann, K, additional, Særvold, I M, additional, Fraas, M, additional, Størdahl, S, additional, Horn, J W, additional, Hildrum, H, additional, Myrstad, C, additional, Tobro, H, additional, Tunvold, J-A, additional, Jacobsen, O, additional, Aamodt, N, additional, Baisa, H, additional, Malmberg, V N, additional, Rohweder, G, additional, Ellekjær, H, additional, Ildstad, F, additional, Egstad, E, additional, Helleberg, B H, additional, Berg, H H, additional, Jørgensen, J, additional, Tronvik, E, additional, Shirzadi, M, additional, Solhoff, R, additional, Van Lessen, R, additional, Vatne, A, additional, Forselv, K, additional, Frøyshov, H, additional, Fjeldstad, M S, additional, Tangen, L, additional, Matapour, S, additional, Kindberg, K, additional, Johannessen, C, additional, Rist, M, additional, Mathisen, I, additional, Nyrnes, T, additional, Haavik, A, additional, Toverud, G, additional, Aakvik, K, additional, Larsson, M, additional, Ytrehus, K, additional, Ingebrigtsen, S, additional, Stokmo, T, additional, Helander, C, additional, Larsen, I C, additional, Solberg, T O, additional, Seljeseth, Y M, additional, Maini, S, additional, Bersås, I, additional, Mathé, J, additional, Rooth, E, additional, Laska, A-C, additional, Rudberg, A-S, additional, Esbjörnsson, M, additional, Andler, F, additional, Ericsson, A, additional, Wickberg, O, additional, Karlsson, J-E, additional, Redfors, P, additional, Jood, K, additional, Buchwald, F, additional, Mansson, K, additional, Gråhamn, O, additional, Sjölin, K, additional, Lindvall, E, additional, Cidh, Å, additional, Tolf, A, additional, Fasth, O, additional, Hedström, B, additional, Fladt, J, additional, Dittrich, T D, additional, Kriemler, L, additional, Hannon, N, additional, Amis, E, additional, Finlay, S, additional, Mitchell-Douglas, J, additional, McGee, J, additional, Davies, R, additional, Johnson, V, additional, Nair, A, additional, Robinson, M, additional, Greig, J, additional, Halse, O, additional, Wilding, P, additional, Mashate, S, additional, Chatterjee, K, additional, Martin, M, additional, Leason, S, additional, Roberts, J, additional, Dutta, D, additional, Ward, D, additional, Rayessa, R, additional, Clarkson, E, additional, Teo, J, additional, Ho, C, additional, Conway, S, additional, Aissa, M, additional, Papavasileiou, V, additional, Fry, S, additional, Waugh, D, additional, Britton, J, additional, Hassan, A, additional, Manning, L, additional, Khan, S, additional, Asaipillai, A, additional, Fornolles, C, additional, Tate, M L, additional, Chenna, S, additional, Anjum, T, additional, Karunatilake, D, additional, Foot, J, additional, VanPelt, L, additional, Shetty, A, additional, Wilkes, G, additional, Buck, A, additional, Jackson, B, additional, Fleming, L, additional, Carpenter, M, additional, Jackson, L, additional, Needle, A, additional, Zahoor, T, additional, Duraisami, T, additional, Northcott, K, additional, Kubie, J, additional, Bowring, A, additional, Keenan, S, additional, Mackle, D, additional, England, T, additional, Rushton, B, additional, Hedstrom, A, additional, Amlani, S, additional, Evans, R, additional, Muddegowda, G, additional, Remegoso, A, additional, Ferdinand, P, additional, Varquez, R, additional, Davis, M, additional, Elkin, E, additional, Seal, R, additional, Fawcett, M, additional, Gradwell, C, additional, Travers, C, additional, Atkinson, B, additional, Woodward, S, additional, Giraldo, L, additional, Byers, J, additional, Cheripelli, B, additional, Lee, S, additional, Marigold, R, additional, Smith, S, additional, Zhang, L, additional, Ghatala, R, additional, Sim, C H, additional, Ghani, U, additional, Yates, K, additional, Obarey, S, additional, Willmot, M, additional, Ahlquist, K, additional, Bates, M, additional, Rashed, K, additional, Board, S, additional, Andsberg, G, additional, Sundayi, S, additional, Garside, M, additional, Macleod, M-J, additional, Manoj, A, additional, Hopper, O, additional, Cederin, B, additional, Toomsoo, T, additional, Gross-Paju, K, additional, Tapiola, T, additional, Kestutis, J, additional, Amthor, K-F, additional, Heermann, B, additional, Ottesen, V, additional, Melum, T A, additional, Kurz, M, additional, and Parsons, M, additional
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- 2023
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11. Blood pressure control to prevent decline in cognition after stroke
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Ihle-Hansen H, Thommessen B, Fagerl, MW, Øksengård AR, Wyller TB, Engedal K, and Fure B
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Hege Ihle-Hansen,1 Bente Thommessen,2 Morten W Fagerland,3 Anne R Øksengård,4 Torgeir B Wyller,5 Knut Engedal,6 Brynjar Fure7 1Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway; 2Department of Neurology, Akershus University Hospital, Lørenskog, Norway; 3Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway; 4Department of Internal medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway; 5Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; 6Norwegian Centre for Dementia Research, Oslo University Hospital, Oslo, Norway; 7Norwegian Knowledge Centre for the Health Services, Oslo, Norway Background: Treatment of hypertension post-stroke preserves cognition through prevention of recurrent stroke, but it is not clear whether it prevents cognitive decline through other mechanisms. We aimed to describe changes in blood pressure from baseline to 1 year post-stroke and to evaluate the association between achieved blood pressure targets and cognitive function, mild cognitive impairment (MCI), and dementia.Methods: We included patients with first-ever stroke, and defined achieved blood pressure goals as systolic blood pressure (SBP) in the categories ≤125 mmHg, ≤140 mmHg, and ≤160 mmHg, SBP reduction of ≥10 mmHg, and diastolic blood pressure (DBP) reduction of ≥5 mmHg. The main outcome variables were cognitive assessments 1 year post stroke. Secondary outcomes were diagnoses of MCI or dementia.Results: Forty-one of 166 patients (25%) reached SBP ≤125 mmHg after 1 year, 92/166 (55%) reached SBP ≤140 mmHg, and 150/166 (90%) reached SBP ≤160 mmHg. SBP was reduced by ≥10 mmHg in 44/150 (29%) and DBP by ≥5 mmHg in 57/150 (38%). We did not find any statistically significant associations between cognitive test performances and different blood pressure goals (P=0.070–1.0). Nor was there any significant association between achieved goal blood pressure or blood pressure reduction after 1 year and the diagnoses of MCI or dementia (P=0.32–0.56).Conclusion: Treatment of hypertension is important for primary and secondary prevention of stroke. Showing a potential beneficial effect of blood pressure control on cognitive function, however, probably needs longer follow-up. Keywords: cognitive impairment, hypertension, cerebrovascular disease, risk factor management, secondary prevention
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- 2015
12. Atrial fibrillation in cryptogenic stroke and TIA patients in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study: Main results
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Ratajczak-Tretel, B, Tancin Lambert, A, Al-Ani, R, Arntzen, K, Bakkejord, GK, Bekkeseth, HMO, Bjerkeli, V, Eldøen, G, Gulsvik, A, Halvorsen, B, Høie, GA, Ihle-Hansen, H, Ihle-Hansen, H, Ingebrigtsen, S, Johansen, H, Kremer, C, Krogseth, SB, Kruuse, C, Kurz, M, Nakstad, I, Novotny, V, Næss, H, Qazi, R, Rezaj, MK, Rørholt, DM, Steffensen, LH, Sømark, J, Tobro, H, Truelsen, TC, Wassvik, L, Ægidius, KL, Atar, D, and Aamodt, AH
- 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< 0.001), had higher pre-stroke CHA₂DS₂-VASc score (median 3 vs 2; p< 0.001) and admission NIHSS (median 2 vs 1; p= 0.001); and more often hypertension (p= 0.045) and dyslipidaemia (p= 0.005) than non-AF patients. The arrhythmia was recurrent in 91.9% and asymptomatic in 93.2%. At 12-month follow-up anticoagulants usage was 97.3%.Discussion and conclusions: ICM was an effective tool for diagnosing underlying AF, capturing AF in 29% of the CS and TIA patients. AF was asymptomatic in most cases and would mainly have gone undiagnosed without ICM. The insertion and use of ICM was feasible for stroke physicians in stroke units.
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- 2023
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13. Brain disconnectivity mapping of post-stroke fatigue
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Andreas Engvig, Ihle Hansen H, Anne-Marthe Sanders, Lars T. Westlye, de Schotten Mt, Kristine Moe Ulrichsen, Sveinung Tornås, Nordvik Je, Erlend S. Dørum, Geneviève Richard, Jennifer Monereo Sánchez, Dag Alnæs, and Knut-Kristian Kolskår
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medicine.medical_specialty ,Neural correlates of consciousness ,business.industry ,Linear model ,Bayes factor ,computer.software_genre ,Lesion ,White matter ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,Voxel ,Post stroke ,medicine ,Etiology ,medicine.symptom ,business ,computer - Abstract
Stroke patients commonly suffer from post stroke fatigue (PSF). Despite a general consensus that brain perturbations constitute a precipitating event in the multifactorial etiology of PSF, the specific predictive value of conventional lesion characteristics such as size and localization remain unclear. The current study represents a novel approach to assess the neural correlates of PSF in chronic stroke patients. While previous research has focused primarily on lesion location or size, with mixed or inconclusive results, we targeted the extended structural network implicated by the lesion, and evaluated the added explanatory value of a disconnectivity approach with regards to the brain correlates of PSF. To this end, we estimated individual brain disconnectome maps in 84 stroke survivors in the chronic phase (≥ 3 months post stroke) using information about lesion location and normative white matter pathways obtained from 170 healthy individuals. PSF was measured by the Fatigue Severity Scale (FSS). Voxel wise analyses using non-parametric permutation-based inference were conducted on disconnectome maps to estimate regional effects of disconnectivity. Associations between PSF and global disconnectivity and clinical lesion characteristics were tested by linear models, and we estimated Bayes factor to quantify the evidence for the null and alternative hypotheses, respectively. The results revealed no significant associations between PSF and disconnectome measures or lesion characteristics, with moderate evidence in favor of the null hypothesis. These results suggest that symptoms of post-stroke fatigue are not simply explained by lesion characteristics or brain disconnectome measures in stroke patients in a chronic phase, and are discussed in light of methodological considerations.
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- 2020
14. Cognitive and emotional symptoms in patients with first-ever mild stroke: The syndrome of hidden impairments
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Vlachos, G, primary, Ihle-Hansen, H, additional, Wyller, T, additional, Brækhus, A, additional, Mangset, M, additional, Hamre, C, additional, and Fure, B, additional
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- 2021
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15. Time trends in incidence rates of atrial fibrillation-related strokes in Norway 2001-2014:a nationwide analysis using data from the cardiovascular disease in Norway (CVDNOR) project
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Ariansen, Inger, Igland, J., Anjum, M., Kjerpeseth, L. J., Selmer, R., Ellekjaer, H., Kalstoe, S., Christophersen, Nicolaj, Myrstad, M., Ihle-Hansen, H., Tveit, A., Mortensen, L. H., Tell, G. S., Berge, T., Ariansen, Inger, Igland, J., Anjum, M., Kjerpeseth, L. J., Selmer, R., Ellekjaer, H., Kalstoe, S., Christophersen, Nicolaj, Myrstad, M., Ihle-Hansen, H., Tveit, A., Mortensen, L. H., Tell, G. S., and Berge, T.
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- 2020
16. Time trends in incidence rates of atrial fibrillation-related strokes in Norway 2001–2014: a nationwide analysis using data from the cardiovascular disease in Norway (CVDNOR) project
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Ariansen, I, primary, Igland, J, additional, Anjum, M, additional, Kjerpeseth, L.J, additional, Selmer, R, additional, Ellekjaer, H, additional, Kalstoe, S, additional, Christophersen, I, additional, Myrstad, M, additional, Ihle-Hansen, H, additional, Tveit, A, additional, Mortensen, L.H, additional, Tell, G.S, additional, and Berge, T, additional
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- 2020
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17. Vascular risk factor control and adherence to secondary preventive medication after ischaemic stroke
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Gynnild, M. N., primary, Aakerøy, R., additional, Spigset, O., additional, Askim, T., additional, Beyer, M. K., additional, Ihle‐Hansen, H., additional, Munthe‐Kaas, R., additional, Knapskog, A. B., additional, Lydersen, S., additional, Næss, H., additional, Røsstad, T.G., additional, Seljeseth, Y. M., additional, Thingstad, P., additional, Saltvedt, I., additional, and Ellekjær, H., additional
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- 2020
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18. Vascular brain pathology is more important than neurodegeneration in pathogenesis of pre-stroke cognitive impairment
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Schellhorn, T, primary, Zucknick, M, additional, Askim, T, additional, Munthe-Kaas, R, additional, Ihle-Hansen, H, additional, Seljeseth, YM, additional, Knapskog, AB, additional, Næss, H, additional, Ellekjær, H, additional, Thingstad, P, additional, Wyller, T Bruun, additional, Saltvedt, I, additional, and Beyer, MK, additional
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- 2020
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19. A physical activity intervention to prevent cognitive decline after stroke: Secondary results from the Life After STroke study, an 18-month randomized controlled trial
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Ihle-Hansen, H, primary, Langhammer, B, additional, Lydersen, S, additional, Gunnes, M, additional, Indredavik, B, additional, and Askim, T, additional
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- 2019
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20. Vascular risk factor control and adherence to secondary preventive medication after ischaemic stroke.
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Gynnild, M. N., Aakerøy, R., Spigset, O., Askim, T., Beyer, M. K., Ihle‐Hansen, H., Munthe‐Kaas, R., Knapskog, A. B., Lydersen, S., Næss, H., Røsstad, T.G., Seljeseth, Y. M., Thingstad, P., Saltvedt, I., and Ellekjær, H.
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PATIENT compliance ,ANTILIPEMIC agents ,BLOOD pressure ,DRUGS ,HYPOGLYCEMIC agents - Abstract
Background: Studies regarding adequacy of secondary stroke prevention are limited. We report medication adherence, risk factor control and factors influencing vascular risk profile following ischaemic stroke. Methods: A total of 664 home‐dwelling participants in the Norwegian Cognitive Impairment After Stroke study, a multicenter observational study, were evaluated 3 and 18 months poststroke. We assessed medication adherence by self‐reporting (4‐item Morisky Medication Adherence Scale) and medication persistence (defined as continuation of medication(s) prescribed at discharge), achievement of guideline‐defined targets of blood pressure (BP) (<140/90 mmHg), low‐density lipoprotein cholesterol (LDL‐C) (<2.0 mmol L−1) and haemoglobin A1c (HbA1c) (≤53 mmol mol−1) and determinants of risk factor control. Results: At discharge, 97% were prescribed antithrombotics, 88% lipid‐lowering drugs, 68% antihypertensives and 12% antidiabetic drugs. Persistence of users declined to 99%, 88%, 93% and 95%, respectively, at 18 months. After 3 and 18 months, 80% and 73% reported high adherence. After 3 and 18 months, 40.7% and 47.0% gained BP control, 48.4% and 44.6% achieved LDL‐C control, and 69.2% and 69.5% of diabetic patients achieved HbA1c control. Advanced age was associated with increased LDL‐C control (OR 1.03, 95% CI 1.01 to 1.06) and reduced BP control (OR 0.98, 0.96 to 0.99). Women had poorer LDL‐C control (OR 0.60, 0.37 to 0.98). Polypharmacy was associated with increased LDL‐C control (OR 1.29, 1.18 to 1.41) and reduced HbA1c control (OR 0.76, 0.60 to 0.98). Conclusion: Risk factor control is suboptimal despite high medication persistence and adherence. Improved understanding of this complex clinical setting is needed for optimization of secondary preventive strategies. [ABSTRACT FROM AUTHOR]
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- 2021
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21. P618Prediction of subclinical atherosclerosis using an ultra-sensitive cardiac troponin I assay: data from the Akershus Cardiac Examination (ACE) 1950 Study
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Lyngbakken, M N, primary, Vigen, T, additional, Ihle-Hansen, H, additional, Brynildsen, J, additional, Berge, T, additional, Ronning, O M, additional, Tveit, A, additional, Rosjo, H R, additional, and Omland, T, additional
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- 2018
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22. P865Prevalence and risk factors for atrial fibrillation in 63-65 years olds: data from the Akershus Cardiac Examination (ACE) 1950 study
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Berge, T, primary, Lyngbakken, M N, additional, Ihle-Hansen, H, additional, Vigen, T, additional, Pervez, O M, additional, Brynildsen, J, additional, Christophersen, I E, additional, Steine, K, additional, Omland, T, additional, Smith, P, additional, Rosjo, H, additional, and Tveit, A, additional
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- 2018
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23. 1667Systematic screening for atrial fibrillation in 65-year-olds with risk factors for stroke. Data from the ACE 1950 Study
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Berge, T., primary, Brynildsen, J., additional, Larssen, HKN, additional, Onarheim, S., additional, Jenssen, GR., additional, Ihle-Hansen, H., additional, Christophersen, IE., additional, Myrstad, M., additional, Smith, P., additional, Rosjo, H., additional, and Tveit, A., additional
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- 2017
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24. Skeletal muscle metabolism after stroke: A comparative study using treadmill and overground walking test
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Loureiro, A, primary, Langhammer, B, additional, Gjøvaag, T, additional, Ihle-Hansen, H, additional, and Guarita-Souza, L, additional
- Published
- 2017
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25. Multidomain intervention for the prevention of cognitive decline after stroke – a pooled patient‐level data analysis.
- Author
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the ASPIS Study Group, Teuschl, Y., Dachenhausen, A., Ratajczak, P., Brainin, M., Matz, K., Tuomilehto, J., Ihle‐Hansen, H., Ursin, M. H., Hagberg, G., Øksengård, A. R., and Thommessen, B.
- Subjects
STROKE risk factors ,COGNITION disorders ,RANDOMIZED controlled trials ,DEMENTIA ,STROKE patients ,MEDICAL care - Abstract
Background and purpose: The aim of this pooled patient‐level data analysis was to test if multidomain interventions, addressing several modifiable vascular risk factors simultaneously, are more effective than usual post‐stroke care for the prevention of cognitive decline after stroke. Methods: This pooled patient‐level data analysis included two randomized controlled trials using a multidomain approach to target vascular risk factors in stroke patients and cognition as primary outcome. Changes from baseline to 12 months in the trail making test (TMT)‐A, TMT‐B and 10‐words test were analysed using stepwise backward linear mixed models with study as random factor. Two analyses were based on the intention‐to‐treat (ITT) principle using different imputation approaches and one was based on complete cases. Results: Data from 322 patients (157 assigned to multidomain intervention and 165 to standard care) were analysed. Differences between randomization groups for TMT‐A scores were found in one ITT model (P = 0.014) and approached significance in the second ITT model (P = 0.087) and for complete cases (P = 0.091). No significant intervention effects were found for any of the other cognitive variables. Conclusion: We found indications that multidomain interventions compared with standard care can improve the scores in TMT‐A at 1 year after stroke but not those for TMT‐B or the 10‐words test. These results have to be interpreted with caution due to the small number of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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26. P-482: The Norwegian Cognitive Impairment After Stroke study (Nor-COAST)
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Saltvedt, I., primary, Askim, T., additional, Indredavik, B., additional, Engstad, T., additional, Næss, H., additional, Ihle-Hansen, H., additional, Fure, B., additional, and Beyer, M., additional
- Published
- 2015
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27. Sedentary behaviors in stroke survivors
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Loureiro, A.P.C., primary, Guarita-Souza, L.C., additional, Gjøvaag, T., additional, Ihle-Hansen, H., additional, and Langhammer, B., additional
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- 2015
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28. Effects of premorbid physical activity on stroke severity and post-stroke functioning
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Ursin, M, primary, Ihle-Hansen, H, additional, Fure, B, additional, Tveit, A, additional, and Bergland, A, additional
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- 2015
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29. Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: A randomized controlled trial
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Ihle-Hansen, H., primary
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- 2013
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30. Malnutrition in Norway
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Ihle-Hansen, H., primary, Mowe, H., additional, and Fure, B., additional
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- 2011
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31. BRAIN IMAGING AS THE PREDICTOR OF ATRIAL FIBRILLATION THE NORDIC ATRIAL FIBRILLATION AND STROKE STUDY (NOR-FIB)
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Lambert, A. T., Ratajczak-Tretel, B., Lambert, M., Bjerkeli, V., Ihle-Hansen, H., Naess, H., Novotny, V., Truelsen, T. C., Aegidius, K. L., Tobro, H., Krogseth, S. B., Kruuse, C., Arntzen, K., Eldoen, G., Gulsvik, A., Qazi, R. Ul-Haq, Rezai, M., Ahmed, H. Khan, Somark, J., Bekkeseth, H. M. Otterholt, Ingebrigtsen, S., Hoie, G., Atar, D., and Anne Hege Aamodt
32. IMPACT OF PRE-STROKE FRAILTY ON OUTCOME THREE YEARS AFTER ACUTE STROKE: THE NOR-COAST STUDY.
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Munthe-Kaas R, Lydersen S, Quinn T, Aam S, Pendlebury ST, and Ihle-Hansen H
- Abstract
Background: We aimed to explore the predictive value of pre-stroke frailty index (FI) on functional dependency and mortality three years after stroke., Methods: Based on the Rockwood 36-item FI score, we calculated the pre-stroke FI from medical conditions recorded at baseline in the multicenter prospective Nor-COAST study 2015-2017. Participants with a FI score and a modified Rankin scale (mRS) 0-6 three years post-stroke were included in this study. We used logistic regression analysis with unfavourable mRS (over 2 vs 0-2) at 3 years, or dead within 3 years, as dependent variable, and frailty and pre-stroke mRS, one at a time, and simultaneously, as predictors. The analyses were carried out unadjusted, and adjusted for the following variables one at a time: Age, sex, years of education, stroke severity at admission, infections treated with antibiotics and stroke progression. We report Odds Ratio (OR) per 0.10 increase in FI., Results: At baseline, the 609 included patients had mean age 72.8 (SD 11.8), 261 (43%) were females, and had a FI mean score of 0.16 (SD 0.12), range 0 to 0.69. During three years, 138 (23%) had died. Both the FI, and pre-stroke mRS, were strong predictors for unfavorable mRS (OR 4.1 and 2.7) and dead within 3 years (OR 2.2 and 1.7). Only adjusting for age affected the result. The OR for pre-stroke mRS decreased relatively more than the OR for FI when entered as predictors simultaneously., Conclusions: FI is a stronger predictor than premorbid mRS for prognostication after stroke., (S. Karger AG, Basel.)
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- 2024
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33. Systolic blood pressure at age 40 and 30-year stroke risk in men and women.
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Walle-Hansen MM, Hagberg G, Myrstad M, Berge T, Vigen T, Ihle-Hansen H, Thommessen B, Ariansen I, Lyngbakken MN, Røsjø H, Rønning OM, Tveit A, and Ihle-Hansen H
- Subjects
- Humans, Female, Male, Norway epidemiology, Adult, Risk Factors, Risk Assessment methods, Sex Factors, Incidence, Follow-Up Studies, Time Factors, Registries, Systole, Age Factors, Blood Pressure Determination methods, Blood Pressure Determination statistics & numerical data, Stroke epidemiology, Stroke etiology, Blood Pressure physiology, Hypertension epidemiology, Hypertension physiopathology, Hypertension complications, Hypertension diagnosis
- Abstract
Background: American and European guidelines define hypertension differently and are sex agnostic. Our aim was to assess the impact of different hypertension thresholds at the age of 40 on 30-year stroke risk and to examine sex differences., Methods: We included 2608 stroke-free individuals from the Akershus Cardiac Examination 1950 Study, a Norwegian regional study conducted in 2012-2015 of the 1950 birth cohort, who had previously participated in the Age 40 Program, a nationwide health examination study conducted in 1990-1993. We categorised participants by systolic blood pressure (SBP) at age 40 (<120 mm Hg (reference), 120-129 mm Hg, 130-139 mm Hg and ≥140 mm Hg) and compared stroke risk using Cox proportional hazard regressions adjusted for age, sex, smoking, cholesterol, physical activity, obesity and education. Fatal and non-fatal strokes were obtained from the Norwegian Cardiovascular Disease Registry from 1 January 2012 to 31 December 2020, in addition to self-reported strokes., Results: The mean age was 40.1±0.3 years (50.4% women) and mean SBP was 128.3±13.5 mm Hg (mean±SD). Stroke occurred in 115 (4.4%) individuals (32 (28%) women and 83 (72%) men) during 29.4±2.9 years of follow-up. SBP between 130 and 139 mm Hg was not associated with stroke (adjusted HR 1.71, 95% CI 0.87 to 3.36) while SBP ≥140 mm Hg was associated with increased stroke risk (adjusted HR 3.11, 95% CI 1.62 to 6.00). The adjusted HR of stroke was 4.32 (95% CI 1.66 to 11.26) for women and 2.66 (95% CI 1.03 to 6.89) for men, with non-significant sex interactions., Conclusions: SBP ≥140 mm Hg was significantly associated with 30-year stroke risk in both sexes. A small subgroup of women had SBP ≥140 mm Hg and systolic hypertension was a strong risk factor for stroke in these women., Trial Registration Number: NCT01555411., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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34. Sleep Duration and Cognitive Function: The Akershus Cardiac Examination 1950 Study.
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Ihle-Hansen H, Einvik G, Hagberg G, Thommessen B, Rønning OM, Vigen T, Lyngbakken MN, Berge T, Røsjø H, Tveit A, and Ihle-Hansen H
- 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., (© 2024 S. Karger AG, Basel.)
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- 2024
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35. Neppe nyttig å finne subklinisk atrieflimmer etter hjerneslag.
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Ihle-Hansen H, Ihle-Hansen H, Steen T, and Hagberg G
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- 2024
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36. The precision by the Face Arm Speech Time (FAST) algorithm in stroke capture, sex and age differences: a stroke registry study.
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Hagberg G, Ihle-Hansen H, Abzhandadze T, Reinholdsson M, Viktorisson A, Ihle-Hansen H, and Stibrant Sunnerhagen K
- Abstract
Background: The shift towards milder strokes and studies suggesting that stroke symptoms vary by age and sex may challenge the Face-Arm-Speech Time (FAST) coverage. We aimed to study the proportion of stroke cases admitted with FAST symptoms, sex and age differences in FAST presentation and explore any additional advantage of including new item(s) from the National Institute of Health Stroke Scale (NIHSS) to the FAST algorithm., Methods: This registry-based study included patients admitted with acute stroke to Sahlgrenska University Hospital (November 2014 to June 2019) with NIHSS items at admission. FAST symptoms were extracted from the NIHSS at admission, and sex and age differences were explored using descriptive statistics., Results: Of 5022 patients, 46% were women. Median NIHSS at admission for women was (2 (8-0) and for men 2 (7-0)). In total, 2972 (59%) had at least one FAST symptom, with no sex difference (p=0.22). No sex or age differences were found in FAST coverage when stratifying for stroke severity. 52% suffered mild strokes, whereas 30% had FAST symptoms. The most frequent focal NIHSS items not included in FAST were sensory (29%) and visual field (25%) and adding these or both in modified FAST algorithms led to a slight increase in strokes captured by the algorithms (59%-67%), without providing enhanced prognostic information., Conclusions: 60% had at least one FAST symptom at admission, only 30% in mild strokes, with no sex or age difference. Adding new items from the NIHSS to the FAST algorithm led only to a slight increase in strokes captured., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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37. What Do We Really Know About the Effect of Prolonged Heart Rhythm Monitoring After Stroke?
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Ihle-Hansen H, Hagberg G, Ihle-Hansen H, Sandset EC, Andrade JG, Mandrola J, and Diederichsen SZ
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- Humans, Risk Factors, Stroke diagnosis, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Atrial Fibrillation drug therapy
- Abstract
The bulk of the current knowledge on atrial fibrillation (AF)-associated stroke risk and benefit of oral anticoagulation derives from studies on patients with clinically diagnosed AF. Subclinical AF (SCAF), defined as AF discovered during the interrogation of prolonged heart monitoring, is often asymptomatic and short-lasting, is associated with increased stroke risk compared with sinus rhythm, and may progress to clinical AF. Despite the extensive screening for and treatment of SCAF, especially in secondary stroke prevention, the net benefit of this practice is not established. Recent studies of SCAF have provided new insights: (1) SCAF is extremely common and may sometimes indicate physiological findings, (2) the stroke risk associated with SCAF is lower than that of clinically detected AF, and (3) any benefit on stroke risk may be countered by increased bleeding risk (no net benefit). How should we interpret the latest knowledge in the setting of poststroke AF screening and prevention?, Competing Interests: Disclosures Dr Andrade has received support from Medtronic, Abbott Canada, Biosense Webster, and Boston Scientific Corporation. Dr Diederichsen has received consultant fees from Bristol-Meyers Squibb/Pfizer and Cortrium, speaker fees from Bristol-Meyers Squibb/Pfizer and Bayer, and is employed by Vital Beats. Dr Sandset has received support from Bayer, Boston Scientific Corporation, Bristol-Myers Squibb, and Daiichi Sankyo Company.
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- 2024
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38. Telephone triage and dispatch of ambulances to patients with suspected and verified acute stroke - a descriptive study.
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Jamtli B, Hov MR, Jørgensen TM, Kramer-Johansen J, Ihle-Hansen H, Sandset EC, Kongsgård HW, and Hardeland C
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- Humans, Triage, Retrospective Studies, Telephone, Ambulances, Stroke diagnosis, Stroke therapy
- Abstract
Objectives: In this study we aimed to explore EMCC triage of suspected and confirmed stroke patients to gain more knowledge about the initial phase of the acute stroke response chain. Accurate dispatch at the Emergency Medical Communication Center (EMCC) is crucial for optimal resource utilization in the prehospital service, and early identification of acute stroke is known to improve patient outcome., Materials and Methods: We conducted a descriptive retrospective study based on data from the Emergency Department and EMCC records at a comprehensive stroke center in Oslo, Norway, during a six-month period (2019-2020). Patients dispatched with EMCC stroke criteria and/or discharged with a stroke diagnosis were included. We identified EMCC true positive, false positive and false negative stroke patients and estimated EMCC stroke sensitivity and positive predictive value (PPV). Furthermore, we analyzed prehospital time intervals and identified patient destinations to gain knowledge on ambulance services assessments., Results: We included 1298 patients. EMCC stroke sensitivity was 77% (95% CI: 72 - 82%), and PPV was 16% (95% CI: 14 - 18%). EMCC false negative stroke patients experienced an increased median prehospital delay of 11 min (p < 0.001). Upon arrival at the scene, 68% of the EMCC false negative patients were identified as suspected stroke cases by the ambulance services. Similarly, 68% of the false positive stroke patients were either referred to a GP, out-of-hours GP acute clinic, local hospitals or left at the scene by the ambulance services, indicating that no obvious stroke symptoms were identified by ambulance personnel upon arrival at the scene., Conclusions: This study reveals a high EMCC stroke sensitivity and an extensive number of false positive stroke dispatches. By comparing the assessments made by both the EMCC and the ambulance service, we have identified specific patient groups that should be the focus for future research efforts aimed at improving the sensitivity and specificity of stroke recognition in the EMCC., (© 2024. The Author(s).)
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- 2024
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39. Patient preferences in geriatric wards, a survey of health care professionals' practice, experience and attitudes.
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Ihle-Hansen H, Pedersen R, Westbye SF, Sævareid TJL, Brøderud L, Larsen MH, Hermansen K, Rostoft S, and Romøren M
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- Humans, Female, Aged, Male, Cross-Sectional Studies, Attitude of Health Personnel, Health Personnel, Patient Preference, Hospitals
- Abstract
Purpose: We aimed to identify whether health care professionals (HCP) examine their patient and next-of-kin preferences, and to study whether medical decisions follow these preferences., Method: A cross-sectional web-based survey was conducted with multidisciplinary HCP from 12 geriatric wards in the South-Eastern Norway Regional Health Authority., Results: Of the 289 HCPs responding (response rate 61%), mean age 37.8 years (SD 11.3), 235 (81.3%) women, 12.4 (SD 9.6) years of experience and 67 (23.2%) medical doctors, only half report clarifying patients' preferences. The majority reported that they did not inform, involve and treat in line with such preferences. However, 53% believe that HCP, patients and next-of-kin should make clinical decisions together., Discussion: Our findings indicate a lack of engagement in conversation and inclusion of patient preferences when providing health interventions in geriatric wards. Measures for change of culture are needed., (© 2024. The Author(s).)
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- 2024
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40. Diagnostic accuracy of the Clock Drawing Test in screening for early post-stroke neurocognitive disorder: the Nor-COAST study.
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Navickaite E, Saltvedt I, Lydersen S, Munthe-Kaas R, Ihle-Hansen H, Grambaite R, and Aam S
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- Aged, Female, Humans, Male, Mental Status and Dementia Tests, Neurocognitive Disorders, Neurologic Examination, Prospective Studies, United States, Middle Aged, Aged, 80 and over, Dementia, Stroke complications, Stroke diagnosis
- Abstract
Background: Post-stroke neurocognitive disorder, though common, is often overlooked by clinicians. Moreover, although the Montreal Cognitive Assessment (MoCA) has proven to be a valid screening test for neurocognitive disorder, even more time saving tests would be preferred. In our study, we aimed to determine the diagnostic accuracy of the Clock Drawing Test (CDT) for post-stroke neurocognitive disorder and the association between the CDT and MoCA., Methods: This study is part of the Norwegian Cognitive Impairment After Stroke study, a multicentre prospective cohort study following patients admitted with acute stroke. At the three-month follow-up, patients were classified with normal cognition, mild neurocognitive disorder, or major neurocognitive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Any neurocognitive disorder compromised both mild- and major neurocognitive disorder. The CDT at the three-month assessment was given scores ranging from 0 to 5. Patients able to complete the CDT and whose cognitive status could be classified were included in analyses. The CDT diagnostic accuracy for post-stroke neurocognitive disorder was identified using receiver operating characteristic curves, sensitivity, specificity, positive predictive value, and negative predictive value. The association between the MoCA and CDT was analysed with Spearman's rho., Results: Of 554 participants, 238 (43.0%) were women. Mean (SD) age was 71.5 (11.8) years, while mean (SD) National Institutes of Health Stroke Scale score was 2.6 (3.7). The area under the receiver operating characteristic curve of the CDT for major neurocognitive disorder and any neurocognitive disorder was 0.73 (95% CI, 0.68-0.79) and 0.68 (95% CI, 0.63-0.72), respectively. A CDT cutoff of < 5 yielded 68% sensitivity and 60% specificity for any neurocognitive disorder and 78% sensitivity and 53% specificity for major neurocognitive disorder. Spearman's correlation coefficient between scores on the MoCA and CDT was 0.50 (95% CI, 0.44-0.57, p < .001)., Conclusions: The CDT is not accurate enough to diagnose post-stroke neurocognitive disorder but shows acceptable accuracy in identifying major neurocognitive disorder. Performance on the CDT was associated with performance on MoCA; however, the CDT is inferior to MoCA in identifying post-stroke neurocognitive disorder., Trial Registration: ClinicalTrials.gov (NCT02650531). Retrospectively registered January 8, 2016., (© 2024. The Author(s).)
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- 2024
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41. Acute ischemic stroke and measurement of apixaban and rivaroxaban: an observational cohort implementation study.
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Amundsen EK, Ihle-Hansen H, Kraglund KL, and Hagberg G
- Abstract
Background: Treatment with intravenous thrombolysis for acute ischemic stroke is contraindicated with intake of apixaban/rivaroxaban in the last 48 hours. Recent European Stroke Organization guidelines suggest that thrombolysis can be considered if anti-factor Xa activity (AFXa) is <0.5 × 10
3 IU/L with low-molecular-weight (LMWH) or unfractionated heparin (UFH) calibrated assays. Some centers also use apixaban/rivaroxaban-calibrated AFXa assays to identify patients with low drug concentrations., Objectives: To prospectively evaluate the first year of implementation of drug-calibrated AFXa assays at our center with 2500 yearly admittances with suspected stroke., Methods: Samples were analyzed on Sysmex CS-5100 instruments with Innovance anti-Xa reagents. Thrombolysis could be considered with drug concentrations <25 μg/L. Patients were registered in an institutionally approved quality register. Outcomes included (1) the number of patients receiving thrombolysis after drug measurement, (2) turn-around time for drug concentration measurements, and (3) sensitivity of LMWH/UFH AFXa to apixaban and rivaroxaban., Results: Apixaban or rivaroxaban was measured in 148 samples, and 4 patients who previously would have been ineligible for thrombolysis were treated with thrombolysis. In total, thrombolysis was administered in 123 patient episodes in the study period. The median turn-around time for the drug measurements was 38 minutes. Apixaban concentrations of 25 μg/L and 50 μg/L corresponded to LMWH/UFH AFXa of 0.13 and 0.27 × 103 IU/L, respectively. There were too few rivaroxaban results for regression analysis., Conclusion: Implementation of apixaban and rivaroxaban measurements led to a small increase in the number of patients receiving thrombolysis. Excluding significant concentrations of apixaban or rivaroxaban using LMWH/UFH AFXa may be feasible., (© 2024 The Authors.)- Published
- 2024
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42. Prognostic value of acute National Institutes of Health Stroke Scale Items on disability: a registry study of first-ever stroke in the western part of Sweden.
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Hagberg G, Ihle-Hansen H, Abzhandadze T, Reinholdsson M, Hansen HI, and Sunnerhagen KS
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- Humans, Female, Aged, Male, United States, Prognosis, Sweden epidemiology, Risk Factors, Registries, National Institutes of Health (U.S.), Treatment Outcome, Severity of Illness Index, Stroke complications, Brain Ischemia complications
- Abstract
Objectives: We aimed to study how the individual items of the National Institutes of Health Stroke Scale (NIHSS) at admission predict functional independence 3 months post-stroke in patients with first-ever stroke., Setting: This registry-based study used data from two Swedish stroke registers (Riksstroke, the mandatory national quality register for stroke care in Sweden, and Väststroke, a local quality stroke register in Gothenburg)., Participants: This study included patients with first-ever acute stroke admitted from November 2014 to August 2018, with available NIHSS at admission and modified Rankin Scale (mRS) at 3-month follow-up., Primary Outcome: The primary outcome variable was mRS≤1 (defined as an excellent outcome) at 3-month follow-up., Results: We included 1471 patients, mean age was 72 (± 14.5) years, 48% were female, and 66% had mild strokes (NIHSS≤3). In adjusted binary logistic regression analysis, the NIHSS items impaired right motor arm and leg, and impairment in visual field, reduced the odds of an excellent outcome at 3 months ((OR 0.60 (95% CI 0.37 to 0.98), OR 0.60 (95% CI 0.37 to 0.97), and OR 0.65 (95% CI 0.45 to 0.94)). When exploring the effect size of associations between NIHSS items and mRS≤1 p, orientation, language and right leg motor had the largest yet small association., Conclusions: Stroke patients with scores on the NIHSS items right motor symptoms or visual field at admission are less likely to have an excellent outcome at 3 months. Clinicians should consider the NIHSS items affected, not only the total NIHSS score, both in treatment guidance and prognostics., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
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43. Reduced physical activity level was associated with poorer quality of life during the early phase of the COVID-19 pandemic: a sub-study of the last-long trial.
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Hokstad A, Thommessen B, Ihle-Hansen H, Indredavik B, Døhl Ø, and Askim T
- Subjects
- Humans, Communicable Disease Control, Cross-Sectional Studies, Exercise, Pandemics, Quality of Life, SARS-CoV-2, Clinical Trials as Topic, COVID-19 epidemiology, Stroke
- Abstract
Objectives: To assess how physical activity levels changed in a stroke cohort during the COVID-19 (SARS-CoV-2) pandemic, and how these changes were associated with quality of life (QoL)., Methods: Between March and July 2021, 150 patients with stroke already included in the Life after Stroke (LAST-long) trial in Norway were invited to participate in this cross-sectional survey. Participants were asked to complete a questionnaire assessing changes in physical activity and self-reported health following the pandemic. Univariate and multivariate logistic regression analyses were used to explore the association between physical activity, loneliness, mental health, social activity and QoL., Results: In all, 118 (79%) participants completed the questionnaire. A total of 80 (68%) reported less physical activity, 46 (39%) felt lonelier, and 43 (37%) reported worse mental health, while 50 (42%) reported reduced QoL compared with before the lockdown. In the univariate analyses less physical activity, feeling lonelier and changes in mental health were associated with reduced QoL. In the multivariate analysis only less physical activity odds ratio (OR) = 4.04 (95% confidence interval (95% CI) 1.44-11.34, p = 0.008) was significantly associated with reduced QoL., Conclusion: More than two-thirds of patients with stroke reported reduced physical activity during the COVID-19 pandemic, and less physical activity was strongly associated with reduced QoL.
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- 2023
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44. Delirium screening in a stroke unit by nurses using 4AT: Results from a quality improvement project.
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Ihle-Hansen H, Johnsen N, Jankowiak T, Hagberg G, Walle-Hansen MM, Landgraff I, Høvik G, Graven E, and Myrstad M
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- Humans, Aged, Sensitivity and Specificity, Quality Improvement, Hospitalization, Delirium diagnosis, Stroke diagnosis
- Abstract
Aim: To assess the feasibility of delirium screening with the screening tool 4AT conducted by stroke unit nurses., Design: Observational., Methods: Patients with confirmed acute stroke admitted to the stroke unit at Baerum Hospital, Norway, from March to October 2020, were consecutively recruited. Nurses performed delirium screening using the rapid screening tool 4AT within 24 h of admission, at discharge and when delirium was suspected, and filled out a questionnaire assessing their experiences with the delirium screening. A geriatrician validated the delirium diagnosis., Results: In all, 62 patients were included, mean age 73.3 years. 4AT was performed according to protocol in 49 (79.0%) and 39 (62.9%) patients at admission and discharge respectively. Lack of time (40%) was reported as the most common reason for not performing delirium screening. The nurses reported that the felt competent to carry out the 4AT screening, and did not experience it as significant extra workload. Five patients (8%) were diagnosed with delirium. Delirium screening performed by stroke unit nurses seemed feasible and the nurses experienced that 4AT was a useful tool for this purpose., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)
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- 2023
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45. Carotid Plaque Score for Stroke and Cardiovascular Risk Prediction in a Middle-Aged Cohort From the General Population.
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Ihle-Hansen H, Vigen T, Berge T, Walle-Hansen MM, Hagberg G, Ihle-Hansen H, Thommessen B, Ariansen I, Røsjø H, Rønning OM, Tveit A, and Lyngbakken M
- Subjects
- Middle Aged, Humans, Prospective Studies, Risk Factors, Carotid Artery, Common, Heart Disease Risk Factors, Plaque, Amyloid, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Stroke epidemiology, Ischemic Stroke
- Abstract
Background We aimed to explore the predictive value of the carotid plaque score, compared with the Systematic Coronary Risk Evaluation 2 (SCORE2) risk prediction algorithm, on incident ischemic stroke and major adverse cardiovascular events and establish a prognostic cutoff of the carotid plaque score. Methods and Results In the prospective ACE 1950 (Akershus Cardiac Examination 1950 study), carotid plaque score was calculated with ultrasonography at inclusion in 2012 to 2015. The largest plaque diameter in each extracranial segment of the carotid artery on both sides was scored from 0 to 3 points. The sum of points in all segments provided the carotid plaque score. The cohort was followed up by linkage to national registries for incident ischemic stroke and major adverse cardiovascular events (nonfatal ischemic stroke, nonfatal myocardial infarction, and cardiovascular death) throughout 2020. Carotid plaque score was available in 3650 (98.5%) participants, with mean±SD age of 63.9±0.64 years at inclusion. Only 462 (12.7%) participants were free of plaque, and and 970 (26.6%) had a carotid plaque score of >3. Carotid plaque score predicted ischemic stroke (hazard ratio [HR], 1.25 [95% CI, 1.15-1.36]) and major adverse cardiovascular events (HR, 1.21 [95% CI, 1.14-1.27]) after adjustment for SCORE2 and provided strong incremental prognostic information to SCORE2. The best cutoff value of carotid plaque score for ischemic stroke was >3, with positive predictive value of 2.5% and negative predictive value of 99.3%. Conclusions The carotid plaque score is a strong predictor of ischemic stroke and major adverse cardiovascular events, and it provides incremental prognostic information to SCORE2 for risk prediction. A cutoff score of >3 seems to be suitable to discriminate high-risk subjects. Registration Information clinicaltrials.gov. Identifier: NCT01555411.
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- 2023
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46. Prehospital screening of acute stroke with the National Institutes of Health Stroke Scale (ParaNASPP): a stepped-wedge, cluster-randomised controlled trial.
- Author
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Guterud M, Fagerheim Bugge H, Røislien J, Kramer-Johansen J, Toft M, Ihle-Hansen H, Bache KG, Larsen K, Braarud AC, Sandset EC, and Ranhoff Hov M
- Subjects
- United States, Humans, Single-Blind Method, Pandemics, National Institutes of Health (U.S.), Administrative Personnel, Mobile Applications
- Abstract
Background: Timely treatment of acute stroke depends on early identification and triage. Improved methods for recognition of stroke in the prehospital setting are needed. We aimed to assess whether use of the National Institutes of Health Stroke Scale (NIHSS) by paramedics in the ambulance could improve communication with the hospital, augment triage, and enhance diagnostic accuracy of acute stroke., Methods: The Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) was a stepped-wedge, single-blind, cluster-randomised controlled trial. Patients with suspected acute stroke, who were evaluated by paramedics from five ambulance stations in Oslo, Norway, were eligible for inclusion. The five ambulance stations (defined as clusters) all initially managed patients according to a standard stroke protocol (control group), with randomised sequential crossover of each station to the intervention group. The intervention consisted of supervised training on NIHSS scoring, a mobile application to aid scoring, and standardised communication with stroke physicians. Random allocation was done via a simple lottery draw by administrators at Oslo University Hospital, who were independent of the research team. Allocation concealment was not possible due to the nature of the intervention. The primary outcome was the positive predictive value (PPV) for prehospital identification of patients with a final discharge diagnosis of acute stroke, analysed by intention to treat. Prespecified secondary safety outcomes were median prehospital on-scene time and median door-to-needle time. This trial is registered with ClinicalTrials.gov, NCT04137874, and is completed., Findings: Between June 3, 2019, and July 1, 2021, 935 patients were evaluated by paramedics for suspected acute stroke. 134 patients met exclusion criteria or did not consent to participate. The primary analysis included 447 patients in the intervention group and 354 in the control group. There was no difference in PPV for prehospital identification of patients with a final discharge diagnosis of acute stroke between the intervention group (48·1%, 95% CI 43·4-52·8) and control group (45·8%, 40·5-51·1), with an estimated percentage points difference between groups of 2·3 (95% CI -4·6 to 9·3; p=0·51). Median prehospital on-scene time increased by 5 min in the intervention group (29 min [IQR 23-36] vs 24 min [19-31]; p<0·0001), whereas median door-to-needle time was similar between groups (26 min [21-36] vs 27 min [20-36]; p=0·90). No prehospital deaths were reported in either group., Interpretation: The intervention did not improve diagnostic accuracy in patients with suspected stroke. A general increase in prehospital time during the pandemic and the identification of smaller strokes that require more deliberation are possible explanations for the increased on-scene time. The ParaNASPP model is to be implemented in Norway from 2023, and will provide real-life data for further research., Funding: Norwegian Air Ambulance Foundation and Oslo University Hospital., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
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- 2023
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47. [Disease course in patients admitted to Bærum Hospital with the Delta and Omicron variants of the SARS-CoV-2 virus].
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Rønningen PS, Walle-Hansen MM, Ihle-Hansen H, Heide JB, Andersen EL, Rønning EJ, Svendsen J, Tveit A, and Myrstad M
- Subjects
- Humans, Pandemics, Hospitals, Disease Progression, SARS-CoV-2, COVID-19 epidemiology
- Abstract
Background: Waves of infection have formed the pattern of the COVID-19 pandemic. A wave dominated by the delta variant of the SARS-CoV-2 virus in autumn 2021 was superseded by the omicron variant over the course of a few weeks around Christmas. We describe how this transition affected the population of patients admitted to a Norwegian local hospital with COVID-19., Material and Method: All patients admitted to Bærum Hospital with confirmed SARS-CoV-2 virus were included in a quality study which aimed to describe patient characteristics and clinical course. We present patients admitted in the periods 28 June 2021-31 December 2021 and 1 January 2022-12 June 2022, described here as the delta wave and the omicron wave., Results: The SARS-CoV-2-virus was confirmed in a total of 144 patients who were admitted during the delta wave, and in 261 patients during the omicron wave, where 14/144 (10 %) and 89/261 (34 %) were admitted for reasons other than COVID-19. Patients with COVID-19 during the delta wave were younger on average (59 vs. 69 years) and had a lower Charlson comorbidity index score (2.6 vs. 4.9) and a lower Clinical Frailty Scale score (2.8 vs. 3.7) than patients in the omicron wave. Among 302/405 patients admitted with COVID-19 as the principal diagnosis, 88/130 (68 %) patients had respiratory failure during the delta wave and 59/172 (34 %) during the omicron wave, with a median number of 8 bed days (interquartile range 5-15) and 5 (interquartile range 3-8)., Interpretation: The transition from the wave of infection that was dominated by the delta variant of the SARS-CoV-2 virus to the wave dominated by the omicron variant had a considerable effect on the characteristics and clinical course of patients admitted to hospital with SARS-CoV-2 infection.
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- 2023
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48. Multimodal individualised intervention to prevent functional decline after stroke: protocol of a randomised controlled trial on long-term follow-up after stroke (LAST-long).
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Askim T, Hokstad A, Bergh E, Døhl Ø, Ellekjær H, Ihle-Hansen H, Indredavik B, Leer ASM, Lydersen S, Saltvedt I, Seljeseth Y, and Thommessen B
- Subjects
- Humans, Follow-Up Studies, Cognition, Exercise, Randomized Controlled Trials as Topic, Activities of Daily Living, Stroke therapy
- Abstract
Introduction: Multimodal interventions have emerged as new approaches to provide more targeted intervention to reduce functional decline after stroke. Still, the evidence is contradictory. The main objective of the Life After Stroke (LAST)-long trial is to investigate if monthly meetings with a stroke coordinator who offers a multimodal approach to long-term follow-up can prevent functional decline after stroke., Methods and Analysis: LAST-long is a pragmatic single-blinded, parallel-group randomised controlled trial recruiting participants living in six different municipalities, admitted to four hospitals in Norway. The patients are screened for inclusion and recruited into the trial 3 months after stroke. A total of 300 patients fulfilling the inclusion criteria will be randomised to an intervention group receiving monthly follow-up by a community-based stroke coordinator who identifies the participants' individual risk profile and sets up an action plan based on individual goals, or to a control group receiving standard care. All participants undergo blinded assessments at 6-month, 12-month and 18-month follow-up. Modified Rankin Scale at 18 months is primary outcome. Secondary outcomes are results of blood tests, blood pressure, adherence to secondary prophylaxis, measures of activities of daily living, cognitive function, physical function, physical activity, patient reported outcome measures, caregiver's burden, the use and costs of health services, safety measures and measures of adherence to the intervention. Mixed models will be used to evaluate differences between the intervention and control group for all endpoints across the four time points, with treatment group, time as categorical covariates and their interaction as fixed effects, and patient as random effect., Ethics and Dissemination: This trial was approved by the Regional Committee of Medical and Health Research Ethics, REC no. 2018/1809. The main results will be published in international peer-reviewed open access scientific journals and to policy-makers and end users in relevant channels., Trial Registration Number: ClincalTrials.gov Identifier: NCT03859063, registered on 1 March 2019., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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49. Predictors of cognitive and emotional symptoms 12 months after first-ever mild stroke.
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Vlachos G, Ihle-Hansen H, Wyller TB, Brækhus A, Mangset M, Hamre C, and Fure B
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- Humans, Female, Anxiety, Cognition, Stroke complications, Stroke psychology, Cognitive Dysfunction, Apathy
- 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.
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- 2023
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50. Biomarkers predictive of atrial fibrillation in patients with cryptogenic stroke. Insights from the Nordic Atrial Fibrillation and Stroke (NOR-FIB) study.
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Tancin Lambert A, Ratajczak-Tretel B, Al-Ani R, Arntzen K, Bakkejord GK, Bekkeseth HMO, Bjerkeli V, Eldøen G, Gulsvik AK, Halvorsen B, Høie GA, Ihle-Hansen H, Ihle-Hansen H, Ingebrigtsen S, Johansen H, Kremer C, Krogseth SB, Kruuse C, Kurz M, Nakstad I, Novotny V, Naess H, Qazi R, Rezai MK, Rørholt DM, Steffensen LH, Sømark J, Tobro H, Truelsen TC, Wassvik L, AEgidius KL, Pesonen M, de Melis M, Atar D, and Aamodt AH
- Subjects
- Humans, Biomarkers, Natriuretic Peptide, Brain, Peptide Fragments, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Stroke complications, Ischemic Attack, Transient complications, Ischemic Stroke complications
- 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., (© 2023 European Academy of Neurology.)
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- 2023
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