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133 results on '"Rodriguez-Campello A"'

2. Blood DNA Methylation Analysis Reveals a Distinctive Epigenetic Signature of Vasospasm in Aneurysmal Subarachnoid Hemorrhage

Author

Fernández-Pérez, Isabel, Jiménez-Balado, Joan, Macias-Gómez, Adrià, Suárez‑Pérez, Antoni, Vallverdú-Prats, Marta, Pérez-Giraldo, Alberto, Viles-García, Marc, Peris-Subiza, Julia, Vidal-Notari, Sergio, Giralt-Steinhauer, Eva, Guisado-Alonso, Daniel, Esteller, Manel, Rodriguez-Campello, Ana, Jiménez-Conde, Jordi, Ois, Angel, and Cuadrado-Godia, Elisa

Published
2024
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3. Acute-to-chronic glycemic ratio as an outcome predictor in ischemic stroke in patients with and without diabetes mellitus

Author

Elisenda Climent, Ana Rodriguez-Campello, Joan Jiménez-Balado, Mercè Fernández-Miró, Jordi Jiménez-Conde, Gemma Llauradó, Ángel Ois, Juana A. Flores, Elisa Cuadrado-Godia, Eva Giralt Steinhauer, Juan J. Chillarón, and Neurovascular Research Group (NEUVAS)

Subjects
Acute-to-chronic glycemic ratio, Diabetes, Hyperglycemia, Ischemic stroke, Mortality, outcome, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Objective Elevated plasma glucose levels are common in patients suffering acute ischemic stroke (AIS), and acute hyperglycemia has been defined as an independent determinant of adverse outcomes. The impact of acute-to-chronic glycemic ratio (ACR) has been analyzed in other diseases, but its impact on AIS prognosis remains unclear. The main aim of this study was to assess whether the ACR was associated with a 3-month poor prognosis in patients with AIS. Research, design and methods Retrospective analysis of patients admitted for AIS in Hospital del Mar, Barcelona. To estimate the chronic glucose levels (CGL) we used the formula eCGL= [28.7xHbA1c (%)]-46.7. The ACR (glycemic at admission / eCGL) was calculated for all subjects. Tertile 1 was defined as: 0.28–0.92, tertile 2: 0.92–1.13 and tertile 3: > 1.13. Poor prognosis at 3 months after stroke was defined as mRS score 3–6. Results 2.774 subjects with AIS diagnosis were included. Age, presence of diabetes, previous disability (mRS), initial severity (NIHSS) and revascularization therapy were associated with poor prognosis (p values

Published
2024
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4. Correction to: Blood DNA Methylation Analysis Reveals a Distinctive Epigenetic Signature of Vasospasm in Aneurysmal Subarachnoid Hemorrhage

Author

Fernández‑Pérez, Isabel, Jiménez‑Balado, Joan, Macias‑Gómez, Adrià, Suárez‑Pérez, Antoni, Vallverdú‑Prats, Marta, Pérez‑Giraldo, Alberto, Viles‑García, Marc, Peris‑Subiza, Julia, Vidal‑Notari, Sergio, Giralt‑Steinhauer, Eva, Guisado‑Alonso, Daniel, Esteller, Manel, Rodriguez‑Campello, Ana, Jiménez‑Conde, Jordi, Ois, Angel, and Cuadrado‑Godia, Elisa

Published
2024
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5. Lipidomic signature of stroke recurrence after transient ischemic attack

Author

F. Purroy, A. Ois, M. Jove, G. Arque, J. Sol, G. Mauri-Capdevila, A. Rodriguez-Campello, R. Pamplona, M. Portero, and J. Roquer

Subjects
Medicine, Science
Abstract

Abstract While TIA patients have transient symptoms, they should not be underestimated, as they could have an underlying pathology that may lead to a subsequent stroke: stroke recurrence (SR). Previously, it has been described the involvement of lipids in different vascular diseases. The aim of the current study was to perform a lipidomic analysis to identify differences in the lipidomic profile between patients with SR and patients without. Untargeted lipidomic analysis was performed in plasma samples of 460 consecutive TIA patients recruited

Published
2023
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8. Influence of Hospital Type on Outcomes of Patients With Acute Spontaneous Intracerebral Hemorrhage: A Population-Based Study.

Author

Marti-Fabregas, Joan, Ramos-Pachón, Anna, Prats-Sanchez, Luis, Núñez-Guillén, Ana, Rodríguez, Blanca Lara, Rodriguez-Luna, David, Amaro, Sergio, Silva, Yolanda, Rodriguez-Campello, Ana, Puig, Isabel, Gomez-Choco, Manuel, Vázquez-Justes, Daniel, Guanyabens, Nicolau, Cocho, Dolores, Cánovas, David, Steinhauer, Eva Giralt, Llull, Laura, Guasch-Jiménez, Marina, Martinez-Domeño, Alejandro, and Marin, Rebeca

Published
2024
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9. The influence of epigenetic biological age on key complications and outcomes in aneurysmal subarachnoid haemorrhage.

Author

Macias-Gómez, Adrià, Jiménez-Balado, Joan, Fernández-Pérez, Isabel, Suárez-Pérez, Antoni, Vallverdú-Prats, Marta, Guimaraens, Leopoldo, Vivas, Elio, Saldaña, Jesus, Giralt-Steinhauer, Eva, Guisado-Alonso, Daniel, Villalba, Gloria, Gracia, Maria-Pilar, Esteller, Manel, Rodriguez-Campello, Ana, Jiménez-Conde, Jordi, Ois, Angel, and Cuadrado-Godia, Elisa

Subjects
CEREBRAL vasospasm, SUBARACHNOID hemorrhage, EPIGENETICS, INTRACRANIAL aneurysm ruptures, DIGITAL subtraction angiography, CLINICAL trials, TRANSCRANIAL Doppler ultrasonography
Published
2024
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10. The Role of Epigenetics in Brain Aneurysm and Subarachnoid Hemorrhage: A Comprehensive Review

Author

Fernández-Pérez, Isabel, primary, Macias-Gómez, Adrià, additional, Suárez-Pérez, Antoni, additional, Vallverdú-Prats, Marta, additional, Giralt-Steinhauer, Eva, additional, Bojtos, Lidia, additional, Susin-Calle, Sílvia, additional, Rodriguez-Campello, Ana, additional, Guisado-Alonso, Daniel, additional, Jimenez-Balado, Joan, additional, Jiménez-Conde, Jordi, additional, and Cuadrado-Godia, Elisa, additional

Published
2024
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16. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Abdelhamid, N, Abdul Rahman, D, Abdul-Saheb, M, Abreu, P, Abroskina, M, Abu Ahmad, F, Accassat, S, Acciaresi, M, Adami, A, Ahmad, N, Ahmed, F, Alberto Hawkes, M, Alemseged, F, Ali, A, Altavilla, R, Alwis, L, Amarenco, P, Amaro, S, Amaya Sanchez, LE, Amelia Pinto, A, Ameriso, SF, Amin, H, Amino, T, Amjad, AK, Anagnostou, E, Andersen, G, Anderson, C, Anderson, DC, Andrea Falco, M, Andres Mackinnon, F, Andreu, D, Androulakis, M, Angel Gamero, M, Angel Saredo, G, Angeles Diaz, R, Angels Font, M, Anticoli, S, Arauz, A, Arauz Gongora, AA, Araya, P, Arenillas Lara, JF, Arias Rivas, S, Arnold, M, Augustin, S, Avelar, W, Azevedo, E, Babikian, V, Bacellar, A, Badalyan, K, Bae, HJ, Baez Martinez, EM, Bagelmann, H, Bailey, P, Bak, Z, Baker, M, Balazs, A, Baldaranov, D, Balogun, I, Balueva, T, Bankuti, Z, Bar, M, Baranowska, A, Bardutzky, J, Barker Trejo, S, Barlinn, J, Baronnet, F, Barroso, C, Barteys, M, Bartolottiova, T, Barulin, A, Bas, M, Bashir, S, Basile, V, Bathe-Peters, R, Bathula, R, Batista, C, Batur Caglayan, H, Baumgartner, P, Bazan, R, Bazhenova, O, Beaudry, M, Beer, J, Behnam, Y, Beilei, C, Beinlich, A, Bejot, Y, Belkin, A, Benavente, OR, Benjamin, A, Berardi, V, Bereczki, D, Berkowitz, SD, Berlingieri, J, Berrios, W, Berrouschot, J, Bhandari, M, Bhargavah, M, Bicker, H, Bicsak, T, Bilik, M, Bindila, D, Birchenall, J, Birnbaum, L, Black, T, Blacker, D, Blacquiere, D, Blanc-Labarre, C, Blank, C, Blazejewska-Hyzorek, B, Bloch, S, Bodiguel, E, Bogdanov, E, Boos, L, Borcsik, L, Bornstein, N, Bouly, S, Braga, G, Bragado, I, Bravi, MC, Brokalaki, C, Brola, W, Brouns, R, Bruce, D, Brzoska-Mizgalska, J, Buck, B, Buksinska-Lisik, M, Burke, J, Burn, M, Bustamante, G, Cabrejo, L, Cai, K, Cajaraville, S, Calejo, M, Calvet, D, Campillo, J, Campos Costa, E, Camps, P, Can Alaydin, H, Candeloro, E, Canepa, C, Cantu Brito, CG, Cappellari, M, Carcel, C, Cardona Portela, P, Cardoso, F, Carek, M, Carletti, M, Carlos Portilla, J, Caruso, P, Casado-Naranjo, I, Castellini, P, Castro, D, Castro Meira, F, Cavallini, A, Cayuela Caudevilla, N, Cenciarelli, S, Cereda, C, Cerrone, P, Chakrabarti, A, Chaloulos-Iakovidis, P, Chamorro, A, Chandrasena, D, Chang, DI, Che, C, Chembala, J, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, G, Chen, L, Chen, S, Cheripelli, B, Chin, M, Chiquete Anaya, E, Chorazy, M, Christensen, H, Christensen, T, Christian, L, Chu, F, Chung, CS, Clark, W, Clarke, R, Claverie, S, Clemente Agostoni, E, Clissold, B, Coelho, J, Cohen, D, Colakoglu, S, Collas, D, Condurso, R, Connolly, SJ, Consoli, D, Constantin, C, Constantino Silva, AB, Contardo, L, Corlobe, A, Correia, M, Correia, C, Cortijo Garcia, E, Coull, B, Coutts, S, Coveney, S, Cras, P, Crols, R, Crozier, S, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Cui, L, Cunha, L, Curtze, S, Czerska, M, Czlonkowska, A, Czurko, M, Czuryszkiewicz, M, Dagnino, M, Dai, C, Daineko, A, Dalek, G, Damgaard, D, Danese, A, Dani, K, Danku, V, Dario Toledo, W, Dávalos, A, De Havenon, A, De Keyser, J, De Klippel, N, De La Torre, J, De Pauw, A, De Smedt, A, De Torres, R, De Vries Basson, MM, Dearborn, J, Deganutto, R, Degeorgia, M, Deguchi, I, Del Giudice, A, Delcourt, C, Delgado-Mederos, R, Della Marca, G, Delpont, B, Deltour, S, Demets, DL, Dennis, M, Desai, J, Devine, J, Dhollander, I, Di Mascio, MT, Diaconu, M, Diaz Otero, F, Dietzel, J, Diez-Tejedor, E, Ding, N, Ding, J, Diomedi, M, Dioszeghy, P, Distefano, M, Domigo, V, Dorodnicov, E, Dossi, D, Doubal, F, Druzenko, I, Du, P, Du, J, Duman, T, Duodu, Y, Dutta, D, Dylewicz, L, Eckstein, J, Ehrensperger, E, Ehrlich, S, Einer Allende, G, Elena Halac, B, Elyas, S, Endres, M, Engelbrecht, JM, Engelter, S, Epinat, M, Eren, F, Esbjornsson, M, Escribano, B, Escudero, I, Esisi, B, Essa, B, Esterbauer, M, Evans, N, Eveson, D, Fabio, S, Fang, L, Fanta, S, Fares, M, Fatar, M, Faust, K, Favate, A, Fazekas, F, Federica Denaro, M, Fedin, A, Felipe Amaya, P, Feng, J, Ferencova, K, Fernanda Gilli, M, Fernandez, MD, Fernandez Pirrone, PN, Fernandez Vera, J, Ferrari, J, Ferreira, A, Ferreira Junior, G, Fidler, M, Field, D, Field, T, Figueroa, C, Fiksa, J, Filipov, A, Firstenfeld, A, Fisch, L, Fischer, U, Fisselier, M, Fiszer, U, Fluri, F, Fortea, G, Fotherby, K, Fraczek, A, France, E, Freitas, G, Frey, S, Frick, M, Friedman, A, Friedrich, M, Frisullo, G, Fryze, W, Fuentes Gimeno, B, Fujigasaki, H, Fukuyama, K, Furlan, A, Furlanis, G, Furnace, J, Gabriel, M, Gabriel Reich, E, Gagliardi, RJ, Galati, F, Galli Giqueauk, E, Gallina, A, Gallinella, E, Gallo, J, Gangadharan, S, Gao, Y, Garcia Lopez, R, Garcia Pastor, A, Garcia Sanchez, SM, Garnauf, M, Garnier, P, Gasecki, D, Gasic, K, Gasiorek, K, Gasser, S, Gaugg, M, Gebreyohanns, M, Gebura, K, Geng, J, Geniz Clavijo, M, Georg Haeusler, K, Geran, R, Geremek, M, Gerocs, Z, Ghia, D, Giannandrea, D, Giatsidis, F, Gien Lopez, JA, Gil Nunez, A, Gimenez, L, Giralt, E, Glabinski, A, Gladstone, D, Gliem, M, Gluszkiewicz, M, Goddeau, R, Gogoleva, E, Gokce, M, Goldemund, D, Golikov, K, Gomes Neto, A, Gomez Schneider, M, Gomez-Choco, M, Gomis, M, Gongora-Rivera, JF, Gonysheva, Y, Gonzalez, L, Gonzalez Toledo, ME, Gottschal, M, Gozdzik, I, Grabowski, S, Graf, S, Green, D, Greer, D, Gregorio, T, Greisenegger, S, Greshnova, I, Griebe, M, Grzesik, M, Guan, J, Guarda, S, Gueguen, A, Guidoux, C, Guillermo Povedano, P, Guillon, B, Guiraudg, V, Gunathilagan, G, Guryanova, N, Gusev, V, Gustavo Persi, G, Gutiérrez, R, Guyler, P, Gyuker, N, Hachinski, V, Hajas, A, Hallevi, H, Hankey, G, Hankey, GJ, Hanouskova, L, Hao, L, Haraguchi, K, Haralur Sreekantaiah, Y, Haratz, S, Hargroves, D, Harkness, K, Harmel, P, Harrasser, M, Hart, RG, Harvey, M, Hasan, R, Hasegawa, Y, Hassan, A, Hattori, M, Hatzitolios, A, Hauk, M, Hayashi, T, Hayhoe, H, Hedna, VS, Heine, M, Held, V, Hellwig, S, Henkner, J, Henninger, N, Hermans, S, Hernandez, J, Herrero, D, Hervieu-Begue, M, Herzig, R, Hicken, L, Hieber, M, Hill, M, Hirose, M, Hobeanu, MC, Hobson, B, Hochstetter, M, Hoe Heo, J, Hoffmann, M, Holmstedt, C, Hon, P, Hong, KS, Honma, Y, Horev, A, Horgan, G, Horvath, L, Horvath, M, Hoyer, C, Huang, D, Huang, H, Huber, B, Huhtakangas, J, Hussain, M, Igarashi, S, Iglesias Mohedano, AM, Ignacio Tembl, J, Impellizzeri, M, Inanc, Y, Ioli, P, Irina Aniculaesei, A, Ishida, K, Itabashi, R, Iversen, H, Jagolino, A, Jakab, K, Jander, S, Janka, H, Jankovych, J, Jansen, J, Jasek, L, Javier Alet, M, Javor, L, Jin, X, Jing, P, Joachim, B, Joan Macleod, M, Johnson, M, Jose Martin, J, Joyner, C, Judit Szabo, K, Jun-Oconnell, A, Jura, R, Kaczorowska, B, Kadlcikova, J, Kahles, T, Kakaletsis, N, Kakuk, I, Kalinowska, K, Kaminska, K, Kaneko, C, Kanellos, I, Kapeller, P, Kapica-Topczewska, K, Karasz, O, Karlinski, M, Karlsson, JE, Kasa, K, Kashaeva, E, Kasner, SE, Kaste, M, Kasza, J, Katalin Iljicsov, A, Katsurayama, M, Kaur, S, Kawanishi, M, Kaygorodtseva, S, Ke, K, Kei, A, Keilitz, J, Kellner, J, Kelly, P, Kelly, S, Kemlink, D, Kerekgyarto, M, Keskinarkaus, I, Khairutdinova, D, Khanna, A, Khaw, A, Kholopov, M, Khoumri, C, Kirpicheva, S, Kirshner, H, Kitagawa, K, Kittner, S, Kivioja, R, Klein, F, Kleindorfer, D, Kleinig, T, Klivenyi, P, Knecht, S, Kobayashi, Y, Kobayashi, A, Koch, M, Koehler, L, Koivu, M, Kolianov, V, Koltsov, I, Kondo, T, Konkov, I, Kopecky, S, Korompoki, E, Korpela, J, Kosarz-Lanczek, K, Koutroubi, A, Kovacs, K, Kovacs, T, Kovacs, H, Kowalczyk, K, Kowalska, M, Krajickova, D, Kral, M, Krarup Hansen, C, Kraska, J, Krebs, S, Krejci, V, Kremer, C, Kreuzpointer, R, Krzyzanowska, M, Kucken, D, Kulakowska, A, Kunzmann, J, Kurenkova, N, Kuris, A, Kurkowska-Jastrzebska, I, Kurtenkova, N, Kurushina, O, Kusnick, G, Kustova, M, Kuwashiro, T, Kwan Cha, J, Lago, A, Lagutenko, M, Lajos, B, Lambeck, J, Lamy, C, Landolfi, A, Lanfranconi, S, Lang, W, Lara Lezama, LB, Lara Rodriguez, B, Largo, T, Lasek-Bal, A, Latte, L, Lauer, V, Lavados, P, Le Bouc, R, Leal Cantu, R, Lechner, H, Lecouturier, K, Leder, S, Lee, J, Lee, BC, Leger, A, Leira, E, Leisse, I, Leker, R, Lembo, G, Lenskaya, L, Leyden, J, Li, G, Li, M, Li, S, Li, J, Liamis, G, Liang, H, Liang, Z, Ligot, N, Lin, H, Lindert, R, Lindgren, A, Linna, M, Litwin, T, Liu, K, Liu, X, Llull, L, Lohninger, B, Longoni, M, Loomis, C, Lopes, D, Lopez Fernandez, M, Lopez Garza, N, Lord, A, Louw, S, Lovasz, R, Lowenkopf, T, Lu, Z, Lubke-Detring, SC, Luder, R, Lujan, S, Luo, B, Lupinogina, L, Luschin, G, Lutsep, H, Lvova, A, Ly, J, Grosse, G.M., Ma, H, Ma, C, Machado, M, Machado, C, Macher, S, Machetanz, J, Macian-Montoro, F, Mackey, E, Mackey, A, Maclean, G, Maestre-Moreno, J, Magadan, A, Magyar, T, Mahagney, A, Majid, A, Majjhoo, A, Makaritsis, K, Mandzia, J, Mangas Guijarro, M, Mangion, D, Manios, E, Mann, S, Manning, L, Manno, C, Manuel Garcia, J, Maqueda, V, Mar Castellanos, M, Mar Freijo, M, Marando, C, Marcela Lepera, S, Marcos Couto, J, Maria Bruera, G, Maria Greco, L, Maria Lorenzo, A, Maria Obmann, S, Maria Roa, A, Marini, C, Marinkovic, I, Mario Sumay, G, Mario Torres, C, Marko, M, Markova, S, Markus, H, Marsh, R, Marsili, E, Marta Esnaola, M, Marta Moreno, J, Marti-Fabregas, J, Martina Angelocola, S, Martínez Sánchez, P, Martinez-Majander, N, Martins, S, Marzelik, O, Mastrocola, S, Matamala, G, Matoltsy, A, Matosevic, B, Matsumoto, S, Maud, A, Mauri Cabdevila, G, May, Z, Mayasi, Y, Mayr, A, Mazzoli, T, Mcarthur, K, Mccullough, L, Medina Pech, CE, Medlin, F, Mehdiratta, M, Mehta, S, Mehta, D, Mehta, B, Melis, M, Melnikova, E, Mendez, B, Mendonca, T, Mengual Chirifie, JJ, Menon, N, Mensch, A, Meseguer, E, Messe, S, Metcalf, K, Meyer, N, Michas, F, Micheletti, N, Mikulik, R, Milionis, H, Miller, B, Milling, T, Minelli, C, Minhas, J, Minns, M, Mircea, D, Mishra, S, Mismas, A, Mistri, A, Mitrovic, N, Miyake, H, Modrau, B, Moey, A, Molina, C, Molina, J, Molis, A, Moller, J, Molnar, S, Moniche, F, Monosi, C, Monzani, V, Moonis, M, Morais, R, Morales, L, Morales, A, Morar-Precup, D, Moreton, F, Moro, C, Morozova, E, Morton, M, Morvan, T, Morvan, E, Motko, T, Mowla, A, Mozhejko, E, Muddegowda, G, Mudhar, O, Mueller, T, Muhl, C, Muir, KW, Mundl, H, Munoz, S, Murphy, C, Murphy, S, Murtuzova, A, Musuka, T, Mutzenbach, J, Myint, M, Mysliwy, W, Naccarato, M, Naeije, G, Nagakane, Y, Natarajan, I, Navaratnam, D, Nave, A, Nazliel, B, Nedeltchev, K, Nel, J, Nell, H, Nemeth, R, Nemeth, L, Neto, O, Ng, K, Ngeh, J, Nicolas Chialvo, L, Nieminen, T, Nikkanen, M, Nikl, J, Nikoforova, M, Nishino, S, Nishiyama, Y, Njovane, X, Nogawa, S, Nombela, F, Norrving, B, Nosek, K, Nowak, B, Nowakowska-Sledz, E, Ntaios, G, Numminen, H, Nunez, F, Obadia, M, Oberndorfer, S, Obrezan, A, Ochiai, J, Oczkowski, W, O'Donnell, MJ, Odyniec, A, Oh, K, Ohira, M, Okamoto, Y, Okpala, M, Okubo, S, Olah, L, Olavarria, V, Oleszek, J, Onat Demirci, N, Ondar, V, Ongun, G, Ooyama, K, Orosz, V, Ortiz, R, Osseby, G, Österlund-Tauriala, E, Ovesen, C, Ozcekic Demirhan, S, Ozdoba-Rot, J, Ozturk, S, Ozyurt, E, Pablo Grecco, M, Pablo Povedano, G, Paciaroni, M, Padiglioni, C, Pagola, J, Palasik, W, Panczel, G, Panos, L, Papadopoulos, G, Papadopoulou, E, Papagiannis, A, Papavasileiou, V, Papina, M, Pardo De Donlebun, JR, Parisi, V, Park, JM, Pasten, J, Patel, N, Pavlik, O, Pawelczyk, M, Peacock, WF, Pei, H, Peisker, T, Pena Sedna, LF, Penn, A, Pentek, S, Pepper, E, Pereira, L, Perera, K, Perez, Y, Perez, S, Perez Leguizamon, P, Pernicka, M, Perry, R, Persico, A, Pesant, Y, Peska, S, Peters, D, Peters, G, Pettigrew, L, Phan, T, Philippi, S, Phinney, T, Pico, F, Pidal, A, Piechowski-Jozwiak, B, Pieroni, A, Pineiro, S, Piras, V, Pizova, N, Polanco, J, Polin, M, Polyakov, A, Polychronopoulou, E, Polymeris, A, Popov, D, Poppe, A, Postorino, P, Pozzerese, C, Pradhan, M, Prats, L, Prazdnichkova, E, Prendl, B, Pretorius, M, Profice, P, Prokopenko, S, Pudov, E, Pujol Lereis, V, Punzo Bravo, G, Purroy, F, Qiu, J, Qu, X, Quenardelle, V, Quesada Garcia, H, Radrizzani, L, Radtke, A, Raffelsberger, T, Ramirez Moreno, JM, Ramos-Estebanez, C, Rani, A, Rapantova, P, Rashed, K, Rasheed Nihara, A, Rasmussen, J, Redondo Robles, L, Reif, M, Reiner, P, Rekova, P, Renu, A, Repetto, M, Reyes, P, Reyes Morales, S, Rha, JH, Ribeiro, J, Ricci, S, Richard, C, Rigual, R, Rinaldi, C, Riveira Rodriguez, C, Rizzato, B, Robinson, TG, Rocco, A, Rodrigues, M, Rodriguez, G, Rodriguez Campello, A, Rodriguez Lucci, F, Rodriguez Yanez, M, Roesler, C, Roffe, C, Roine, R, Roine, S, Roldan, A, Romana Pezzella, F, Romano, M, Roos, JS, Rosso, C, Rostrup Kruuse, C, Roth, Y, Roukens, R, Roveri, L, Rozanski, D, Rozniecki, J, Rozsa, C, Rudilosso, S, Ruiz Ares, G, Ruiz Franco, A, Rum, G, Ruuskanen, J, Rybinnik, I, Ryota, K, Saarinen, J, Saavedra, V, Sabben, C, Sabet, A, Sagris, D, Sahlas, J, Sakai, N, Salamanca, P, Salgado, P, Salig, S, Salletmayr, T, Salnikov, M, Samoshkina, O, Samson, Y, Sanak, D, Sànchez Cerón, M, Santalucia, P, Santamaria Cadavid, M, Santiago, P, Santo, G, Sanz Cuesta, B, Sargento, J, Sarraj, A, Sas, K, Sas, A, Satoshi, O, Satsoglou, S, Sattar, N, Savitz, S, Savopoulos, C, Saw, J, Sawicka, M, Sawyer, R, Scandura, T, Schillinger, N, Schindler, J, Schlachetzki, F, Schneider, I, Schuppner, R, Schurig, J, Schwarzbach, CJ, Sebejova, M, Seidel, G, Sekaran, L, Selcuk, D, Selvarajah, J, Semerano, A, Semjen, J, Semushina, D, Sen, S, Seok Park, M, Serena, J, Serhat Tokgoz, O, Serles, W, Serrano, F, Sevin, M, Seynaeve, L, Shah, S, Shamalov, N, Shang, T, Sharma, M, Sharrief, A, Shazam Hussain, M, Shchukin, I, Shen, W, Shepeleva, E, Shinsuke, I, Shmonin, A, Shoamanesh, A, Shuaib, A, Shulga, A, Sibolt, G, Sibon, I, Sicilia, I, Siebert, M, Sieczkowska, E, Sila, C, Silva, AA, Silva, D, Silva, P, Silva, Y, Silvestrini, M, Simony, Z, Simpkins, A, Singh, B, Sinha, D, Sipos, I, Skoda, O, Skowron, P, Skowronska, M, Sliwinska, B, Slonkova, J, Smolkin, A, Smyth, A, Sobolewski, P, Sobota, A, Sohn, SI, Soldatov, M, Solganov, I, Soloveva, L, Solovyeva, E, Sonntag, N, Soors, P, Sorgun, M, Soriano, C, Spence, D, Spengos, K, Sposato, L, Staaf, G, Stadler, K, Stakhovskaya, L, Stamatelopoulos, K, Steinert, S, Stetkarova, I, Stiehm, M, Stocker, R, Stoinski, J, Stoll, A, Stotts, G, Stumpp, A, Sucapane, P, Suenaga, T, Sun, X, Sundararajan, S, Sung Kim, J, Suzuki, H, Svaneborg, N, Szasz, G, Szczuchniak, W, Szczyrba, S, Szegedi, N, Szekely, A, Szewczyk, Z, Szilagyi, G, Szlufik, S, Szoboszlai, K, Szpisjak, L, Sztajzel, R, Sztriha, L, Ta Wil, SE, Taggeselle, J, Takamatsu, K, Takao, M, Taki, W, Takizawa, S, Talahma, M, Tamayo, A, Tan, J, Tanne, D, Tapanainen, A, Tapiola, T, Tarasiuk, J, Tatlisumak, T, Tayal, A, Tcvetkova, S, Teal, P, Tejada Garcia, J, Tejada Meza, H, Tenora, D, Terceno, M, Terentiou, A, Tezcan, S, Thaler, D, Thomson, A, Thouvenot, E, Tiainen, M, Timberg, I, Timsit, S, Tinchon, A, Tirschwell, D, Togay Isikay, C, Tokunaga, K, Tolino, M, Toloza, C, Tomelleri, G, Tomoyuki, K, Tomppo, LM, Tong, Z, Tong, L, Toni, D, Torres, J, Tossavainen, C, Toth, G, Tountopoulou, A, Touze, E, Tovar, M, Toyoda, K, Trillo, S, Trommer, A, Tropepi, D, Tryambake, D, Tu, H, Tuetuencue, S, Tumova, R, Tumpula, O, Turc, G, Tutaj, A, Tynkkynen, J, Uchiyama, S, Uchwat, U, Uhrinyakova, L, Ulku Acar, R, Uluduz Ugurlu, D, Urra, X, Urui, S, Usero Ruiz, M, Vaclavik, D, Vahedi, K, Valikovics, A, Valpas, J, Van Acker, P, Van Daele, W, Vanderschueren, G, Vanina Jure, L, Varela, R, Varga, Z, Varvat, J, Varvyanskaya, N, Vasco Salgado, A, Vasko, P, Vass, L, Vassilopoulou, S, Vastagh, I, Vazquez, P, Vecsei, L, Veltkamp, R, Venti, M, Verdugo, M, Verocai, V, Veronica Marroquin, M, Veronica Simonsini, C, Veverka, T, Vigl, M, Vila, A, Vilar, C, Villanueva Osorio, JA, Virta, J, Vitkova, E, Voglsperger, B, Volna, J, Von Weitzel-Mudersbach, PA, Vora, N, Voznyuk, I, Wach-Klink, A, Wacongne, A, Walters, D, Wang, Y, Wang, J, Wang, L, Wang, X, Wang, W, Wang, N, Wang, D, Wang, H, Warnack, W, Wartenberg, K, Waters, R, Waters, M, Webb, T, Weber, J, Weiss, G, Weissenborn, K, Weitz, JI, Weller, B, Wen, G, Weng, G, Werner, P, Werring, D, Wester, P, Whiteley, W, Whiting, R, Wijeratne, T, Willems, C, Wilson, L, Wilson, C, Winder, T, Windt, J, Winkler, A, Winska-Tereszkiewicz, A, Wisniewska, A, Wittayer, M, Wlodek, A, Wojnarowska-Arendt, A, Wolf, M, Wolff, V, Wolter, C, Wong, A, Wook Nah, H, Worthmann, H, Wu, W, Wu, S, Wunderlich, S, Wurzinger, H, Wyse, DG, Xiao, B, Xiaopeng, W, Ximenez-Carrillo, A, Xiong, L, Xiong, Y, Xiong, W, Xu, Y, Xu, J, Xu, Z, Yalo, B, Yamada, T, Yamasaki, M, Yang, L, Yang, Y, Yang, X, Yang, Q, Yang, B, Yang, J, Yasuhiro, I, Yee Lam, M, Yegappan, C, Yip, S, Ylikallio, E, Ylikotila, P, Yongwon Jin, A, Yoon, BW, Yoshida, Y, Yperzeele, L, Yuan, H, Yuasa, H, Zalewska, J, Zanferrari, C, Zapata, E, Zboznovits, D, Zelenka, I, Zhang, C, Zhang, B, Zhang, S, Zhang, M, Zhang, X, Zhang, J, Zhao, L, Zhirnova, O, Zhou, L, Zielinska-Turek, J, Zinchenko, I, Ziomek, M, Zitzmann, A, Zweifler, R, Zwiernik, J, Kasner, Scott E, Swaminathan, Balakumar, Lavados, Pablo, Sharma, Mukul, Muir, Keith, Veltkamp, Roland, Ameriso, Sebastian F, Endres, Matthias, Lutsep, Helmi, Messé, Steven R, Spence, J David, Nedeltechev, Krassen, Perera, Kanjana, Santo, Gustavo, Olavarria, Veronica, Lindgren, Arne, Bangdiwala, Shrikant, Shoamanesh, Ashkan, Berkowitz, Scott D, Mundl, Hardi, Connolly, Stuart J, and Hart, Robert G

Published
2018
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19. Prolonged Cardiac Monitoring and Stroke Recurrence

Author

Georgios Tsivgoulis, Sokratis Triantafyllou, Lina Palaiodimou, Brian Mac Grory, Spyridon Deftereos, Martin Köhrmann, Polychronis Dilaveris, Brittany Ricci, Konstantinos Tsioufis, Shawna Cutting, Gkikas Magiorkinis, Christos Krogias, Peter D. Schellinger, Efthymios Dardiotis, Ana Rodriguez-Campello, Elisa Cuadrado-Godia, Diana Aguiar de Sousa, Mukul Sharma, David J. Gladstone, Tommaso Sanna, Rolf Wachter, Karen L. Furie, Andrei V. Alexandrov, Shadi Yaghi, and Aristeidis H. Katsanos

Subjects
Medizin, Neurology (clinical)
Abstract

Background and ObjectivesProlonged poststroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of patients with ischemic stroke (IS) with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We evaluated the association between PCM and the institution of stroke preventive strategies and stroke recurrence.MethodsWe searched MEDLINE and SCOPUS databases to identify studies reporting stroke recurrence rates in patients with history of recent IS or TIA receiving PCM compared with patients receiving conventional cardiac rhythm monitoring. Pairwise meta-analyses were performed under the random effects model. To explore for differences between the monitoring strategies, we combined direct and indirect evidence for any given pair of monitoring devices assessed within a randomized controlled trial (RCT).ResultsWe included 8 studies (5 RCTs, 3 observational; 2,994 patients). Patients receiving PCM after their index event had a higher rate of AF detection and anticoagulant initiation in RCTs (risk ratio [RR] 3.91, 95% CI 2.54–6.03; RR 2.16, 95% CI 1.66–2.80, respectively) and observational studies (RR 2.06, 95% CI 1.57–2.70; RR 2.01, 95% CI 1.43–2.83, respectively). PCM was associated with a lower risk of recurrent stroke during follow-up in observational studies (RR 0.29, 95% CI 0.15–0.59), but not in RCTs (RR 0.72, 95% CI 0.49–1.07). In indirect analyses of RCTs, the likelihood of AF detection and anticoagulation initiation was higher for implantable loop recorders compared with Holter monitors and external loop recorders.DiscussionPCM after an IS or TIA can lead to higher rates of AF detection and anticoagulant initiation. There is no solid RCT evidence supporting that PCM may be associated with lower stroke recurrence risk.

Published
2022
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20. Lipidomic signature of stroke recurrence after transient ischemic attack

Author

Francisco Purroy, A Ois, M. Jove, G Arque, J Sol, G Mauri-Capdevila, A. Rodriguez Campello, R Pamplona, M Portero, and J Roquer

Abstract

Objective To find new biomarkers of early stroke recurrence (SR) by using lipidomic strategies on patients who suffered a transient ischemic attack. Methods Untargeted lipidomic analysis was performed in plasma samples of 460 consecutive TIA patients. Recruited

Published
2023
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27. Abstract WP179: Impact Of Different Cardiac Rhythm Monitoring Strategies On Secondary Stroke Prevention: A Systematic Review And Network Meta-analysis Of Randomized Controlled Clinical Trials

Author

Aristeidis Katsanos, Sokratis Triantafyllou, Lina Palaiodimou, Brian Mac Grory, Spyridon Deftereos, Martin Köhrmann, Polychronis Dilaveris, Brittany A Ricci, Konstantinos Tsioufis, Shawna M Cutting, Gkikas Magiorkinis, Christos Krogias, Peter D Schellinger, Efthymios Dardiotis, Ana Rodriguez Campello, Elisa Cuadrado-Godia, Diana Aguiar de Sousa, Mukul A Sharma, David J GLADSTONE, Tommaso Sanna, Rolf Wachter, Karen L Furie, Andrei V Alexandrov, shadi yaghi, and Georgios Tsivgoulis

Subjects
Advanced and Specialized Nursing, Neurology (clinical), Cardiology and Cardiovascular Medicine
Abstract

Background and Purpose: Prolonged cardiac rhythm monitoring can reveal a substantial proportion of ischemic stroke (IS) patients with atrial fibrillation (AF). We sought to evaluate the potential utility of available prolonged cardiac rhythm monitoring strategies with respect to secondary stroke prevention. Methods: We searched Medline and Scopus databases to identify randomized controlled clinical trials (RCTs) comparing AF detection, anticoagulation initiation and stroke recurrence rates in patients with history of recent IS or transient ischemic attack (TIA) receiving cardiac rhythm monitoring with implantable loop recorders (ILRs), 30-days external loop recorders or Holter monitors. We performed a network meta-analysis to combine direct and indirect evidence for any given pair of monitoring devices that were evaluated within a trial and reported effect estimates with risk ratios (RRs) and corresponding 95% confidence intervals (95%CIs). Results: We identified 5 RCTs including a total of 2202 patients (mean age 68 years, 40% women). In indirect analyses the likelihood of AF detection and anticoagulation initiation was higher for both ILR (RR=8.48, 95%CI: 3.41, 21.06; RR=3.29, 95%CI: 1.70-6.39) and external loop recorders (RR=3.06, 95%CI: 1.66, 5.61; RR=1.63, 95%CI: 1.03-2.58) compared to Holter devices. The probability of AF detection and anticoagulation initiation was lower for Holter and external loop recorders compared to ILR devices (RR=0.36, 95%CI: 0.15, 0.85 and RR=0.50, 95%CI: 0.25-0.98, respectively). No difference in the risk of stroke recurrence was found in the indirect comparisons of different cardiac rhythm monitoring strategies. Conclusion: The likelihood of AF detection and anticoagulation initiation after an ischemic stroke or TIA is higher with ILRs compared to both external loop recorders and Holter devices.

Published
2022
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28. Prolonged Cardiac Monitoring and Stroke Recurrence: A Meta-analysis

Author

Tsivgoulis, Georgios Triantafyllou, Sokratis Palaiodimou, Lina Grory, Brian Mac Deftereos, Spyridon Köhrmann, Martin Dilaveris, Polychronis Ricci, Brittany Tsioufis, Konstantinos Cutting, Shawna Magiorkinis, Gkikas Krogias, Christos Schellinger, Peter D. Dardiotis, Efthymios Rodriguez-Campello, Ana Cuadrado-Godia, Elisa Aguiar de Sousa, Diana Sharma, Mukul Gladstone, David J. Sanna, Tommaso Wachter, Rolf Furie, Karen L. Alexandrov, Andrei V. Yaghi, Shadi Katsanos, Aristeidis H.

Abstract

OBJECTIVE: Prolonged post-stroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of ischemic stroke (IS) patients with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We aim to evaluate the association between PCM and the institution of stroke preventive strategies and stroke recurrence. METHODS: We searched MEDLINE and SCOPUS databases to identify studies reporting stroke recurrence rates in patients with history of recent IS or transient ischemic attack (TIA) receiving PCM compared with patients receiving conventional cardiac rhythm monitoring. Pairwise meta-analyses were performed under the random-effects model. To explore for differences between the monitoring strategies we combined direct and indirect evidence for any given pair of monitoring devices assessed within a randomized controlled trial (RCT). RESULTS: We included 8 studies (5 RCTs, 3 observational; 2994 patients). Patients receiving PCM after their index event had a higher rate of AF detection and anticoagulant initiation in both RCTs (RR=3.91, 95%CI:2.54-6.03 & RR=2.16, 95%CI:1.66-2.80) and observational studies (RR=2.06, 95%CI:1.57-2.70 & RR=2.01; 95%CI:1.43-2.83), respectively. PCM was associated with a lower risk of recurrent stroke during follow-up in observational studies (RR=0.29; 95%CI:0.15-0.59), but not in RCTs (RR=0.72, 95%CI:0.49-1.07). In the indirect analyses of RCTs the likelihood of AF detection and anticoagulation initiation was higher for implantable loop recorders compared with both Holter monitors and external loop recorders. CONCLUSIONS: PCM after an IS or TIA can lead to higher rates of AF detection and anticoagulant initiation. Currently, there is no solid RCT evidence supporting that PCM may be associated with lower stroke recurrence risk.

Published
2022

29. Prolonged Cardiac Monitoring and Stroke Recurrence

Author

Tsivgoulis, Georgios, primary, Triantafyllou, Sokratis, additional, Palaiodimou, Lina, additional, Grory, Brian Mac, additional, Deftereos, Spyridon, additional, Köhrmann, Martin, additional, Dilaveris, Polychronis, additional, Ricci, Brittany, additional, Tsioufis, Konstantinos, additional, Cutting, Shawna, additional, Magiorkinis, Gkikas, additional, Krogias, Christos, additional, Schellinger, Peter D., additional, Dardiotis, Efthymios, additional, Rodriguez-Campello, Ana, additional, Cuadrado-Godia, Elisa, additional, Aguiar de Sousa, Diana, additional, Sharma, Mukul, additional, Gladstone, David J., additional, Sanna, Tommaso, additional, Wachter, Rolf, additional, Furie, Karen L., additional, Alexandrov, Andrei V., additional, Yaghi, Shadi, additional, and Katsanos, Aristeidis H., additional

Published
2022
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30. Abstract WP179: Impact Of Different Cardiac Rhythm Monitoring Strategies On Secondary Stroke Prevention: A Systematic Review And Network Meta-analysis Of Randomized Controlled Clinical Trials

Author

Katsanos, Aristeidis, primary, Triantafyllou, Sokratis, additional, Palaiodimou, Lina, additional, Mac Grory, Brian, additional, Deftereos, Spyridon, additional, Köhrmann, Martin, additional, Dilaveris, Polychronis, additional, Ricci, Brittany A, additional, Tsioufis, Konstantinos, additional, Cutting, Shawna M, additional, Magiorkinis, Gkikas, additional, Krogias, Christos, additional, Schellinger, Peter D, additional, Dardiotis, Efthymios, additional, Rodriguez Campello, Ana, additional, Cuadrado-Godia, Elisa, additional, Aguiar de Sousa, Diana, additional, Sharma, Mukul A, additional, GLADSTONE, David J, additional, Sanna, Tommaso, additional, Wachter, Rolf, additional, Furie, Karen L, additional, Alexandrov, Andrei V, additional, yaghi, shadi, additional, and Tsivgoulis, Georgios, additional

Published
2022
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32. Impact of general anesthesia on posterior circulation large vessel occlusions after endovascular thrombectomy

Author

Terceno, M, Silva, Y, Bashir, S, Vera-Monge, VA, Cardona, P, Molina, C, Chamorro, A, de la Ossa, NP, Hernandez-Perez, M, Werner, M, Camps-Renom, P, Rodriguez-Campello, A, Canovas, D, Purroy, F, and Serena, J

Subjects
large vessel occlusion, posterior circulation stroke, General anesthesia
Abstract

Background The impact of general anesthesia on functional outcome in patients with large vessel occlusion remains unclear. Most studies have focused on anterior circulation large vessel occlusion; however, little is known about the effect of general anesthesia in patients with posterior circulation-large vessel occlusion. Methods We performed a retrospective analysis from the prospective CICAT registry. All patients with posterior circulation-large vessel occlusion-and undergoing endovascular therapy between January 2016 and January 2020 were included. Demographics, baseline characteristics, procedural data, and anesthesia modality (general anesthesia or conscious sedation) were evaluated. The primary outcome was the proportion of patients with good clinical outcome (modified Rankin Scale score of 0-2) at three months. Results 298 patients underwent endovascular treatment with posterior circulation-large vessel occlusion-were included. Age, diabetes mellitus, renal insufficiency, baseline National Institutes of Health Stroke Scale score, puncture to recanalization length, >= 3 device passes, absent of successful recanalization (defined as treatment in cerebral ischemia of 3), and general anesthesia were statistically associated with poor outcome (mRS: 3-6). In the multivariable regression, general anesthesia and >= 3 device passes were independently associated with poor outcome (aOR: 3.11, (95% CI: 1.34-7.2); P = 0.01 and 3.77, (95% CI: 1.29-11.01); P = 0.02, respectively). Patients treated with general anesthesia were less likely to have a good outcome at three months compared to conscious sedation (19.7% vs. 45.1%, P < 0.001). Conclusions In our study population, general anesthesia use is associated with poor clinical outcome in patients with posterior circulation-large vessel occlusion-treated endovascularly.

Published
2021

37. Identification of 20 novel loci associated with ischaemic stroke. Epigenome-wide association study

Author

Soriano-Tarraga, C, Lazcano, U, Giralt-Steinhauer, E, Avellaneda-Gomez, C, Ois, A, Rodriguez-Campello, A, Cuadrado-Godia, E, Gomez-Gonzalez, A, Fernandez-Sanles, A, Elosua, R, Fernandez-Cadenas, I, Cullell, N, Montaner, J, Moran, S, Esteller, M, and Jimenez-Conde, J

Subjects
DNA methylation, Ischaemic stroke, EWAS
Abstract

DNA methylation is dynamic, varies throughout the life course, and its levels are influenced by lifestyle and environmental factors, as well as by genetic variation. The leading genetic variants at stroke risk loci identified to date explain roughly 1-2% of stroke heritability. Most of these single nucleotide polymorphisms are situated within a regulatory sequence marked by DNase I hypersensitivity sites, which would indicate involvement of an epigenetic mechanism. To detect epigenetic variants associated with stroke occurrence and stroke subtypes. A two-stage case-control epigenome-wide association study was designed. The discovery sample with 401 samples included 218 ischaemic stroke (IS) patients, assessed at Hospital del Mar (Barcelona, Spain) and 183 controls from the REGICOR cohort. In two independent samples (N = 226 and N = 166), we replicated 22 CpG sites differentially methylated in IS in 21 loci, including 2 CpGs in locus ZFHX3, which includes known genetic variants associated with stroke. The pathways associated with these loci are inflammation and angiogenesis. The meta-analysis identified 384 differentially methylated CpGs, including loci of known stroke and vascular risk genetic variants, enriched by loci involved in lipid metabolism, adipogenesis, circadian clock, and glycolysis pathways. We identified a set of 22 CpGs in 21 loci associated with IS. Our analysis suggests that DNA methylation changes may contribute to orchestrating gene expression that contributes to IS.

Published
2020

44. Thrombolysis in Capsular Warning Syndrome

Author

Vivanco-Hidalgo, Rosa Maria, Rodriguez-Campello, Ana, Ois, Angel, Cucurella, Gràcia, Pont-Sunyer, Claustre, Gomis, Meritxell, Cuadrado-Godia, Elisa, and Roquer, Jaume

Published
2008

45. An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial

Author

Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut Tatlisumak, Igor Kuzmanovski, Benoit Guillon, Hugues Chabriat, Marie Helene Mahagne, Serge Timsit, Thomas Ronziere, Gocha Ingorokva, Maya Beridze, Mzia Beridze, Nino Kharaishvili, Nodar Kakabadze, Bernd Griewing, Carsten Hobohm, Dietmar Schneider, Christian Weimar, Holger Poppert, Hubert Kimmig, Joerg Berrouschot, Peter Ringleb, Stefan Schwab, Martin Kohrmann, Bernd Kallmunzer, Rainer Kollmar, Matthias Endres, Karl-Georg Hausler, Raymond Cheung, Thomas Wai Hong Leung, Elena Dorodnicov, Hen Halevi, Eitan Auriel, Jonathan Streifler, Ronen Leker, Yvonne Schwammenthal, Danilo Toni, Giancarlo Agnelli, Valeria Caso, Agnieszka Słowik, Anna Czlonkowska, Ignacy Lubinski, Jan Kochanowicz, Piotr Sobolewski, Waldemar Brola, Antonio Vasco Salgado, Carlos Correia, Elsa Azevedo, Jose Roriz, Marija Zarkov, Zarko Petrovic, Georgi Krastev, Miloslav Dvorak, Ana Rodriguez Campello, Antonio Gil Nunez, Carlos Molina, Francisco Purroy, Joan Marti-Fabregas, Juan Arenillas, Maria Alonso, Pedro Cardona, Miguel Blanco Gonzalez, Silvia Tur, Tomas Segura Martin, Payenok Anzhelika, Harish Shownkeen, Mauricio Concha, Pramod Sethi, Souvik Sen, Syed Zaidi, and Thomas Devlin

Subjects
Adult, Male, Population, Medizin, Stimulation, Electric Stimulation Therapy, 030204 cardiovascular system & hematology, law.invention, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Reperfusion therapy, Randomized controlled trial, Quality of life, Double-Blind Method, law, medicine, Humans, 030212 general & internal medicine, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, Ganglia, Parasympathetic, General Medicine, Odds ratio, Middle Aged, Ganglion, Stroke, medicine.anatomical_structure, Implantable Neurostimulators, Treatment Outcome, Anesthesia, Quality of Life, Female, Implant, business, Tomography, X-Ray Computed
Abstract

Sphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood-brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potential benefit in a pilot randomised trial in humans. The pivotal ImpACT-24B trial aimed to determine whether sphenopalatine ganglion stimulation 8-24 h after acute ischaemic stroke improved functional outcome.ImpACT-24B is a randomised, double-blind, sham-controlled, pivotal trial done at 73 centres in 18 countries. It included patients (men aged 40-80 years and women aged 40-85 years) with anterior-circulation acute ischaemic stroke, not undergoing reperfusion therapy. Enrolled patients were randomly assigned via web-based randomisation to receive active sphenopalatine ganglion stimulation (intervention group) or sham stimulation (sham-control group) 8-24 h after stroke onset. Patients, clinical care providers, and all outcome assessors were masked to treatment allocation. The primary efficacy endpoint was the difference between active and sham groups in the proportion of patients whose 3-month level of disability improved above expectations. This endpoint was evaluated in the modified intention-to-treat (mITT) population (defined as all patients who received one active or sham treatment session) and the population with confirmed cortical involvement (CCI) and was analysed using the Hochberg multi-step procedure (significance in both populations if p0·05 in both, and in one population if p0·025 in that one). Safety endpoints at 3 months were all serious adverse events (SAEs), SAEs related to implant placement or removal, SAEs related to stimulation, neurological deterioration, and mortality. All patients who underwent an attempted sphenopalatine ganglion stimulator or sham stimulator placement procedure were included in the safety analysis. This trial is registered with ClinicalTrials.gov, number NCT00826059.Between June 10, 2011, and March 7, 2018, 1078 patients were enrolled and randomly assigned to either the intervention or the sham-control group. 1000 patients received at least one session of sphenopalatine ganglion stimulation or sham stimulation and entered the mITT population (481 [48%] received sphenopalatine ganglion stimulation, 519 [52%] were sham controls), among whom 520 (52%) patients had CCI on imaging. The proportion of patients in the mITT population whose 3-month disability level was better than expected was 49% (234/481) in the intervention group versus 45% (236/519) in the sham-control group (odds ratio 1·14, 95% CI 0·89-1·46; p=0·31). In the CCI population, the proportion was 50% (121/244) in the intervention group versus 40% (110/276) in the sham-control group (1·48, 1·05-2·10; p=0·0258). There was an inverse U-shaped dose-response relationship between attained sphenopalatine ganglion stimulation intensity and the primary outcome in the CCI population: the proportion with favourable outcome increased from 40% to 70% at low-midrange intensity and decreased back to 40% at high intensity stimulation (p=0·0034). There were no differences in mortality or SAEs between the intervention group (n=536) and the sham-control group (n=519) in the safety population.Sphenopalatine ganglion stimulation is safe for patients with acute ischaemic stroke 8-24 h after onset, who are ineligible for thrombolytic therapy. Although not reaching significance, the trial's results support that, among patients with imaging evidence of cortical involvement at presentation, sphenopalatine ganglion stimulation is likely to improve functional outcome.BrainsGate Ltd.

Published
2019

47. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart, N Abdelhamid, D Abdul Rahman, M Abdul-Saheb, P Abreu, M Abroskina, F Abu Ahmad, S Accassat, M Acciaresi, A Adami, N Ahmad, F Ahmed, M Alberto Hawkes, F Alemseged, A Ali, R Altavilla, L Alwis, P Amarenco, S Amaro, LE Amaya Sanchez, A Amelia Pinto, SF Ameriso, H Amin, T Amino, AK Amjad, E Anagnostou, G Andersen, C Anderson, DC Anderson, M Andrea Falco, F Andres Mackinnon, D Andreu, M Androulakis, M Angel Gamero, G Angel Saredo, R Angeles Diaz, M Angels Font, S Anticoli, A Arauz, AA Arauz Gongora, P Araya, JF Arenillas Lara, S Arias Rivas, M Arnold, S Augustin, W Avelar, E Azevedo, V Babikian, A Bacellar, K Badalyan, HJ Bae, EM Baez Martinez, H Bagelmann, P Bailey, Z Bak, M Baker, A Balazs, D Baldaranov, I Balogun, T Balueva, Z Bankuti, M Bar, A Baranowska, J Bardutzky, S Barker Trejo, J Barlinn, F Baronnet, C Barroso, M Barteys, T Bartolottiova, A Barulin, M Bas, S Bashir, V Basile, R Bathe-Peters, R Bathula, C Batista, H Batur Caglayan, P Baumgartner, R Bazan, O Bazhenova, M Beaudry, J Beer, Y Behnam, C Beilei, A Beinlich, Y Bejot, A Belkin, OR Benavente, A Benjamin, V Berardi, D Bereczki, SD Berkowitz, J Berlingieri, W Berrios, J Berrouschot, M Bhandari, M Bhargavah, H Bicker, T Bicsak, M Bilik, D Bindila, J Birchenall, L Birnbaum, T Black, D Blacker, D Blacquiere, C Blanc-Labarre, C Blank, B Blazejewska-Hyzorek, S Bloch, E Bodiguel, E Bogdanov, L Boos, L Borcsik, N Bornstein, S Bouly, G Braga, I Bragado, MC Bravi, C Brokalaki, W Brola, R Brouns, D Bruce, J Brzoska-Mizgalska, B Buck, M Buksinska-Lisik, J Burke, M Burn, G Bustamante, L Cabrejo, K Cai, S Cajaraville, M Calejo, D Calvet, J Campillo, E Campos Costa, P Camps, H Can Alaydin, E Candeloro, C Canepa, CG Cantu Brito, M Cappellari, C Carcel, P Cardona Portela, F Cardoso, M Carek, M Carletti, J Carlos Portilla, P Caruso, I Casado-Naranjo, P Castellini, D Castro, F Castro Meira, A Cavallini, N Cayuela Caudevilla, S Cenciarelli, C Cereda, P Cerrone, A Chakrabarti, P Chaloulos-Iakovidis, A Chamorro, D Chandrasena, DI Chang, C Che, J Chembala, J Chen, Z Chen, T Chen, H Chen, X Chen, G Chen, L Chen, S Chen, B Cheripelli, M Chin, E Chiquete Anaya, M Chorazy, H Christensen, T Christensen, L Christian, F Chu, CS Chung, W Clark, R Clarke, S Claverie, E Clemente Agostoni, B Clissold, J Coelho, D Cohen, S Colakoglu, D Collas, R Condurso, SJ Connolly, D Consoli, C Constantin, AB Constantino Silva, L Contardo, A Corlobe, M Correia, C Correia, E Cortijo Garcia, B Coull, S Coutts, S Coveney, P Cras, R Crols, S Crozier, A Csanyi, L Csiba, K Csontos, R Csuha, L Cui, L Cunha, S Curtze, M Czerska, A Czlonkowska, M Czurko, M Czuryszkiewicz, M Dagnino, C Dai, A Daineko, G Dalek, D Damgaard, A Danese, K Dani, V Danku, W Dario Toledo, A Dávalos, A De Havenon, J De Keyser, N De Klippel, J De La Torre, A De Pauw, A De Smedt, R De Torres, MM De Vries Basson, J Dearborn, R Deganutto, M Degeorgia, I Deguchi, A Del Giudice, C Delcourt, R Delgado-Mederos, G Della Marca, B Delpont, S Deltour, DL Demets, M Dennis, J Desai, J Devine, I Dhollander, MT Di Mascio, M Diaconu, F Diaz Otero, J Dietzel, E Diez-Tejedor, N Ding, J Ding, M Diomedi, P Dioszeghy, M Distefano, V Domigo, E Dorodnicov, D Dossi, F Doubal, I Druzenko, P Du, J Du, T Duman, Y Duodu, D Dutta, L Dylewicz, J Eckstein, E Ehrensperger, S Ehrlich, G Einer Allende, B Elena Halac, S Elyas, M Endres, JM Engelbrecht, S Engelter, M Epinat, F Eren, M Esbjornsson, B Escribano, I Escudero, B Esisi, B Essa, M Esterbauer, N Evans, D Eveson, S Fabio, L Fang, S Fanta, M Fares, M Fatar, K Faust, A Favate, F Fazekas, M Federica Denaro, A Fedin, P Felipe Amaya, J Feng, K Ferencova, M Fernanda Gilli, MD Fernandez, PN Fernandez Pirrone, J Fernandez Vera, J Ferrari, A Ferreira, G Ferreira Junior, M Fidler, D Field, T Field, C Figueroa, J Fiksa, A Filipov, A Firstenfeld, L Fisch, U Fischer, M Fisselier, U Fiszer, F Fluri, G Fortea, K Fotherby, A Fraczek, E France, G Freitas, S Frey, M Frick, A Friedman, M Friedrich, G Frisullo, W Fryze, B Fuentes Gimeno, H Fujigasaki, K Fukuyama, A Furlan, G Furlanis, J Furnace, M Gabriel, E Gabriel Reich, RJ Gagliardi, F Galati, E Galli Giqueauk, A Gallina, E Gallinella, J Gallo, S Gangadharan, Y Gao, R Garcia Lopez, A Garcia Pastor, SM Garcia Sanchez, M Garnauf, P Garnier, D Gasecki, K Gasic, K Gasiorek, S Gasser, M Gaugg, M Gebreyohanns, K Gebura, J Geng, M Geniz Clavijo, K Georg Haeusler, R Geran, M Geremek, Z Gerocs, D Ghia, D Giannandrea, F Giatsidis, JA Gien Lopez, A Gil Nunez, L Gimenez, E Giralt, A Glabinski, D Gladstone, M Gliem, M Gluszkiewicz, R Goddeau, E Gogoleva, M Gokce, D Goldemund, K Golikov, A Gomes Neto, M Gomez Schneider, M Gomez-Choco, M Gomis, JF Gongora-Rivera, Y Gonysheva, L Gonzalez, ME Gonzalez Toledo, M Gottschal, I Gozdzik, S Grabowski, S Graf, D Green, D Greer, T Gregorio, S Greisenegger, I Greshnova, M Griebe, M Grzesik, J Guan, S Guarda, A Gueguen, C Guidoux, P Guillermo Povedano, B Guillon, V Guiraudg, G Gunathilagan, N Guryanova, V Gusev, G Gustavo Persi, R Gutiérrez, P Guyler, N Gyuker, V Hachinski, A Hajas, H Hallevi, G Hankey, GJ Hankey, L Hanouskova, L Hao, K Haraguchi, Y Haralur Sreekantaiah, S Haratz, D Hargroves, K Harkness, P Harmel, M Harrasser, RG Hart, M Harvey, R Hasan, Y Hasegawa, A Hassan, M Hattori, A Hatzitolios, M Hauk, T Hayashi, H Hayhoe, VS Hedna, M Heine, V Held, S Hellwig, J Henkner, N Henninger, S Hermans, J Hernandez, D Herrero, M Hervieu-Begue, R Herzig, L Hicken, M Hieber, M Hill, M Hirose, MC Hobeanu, B Hobson, M Hochstetter, J Hoe Heo, M Hoffmann, C Holmstedt, P Hon, KS Hong, Y Honma, A Horev, G Horgan, L Horvath, M Horvath, C Hoyer, D Huang, H Huang, B Huber, J Huhtakangas, M Hussain, S Igarashi, AM Iglesias Mohedano, J Ignacio Tembl, M Impellizzeri, Y Inanc, P Ioli, A Irina Aniculaesei, K Ishida, R Itabashi, H Iversen, A Jagolino, K Jakab, S Jander, H Janka, J Jankovych, J Jansen, L Jasek, M Javier Alet, L Javor, X Jin, P Jing, B Joachim, M Joan Macleod, M Johnson, J Jose Martin, C Joyner, K Judit Szabo, A Jun-Oconnell, R Jura, B Kaczorowska, J Kadlcikova, T Kahles, N Kakaletsis, I Kakuk, K Kalinowska, K Kaminska, C Kaneko, I Kanellos, P Kapeller, K Kapica-Topczewska, O Karasz, M Karlinski, JE Karlsson, K Kasa, E Kashaeva, SE Kasner, M Kaste, J Kasza, A Katalin Iljicsov, M Katsurayama, S Kaur, M Kawanishi, S Kaygorodtseva, K Ke, A Kei, J Keilitz, J Kellner, P Kelly, S Kelly, D Kemlink, M Kerekgyarto, I Keskinarkaus, D Khairutdinova, A Khanna, A Khaw, M Kholopov, C Khoumri, S Kirpicheva, H Kirshner, K Kitagawa, S Kittner, R Kivioja, F Klein, D Kleindorfer, T Kleinig, P Klivenyi, S Knecht, Y Kobayashi, A Kobayashi, M Koch, L Koehler, M Koivu, V Kolianov, I Koltsov, T Kondo, I Konkov, S Kopecky, E Korompoki, J Korpela, K Kosarz-Lanczek, A Koutroubi, K Kovacs, T Kovacs, H Kovacs, K Kowalczyk, M Kowalska, D Krajickova, M Kral, C Krarup Hansen, J Kraska, S Krebs, V Krejci, C Kremer, R Kreuzpointer, M Krzyzanowska, D Kucken, A Kulakowska, J Kunzmann, N Kurenkova, A Kuris, I Kurkowska-Jastrzebska, N Kurtenkova, O Kurushina, G Kusnick, M Kustova, T Kuwashiro, J Kwan Cha, A Lago, M Lagutenko, B Lajos, J Lambeck, C Lamy, A Landolfi, S Lanfranconi, W Lang, LB Lara Lezama, B Lara Rodriguez, T Largo, A Lasek-Bal, L Latte, V Lauer, P Lavados, R Le Bouc, R Leal Cantu, H Lechner, K Lecouturier, S Leder, J Lee, BC Lee, A Leger, E Leira, I Leisse, R Leker, G Lembo, L Lenskaya, J Leyden, G Li, M Li, S Li, J Li, G Liamis, H Liang, Z Liang, N Ligot, H Lin, R Lindert, A Lindgren, M Linna, T Litwin, K Liu, X Liu, L Llull, B Lohninger, M Longoni, C Loomis, D Lopes, M Lopez Fernandez, N Lopez Garza, A Lord, S Louw, R Lovasz, T Lowenkopf, Z Lu, SC Lubke-Detring, R Luder, S Lujan, B Luo, L Lupinogina, G Luschin, H Lutsep, A Lvova, J Ly, G.M. Grosse, H Ma, C Ma, M Machado, C Machado, S Macher, J Machetanz, F Macian-Montoro, E Mackey, A Mackey, G Maclean, J Maestre-Moreno, A Magadan, T Magyar, A Mahagney, A Majid, A Majjhoo, K Makaritsis, J Mandzia, M Mangas Guijarro, D Mangion, E Manios, S Mann, L Manning, C Manno, J Manuel Garcia, V Maqueda, M Mar Castellanos, M Mar Freijo, C Marando, S Marcela Lepera, J Marcos Couto, G Maria Bruera, L Maria Greco, A Maria Lorenzo, S Maria Obmann, A Maria Roa, C Marini, I Marinkovic, G Mario Sumay, C Mario Torres, M Marko, S Markova, H Markus, R Marsh, E Marsili, M Marta Esnaola, J Marta Moreno, J Marti-Fabregas, S Martina Angelocola, P Martínez Sánchez, N Martinez-Majander, S Martins, O Marzelik, S Mastrocola, G Matamala, A Matoltsy, B Matosevic, S Matsumoto, A Maud, G Mauri Cabdevila, Z May, Y Mayasi, A Mayr, T Mazzoli, K Mcarthur, L Mccullough, CE Medina Pech, F Medlin, M Mehdiratta, S Mehta, D Mehta, B Mehta, M Melis, E Melnikova, B Mendez, T Mendonca, JJ Mengual Chirifie, N Menon, A Mensch, E Meseguer, S Messe, K Metcalf, N Meyer, F Michas, N Micheletti, R Mikulik, H Milionis, B Miller, T Milling, C Minelli, J Minhas, M Minns, D Mircea, S Mishra, A Mismas, A Mistri, N Mitrovic, H Miyake, B Modrau, A Moey, C Molina, J Molina, A Molis, J Moller, S Molnar, F Moniche, C Monosi, V Monzani, M Moonis, R Morais, L Morales, A Morales, D Morar-Precup, F Moreton, C Moro, E Morozova, M Morton, T Morvan, E Morvan, T Motko, A Mowla, E Mozhejko, G Muddegowda, O Mudhar, T Mueller, C Muhl, KW Muir, H Mundl, S Munoz, C Murphy, S Murphy, A Murtuzova, T Musuka, J Mutzenbach, M Myint, W Mysliwy, M Naccarato, G Naeije, Y Nagakane, I Natarajan, D Navaratnam, A Nave, B Nazliel, K Nedeltchev, J Nel, H Nell, R Nemeth, L Nemeth, O Neto, K Ng, J Ngeh, L Nicolas Chialvo, T Nieminen, M Nikkanen, J Nikl, M Nikoforova, S Nishino, Y Nishiyama, X Njovane, S Nogawa, F Nombela, B Norrving, K Nosek, B Nowak, E Nowakowska-Sledz, G Ntaios, H Numminen, F Nunez, M Obadia, S Oberndorfer, A Obrezan, J Ochiai, W Oczkowski, MJ O'Donnell, A Odyniec, K Oh, M Ohira, Y Okamoto, M Okpala, S Okubo, L Olah, V Olavarria, J Oleszek, N Onat Demirci, V Ondar, G Ongun, K Ooyama, V Orosz, R Ortiz, G Osseby, E Österlund-Tauriala, C Ovesen, S Ozcekic Demirhan, J Ozdoba-Rot, S Ozturk, E Ozyurt, M Pablo Grecco, G Pablo Povedano, M Paciaroni, C Padiglioni, J Pagola, W Palasik, G Panczel, L Panos, G Papadopoulos, E Papadopoulou, A Papagiannis, V Papavasileiou, M Papina, JR Pardo De Donlebun, V Parisi, JM Park, J Pasten, N Patel, O Pavlik, M Pawelczyk, WF Peacock, H Pei, T Peisker, LF Pena Sedna, A Penn, S Pentek, E Pepper, L Pereira, K Perera, Y Perez, S Perez, P Perez Leguizamon, M Pernicka, R Perry, A Persico, Y Pesant, S Peska, D Peters, G Peters, L Pettigrew, T Phan, S Philippi, T Phinney, F Pico, A Pidal, B Piechowski-Jozwiak, A Pieroni, S Pineiro, V Piras, N Pizova, J Polanco, M Polin, A Polyakov, E Polychronopoulou, A Polymeris, D Popov, A Poppe, P Postorino, C Pozzerese, M Pradhan, L Prats, E Prazdnichkova, B Prendl, M Pretorius, P Profice, S Prokopenko, E Pudov, V Pujol Lereis, G Punzo Bravo, F Purroy, J Qiu, X Qu, V Quenardelle, H Quesada Garcia, L Radrizzani, A Radtke, T Raffelsberger, JM Ramirez Moreno, C Ramos-Estebanez, A Rani, P Rapantova, K Rashed, A Rasheed Nihara, J Rasmussen, L Redondo Robles, M Reif, P Reiner, P Rekova, A Renu, M Repetto, P Reyes, S Reyes Morales, JH Rha, J Ribeiro, S Ricci, C Richard, R Rigual, C Rinaldi, C Riveira Rodriguez, B Rizzato, TG Robinson, A Rocco, M Rodrigues, G Rodriguez, A Rodriguez Campello, F Rodriguez Lucci, M Rodriguez Yanez, C Roesler, C Roffe, R Roine, S Roine, A Roldan, F Romana Pezzella, M Romano, JS Roos, C Rosso, C Rostrup Kruuse, Y Roth, R Roukens, L Roveri, D Rozanski, J Rozniecki, C Rozsa, S Rudilosso, G Ruiz Ares, A Ruiz Franco, G Rum, J Ruuskanen, I Rybinnik, K Ryota, J Saarinen, V Saavedra, C Sabben, A Sabet, D Sagris, J Sahlas, N Sakai, P Salamanca, P Salgado, S Salig, T Salletmayr, M Salnikov, O Samoshkina, Y Samson, D Sanak, M Sànchez Cerón, P Santalucia, M Santamaria Cadavid, P Santiago, G Santo, B Sanz Cuesta, J Sargento, A Sarraj, K Sas, A Sas, O Satoshi, S Satsoglou, N Sattar, S Savitz, C Savopoulos, J Saw, M Sawicka, R Sawyer, T Scandura, N Schillinger, J Schindler, F Schlachetzki, I Schneider, R Schuppner, J Schurig, CJ Schwarzbach, M Sebejova, G Seidel, L Sekaran, D Selcuk, J Selvarajah, A Semerano, J Semjen, D Semushina, S Sen, M Seok Park, J Serena, O Serhat Tokgoz, W Serles, F Serrano, M Sevin, L Seynaeve, S Shah, N Shamalov, T Shang, M Sharma, A Sharrief, M Shazam Hussain, I Shchukin, W Shen, E Shepeleva, I Shinsuke, A Shmonin, A Shoamanesh, A Shuaib, A Shulga, G Sibolt, I Sibon, I Sicilia, M Siebert, E Sieczkowska, C Sila, AA Silva, D Silva, P Silva, Y Silva, M Silvestrini, Z Simony, A Simpkins, B Singh, D Sinha, I Sipos, O Skoda, P Skowron, M Skowronska, B Sliwinska, J Slonkova, A Smolkin, A Smyth, P Sobolewski, A Sobota, SI Sohn, M Soldatov, I Solganov, L Soloveva, E Solovyeva, N Sonntag, P Soors, M Sorgun, C Soriano, D Spence, K Spengos, L Sposato, G Staaf, K Stadler, L Stakhovskaya, K Stamatelopoulos, S Steinert, I Stetkarova, M Stiehm, R Stocker, J Stoinski, A Stoll, G Stotts, A Stumpp, P Sucapane, T Suenaga, X Sun, S Sundararajan, J Sung Kim, H Suzuki, N Svaneborg, G Szasz, W Szczuchniak, S Szczyrba, N Szegedi, A Szekely, Z Szewczyk, G Szilagyi, S Szlufik, K Szoboszlai, L Szpisjak, R Sztajzel, L Sztriha, SE Ta Wil, J Taggeselle, K Takamatsu, M Takao, W Taki, S Takizawa, M Talahma, A Tamayo, J Tan, D Tanne, A Tapanainen, T Tapiola, J Tarasiuk, T Tatlisumak, A Tayal, S Tcvetkova, P Teal, J Tejada Garcia, H Tejada Meza, D Tenora, M Terceno, A Terentiou, S Tezcan, D Thaler, A Thomson, E Thouvenot, M Tiainen, I Timberg, S Timsit, A Tinchon, D Tirschwell, C Togay Isikay, K Tokunaga, M Tolino, C Toloza, G Tomelleri, K Tomoyuki, LM Tomppo, Z Tong, L Tong, D Toni, J Torres, C Tossavainen, G Toth, A Tountopoulou, E Touze, M Tovar, K Toyoda, S Trillo, A Trommer, D Tropepi, D Tryambake, H Tu, S Tuetuencue, R Tumova, O Tumpula, G Turc, A Tutaj, J Tynkkynen, S Uchiyama, U Uchwat, L Uhrinyakova, R Ulku Acar, D Uluduz Ugurlu, X Urra, S Urui, M Usero Ruiz, D Vaclavik, K Vahedi, A Valikovics, J Valpas, P Van Acker, W Van Daele, G Vanderschueren, L Vanina Jure, R Varela, Z Varga, J Varvat, N Varvyanskaya, A Vasco Salgado, P Vasko, L Vass, S Vassilopoulou, I Vastagh, P Vazquez, L Vecsei, R Veltkamp, M Venti, M Verdugo, V Verocai, M Veronica Marroquin, C Veronica Simonsini, T Veverka, M Vigl, A Vila, C Vilar, JA Villanueva Osorio, J Virta, E Vitkova, B Voglsperger, J Volna, PA Von Weitzel-Mudersbach, N Vora, I Voznyuk, A Wach-Klink, A Wacongne, D Walters, Y Wang, J Wang, L Wang, X Wang, W Wang, N Wang, D Wang, H Wang, W Warnack, K Wartenberg, R Waters, M Waters, T Webb, J Weber, G Weiss, K Weissenborn, JI Weitz, B Weller, G Wen, G Weng, P Werner, D Werring, P Wester, W Whiteley, R Whiting, T Wijeratne, C Willems, L Wilson, C Wilson, T Winder, J Windt, A Winkler, A Winska-Tereszkiewicz, A Wisniewska, M Wittayer, A Wlodek, A Wojnarowska-Arendt, M Wolf, V Wolff, C Wolter, A Wong, H Wook Nah, H Worthmann, W Wu, S Wu, S Wunderlich, H Wurzinger, DG Wyse, B Xiao, W Xiaopeng, A Ximenez-Carrillo, L Xiong, Y Xiong, W Xiong, Y Xu, J Xu, Z Xu, B Yalo, T Yamada, M Yamasaki, L Yang, Y Yang, X Yang, Q Yang, B Yang, J Yang, I Yasuhiro, M Yee Lam, C Yegappan, S Yip, E Ylikallio, P Ylikotila, A Yongwon Jin, BW Yoon, Y Yoshida, L Yperzeele, H Yuan, H Yuasa, J Zalewska, C Zanferrari, E Zapata, D Zboznovits, I Zelenka, C Zhang, B Zhang, S Zhang, M Zhang, X Zhang, J Zhang, L Zhao, O Zhirnova, L Zhou, J Zielinska-Turek, I Zinchenko, M Ziomek, A Zitzmann, R Zweifler, J Zwiernik, Yperzeele, Laetitia, and NAVIGATE ESUS Investigators

Subjects
Male, International Cooperation, 030204 cardiovascular system & hematology, antiplatelet therapy, law.invention, Neurology (clinical), ischemic stroke, anticoagulation, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Stroke, education.field_of_study, Aspirin, Anticoagulant, Settore BIO/14, Middle Aged, 3. Good health, Treatment Outcome, N/A, Cardiology, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Female, medicine.drug, medicine.medical_specialty, medicine.drug_class, MEDLINE, Population, Foramen Ovale, Patent, Subgroup analysis, Article, Statistics, Nonparametric, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, education, Aged, business.industry, medicine.disease, Human medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract

Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

Published
2018
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48. Rivaroxaban for stroke prevention after embolic stroke of undetermined source

Author

Hart, Robert G, Sharma, Mukul, Mundl, Hardi, Kasner, Scott E, Bangdiwala, Shrikant I, Berkowitz, Scott D, Swaminathan, Balakumar, Lavados, Pablo, Wang, Yongjun, Wang, Yilong, Davalos, Antonio, Shamalov, Nikolay, Mikulik, Robert, Cunha, Luis, Lindgren, Arne, Arauz, Antonio, Lang, Wilfried, Czlonkowska, Anna, Eckstein, Jens, Gagliardi, Rubens J, Amarenco, Pierre, Ameriso, Sebastian F, Tatlisumak, Turgut, Veltkamp, Roland, Hankey, Graeme J, Toni, Danilo, Bereczki, Daniel, Uchiyama, Shinichiro, Ntaios, George, Yoon, Byung-Woo, Brouns, Raf, Endres, Matthias, Muir, Keith W, Bornstein, Natan, Ozturk, Serefnur, O'Donnell, Martin J, De Vries Basson, Matthys M, Pare, Guillaume, Pater, Calin, Kirsch, Bodo, Sheridan, Patrick, Peters, Gary, Weitz, Jeffrey I, Peacock, W Frank, Shoamanesh, Ashkan, Benavente, Oscar R, Joyner, Campbell, Themeles, Ellison, Connolly, Anderson DC, Stuart J., Demets, Dl, Kaste, M, Norrving, B, Wyse, Dg, Alet, M, Allende, G, Beinlich, A, Berrios, W, Bruera, G, Castro, D, Chialvo, L, Claverie, S, Contardo, L, Couto, J, Deganutto, R, Diaz, R, Dossi, D, Esnaola, M, Falco, M, Fernandez Pirrone, P, Ferrari, J, Firstenfeld, A, Galli Giqueauk, E, Gilli, M, Gonzalez, L, Gonzalez Toledo, M, Grecco, M, Halac, B, Hawkes, M, Ioli, P, Jure, L, Klein, F, Lepera, S, Lujan, S, Mackinnon, F, Marroquin, M, Martin, J, Parisi, V, Perez Leguizamon, P, Persi, G, Povedano, P, Povedano, G, Pujol Lereis, V, Radrizzani, L, Reich, E, Repetto, M, Rodriguez Lucci, F, Romano, M, Saredo, G, Schneider, M, Simonsini, C, Sumay, G, Thomson, A, Toledo, W, Torres, C, Vila, A, Abdul Rasheed, N, Anderson, C, Bailey, P, Blacker, D, Carcel, C, Clissold, B, Delcourt, C, Field, D, Gangadharan, S, Ghia, D, Kleinig, T, Leyden, J, Ly, J, Ma, H, Mackey, E, Mishra, S, Moey, A, Musuka, T, Pepper, E, Phan, T, Sabet, A, Saw, J, Singh, B, Tryambake, D, Tu, H, Wijeratne, T, Wong, A, Augustin, S, Esterbauer, M, Garnauf, M, Gasiorek, K, Gasser, S, Gaugg, M, Greisenegger, S, Harrasser, M, Heine, M, Huber, B, Joachim, B, Kapeller, P, Krebs, S, Kreuzpointer, R, Kunzmann, J, Lechner, H, Lohninger, B, Luschin, G, Macher, S, Marko, M, Matosevic, B, Mayr, A, Mismas, A, Mitrovic, N, Mutzenbach, J, Oberndorfer, S, Obmann, S, Raffelsberger, T, Roesler, C, Salletmayr, T, Serles, W, Stadler, K, Tinchon, A, Tolino, M, Verocai, V, Vigl, M, Voglsperger, B, Weber, J, Werner, P, Windt, J, Winkler, A, Wurzinger, H, Zelenka, I, Cras, P, Crols, R, De Keyser, J, De Klippel, N, De Pauw, A, De Smedt, A, Dhollander, I, Hermans, S, Ligot, N, Maqueda, V, Maqueda Maqueda, V, Naeije, G, Seynaeve, L, Soors, P, Van Daele, W, Vanacker, P, Vanderschueren, G, Willems, C, Yperzeele, L, Avelar, W, Bacellar, A, Batista, C, Bazan, R, Braga, G, Cardoso, F, Dagnino, M, Fabio, S, Ferreira Junior, G, Freitas, G, Friedrich, M, Gomes Neto, A, Guarda, S, Katsurayama, M, Machado, M, Martins, S, Meira, F, Minelli, C, Morais, R, Moro, C, Neto, O, Polin, M, Silva, D, Weiss, G, Basile, V, Beaudry, M, Berlingieri, J, Blacquiere, D, Buck, B, Chan, R, Coutts, S, Das, S, Desai, J, Ehrensperger, E, Field, T, Gladstone, D, Hachinski, V, Hassan, A, Hegedus, J, Hill, M, Jin, A, Khaw, A, Mackey, A, Maclean, G, Mandzia, J, Mann, S, Mehdiratta, M, Murphy, C, Ng, K, Oczkowski, W, Penn, A, Perera, K, Perez, Y, Pesant, Y, Phillips, S, Poppe, A, Sahlas, J, Shuaib, A, Spence, D, Sposato, L, Stotts, G, Tamayo, A, Teal, P, Wilson, L, Winder, T, Yegappan, C, Yip, S, Andreu, D, Araya, P, Bustamante, G, Figueroa, C, Gasic, K, Herrero, D, Matamala, G, Munoz, S, Olavarria, V, Pasten, J, Polanco, J, Reyes, P, Roldan, A, Salamanca, P, Silva, P, Toloza, C, Verdugo, M, Cai, K, Che, C, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, B, Chen, G, Chen, L, Chu, F, Cui, L, Dai, C, Ding, N, Ding, J, Du, P, Du, J, Fang, L, Feng, J, Gao, Y, Geng, J, Guan, J, Hao, L, Huang, D, Huang, H, Jin, X, Jing, P, Ke, K, Li, G, Li, M, Li, S, Li, J, Liang, Z, Lin, H, Liu, K, Liu, X, Lu, Z, Ma, C, Pei, H, Qiu, J, Qu, X, Shen, W, Sun, X, Tian, J, Tong, L, Tong, Z, Wang, J, Wang, L, Wang, X, Wang, W, Wang, N, Wang, D, Wang, H, Wen, G, Weng, G, Wu, W, Wu, S, Xiao, B, Xiaopeng, W, Xiong, L, Xiong, Y, Xu, Y, Xu, J, Xu, Z, Yang, L, Yang, Y, Yang, X, Yang, J, Yang, Q, Yang, B, Zhang, C, Zhang, B, Zhang, Y, Zhang, S, Zhang, M, Zhang, X, Zhang, J, Zhao, L, Zhou, L, Bar, M, Barteys, M, Bartolottiova, T, Carek, M, Ferencova, K, Fiksa, J, Gallo, J, Goldemund, D, Hanouskova, L, Herzig, R, Hon, P, Jankovych, J, Jura, R, Kadlcikova, J, Kemlink, D, Kopecky, S, Krajickova, D, Kral, M, Krejci, V, Pavlik, O, Peisker, T, Pernicka, M, Peska, S, Rapantova, P, Reif, M, Rekova, P, Sanak, D, Sebejova, M, Skoda, O, Slonkova, J, Stetkarova, I, Tenora, D, Tumova, R, Vaclavik, D, Vasko, P, Veverka, T, Vitkova, E, Volna, J, Andersen, G, Christensen, H, Christensen, T, Damgaard, D, Iversen, H, Krarup Hansen, C, Kruuse, C, Martinussen, M, Modrau, B, Murtuzova, A, Ovesen, C, Papina, M, Svaneborg, N, Von Weitzel-Mudersbach, P, Curtze, S, Fanta, S, Huhtakangas, J, Keskinarkaus, I, Kivioja, R, Koivu, M, Korpela, J, Larjo, T, Linna, M, Marinkovic, I, Martinez-Majander, N, Nieminen, T, Nikkanen, M, Numminen, H, Ortiz, R, Österlund-Tauriala, E, Roine, R, Roine, S, Ruuskanen, J, Saarinen, J, Shulga, A, Sibolt, G, Tapanainen, A, Tapiola, T, Tiainen, M, Tomppo, L, Tumpula, O, Tuomainen, P, Tynkkynen, J, Vainikka, S, Valpas, J, Virta, J, Ylikallio, E, Ylikotila, P, Accassat, S, Aniculaesei, A, Baronnet, F, Bejot, Y, Bindila, D, Birchenall, J, Blanc-Labarre, C, Bodiguel, E, Bouly, S, Cabrejo, L, Calvet, D, Corlobe, A, Crozier, S, Delpont, B, Deltour, S, Diaconu, M, Domigo, V, Epinat, M, Ferreira, A, Fisselier, M, Garnier, P, Gimenez, L, Gueguen, A, Guidoux, C, Guillon, B, Guiraudg, V, Hervieu-Begue, M, Hobeanu, M, Khoumri, C, Lamy, C, Lauer, V, Le Bouc, R, Lecouturier, K, Leder, S, Leger, A, Macian-Montoro, F, Meseguer, E, Morar-Precup, D, Morvan, T, Morvan, E, Obadia, M, Osseby, G, Philippi, S, Pico, F, Quenardelle, V, Reiner, P, Rigual, R, Rosso, C, Sabben, C, Samson, Y, Sevin, M, Sibon, I, Thouvenot, E, Timsit, S, Touze, E, Turc, G, Vahedi, K, Varvat, J, Wacongne, A, Wolff, V, Yalo, B, Zinchenko, I, Bagelmann, H, Bardutzky, J, Barlinn, J, Bathe-Peters, R, Berrouschot, J, Dietzel, J, Ehrlich, S, Fatar, M, Filipov, A, Fluri, F, Gabriel, M, Geran, R, Gliem, M, Graf, S, Griebe, M, Grosse, G, Haeusler, K, Harmel, P, Held, V, Hellwig, S, Henkner, J, Hieber, M, Hoyer, C, Jander, S, Keilitz, J, Kellner, J, Knecht, S, Koch, M, Koehler, L, Kucken, D, Kusnick, G, Lambeck, J, Lee, J, Leisse, I, Lubke-Detring, S, Machetanz, J, Mensch, A, Meyer, N, Molis, A, Mueller, T, Muhl, C, Nave, A, Radtke, A, Roth, Y, Roukens, R, Schlachetzki, F, Schneider, I, Schuppner, R, Schurig, J, Schwarzbach, C, Seidel, G, Sonntag, N, Steinert, S, Stoll, A, Stumpp, A, Taggeselle, J, Trommer, A, Tuetuencue, S, Wartenberg, K, Weissenborn, K, Wittayer, M, Wolf, M, Wolter, C, Worthmann, H, Wunderlich, S, Zitzmann, A, Anagnostou, E, Brokalaki, C, Hatzitolios, A, Kakaletsis, N, Kanellos, I, Kei, A, Korompoki, E, Koutroubi, A, Liamis, G, Makaritsis, K, Manios, E, Michas, F, Milionis, H, Papadopoulos, G, Papadopoulou, E, Papagiannis, A, Polychronopoulou, E, Sagris, D, Satsoglou, S, Savopoulos, C, Solganov, I, Spengos, K, Stamatelopoulos, K, Terentiou, A, Tountopoulou, A, Vassilopoulou, S, Amjad, A, Balazs, A, Bankuti, Z, Bicsak, T, Borcsik, L, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Czurko, M, Danku, V, Dioszeghy, P, Faust, K, Fazekas, F, Gerocs, Z, Gottschal, M, Gyuker, N, Hajas, A, Horvath, L, Horvath, M, Iljicsov, A, Jakab, K, Javor, L, Kakuk, I, Karasz, O, Kasa, K, Kasza, J, Kerekgyarto, M, Klivenyi, P, Kovacs, K, Kovacs, T, Kovacs, H, Lajos, B, Lovasz, R, Magyar, T, Matoltsy, A, May, Z, Molnar, S, Monosi, C, Motko, T, Nemeth, R, Nemeth, L, Nikl, J, Olah, L, Orosz, V, Panczel, G, Pentek, S, Prendl, B, Rozsa, C, Rum, G, Sas, K, Sas, A, Semjen, J, Simony, Z, Sipos, I, Szabo, K, Szasz, G, Szegedi, N, Szekely, A, Szilagyi, G, Szoboszlai, K, Szpisjak, L, Toth, G, Uhrinyakova, L, Valikovics, A, Varga, Z, Vass, L, Vastagh, I, Vecsei, L, Zboznovits, D, Coveney, S, Horgan, G, Kelly, P, Murphy, S, Smyth, A, Waters, R, Abu Ahmad, F, Bloch, S, Dorodnicov, E, Hallevi, H, Haratz, S, Horev, A, Kolianov, V, Leker, R, Mahagney, A, Marzelik, O, Rephaeli, G, Tanne, D, Weller, B, Acciarresi, M, Adami, A, Agostoni, E, Alemseged, F, Altavilla, R, Angelocola, S, Anticoli, S, Berardi, V, Bravi, M, Candeloro, E, Cappellari, M, Carletti, M, Caruso, P, Castellini, P, Cavallini, A, Cenciarelli, S, Cerrone, P, Condurso, R, Consoli, D, Danese, A, Della Marca, G, Denaro, M, Di Mascio, M, Diomedi, M, Distefano, M, Frisullo, G, Furlanis, G, Galati, F, Gallina, A, Gallinella, E, Giannandrea, D, Giatsidis, F, Greco, L, Impellizzeri, M, Landolfi, A, Lanfranconi, S, Latte, L, Lembo, G, Longoni, M, Marando, C, Marini, C, Marsili, E, Mastrocola, S, Mazzoli, T, Melis, M, Micheletti, N, Moller, J, Monzani, V, Naccarato, M, Paciaroni, M, Padiglioni, C, Persico, A, Pezzella, F, Pieroni, A, Piras, V, Postorino, P, Pozzerese, C, Profice, P, Ricci, S, Rinaldi, C, Rizzato, B, Rocco, A, Roveri, L, Santalucia, P, Semerano, A, Sicilia, I, Silvestrini, M, Sucapane, P, Tomelleri, G, Tropepi, D, Venti, M, Amino, T, Chin, M, Deguchi, I, Fujigasaki, H, Fukuyama, K, Haraguchi, K, Hasegawa, Y, Hattori, M, Hayashi, T, Hirose, M, Honma, Y, Igarashi, S, Irie, S, Itabashi, R, Ito, Y, Kamata, T, Kaneko, C, Kawanishi, M, Kimura, R, Kitagawa, K, Kobayashi, Y, Kondo, T, Kuwashiro, T, Matsumoto, S, Miyake, H, Nagakane, Y, Nishino, S, Nishiyama, Y, Nogawa, S, Ochiai, J, Ohira, M, Okamoto, Y, Okubo, S, Okuda, S, Ooyama, K, Sakai, N, Suenaga, T, Suzuki, H, Takamatsu, K, Takao, M, Taki, W, Takizawa, S, Tokunaga, K, Toyoda, K, Urui, S, Yamada, T, Yamasaki, M, Yoshida, Y, Yuasa, H, Bae, H, Cha, J, Chang, D, Chung, C, Heo, J, Hong, K, Kim, J, Lee, B, Nah, H, Oh, K, Park, M, Park, J, Rha, J, Sohn, S, Amaya Sanchez, L, Arauz Gongora, A, Cantu Brito, C, Chiquete Anaya, E, Felipe Amaya, P, Fernandez Vera, J, Garcia Lopez, R, Gien Lopez, J, Gongora-Rivera, J, Hernandez, J, Leal Cantu, R, Lopez Garza, N, Medina Pech, C, Mendez, B, Pena Sedna, L, Reyes Morales, S, Ruiz Franco, A, Serrano, F, Tovar, M, Uribe, R, Bak, Z, Baranowska, A, Bilik, M, Blazejewska-Hyzorek, B, Brola, W, Brzoska-Mizgalska, J, Buksinska-Lisik, M, Chorazy, M, Czerska, M, Czuryszkiewicz, M, Dalek, G, Dylewicz, L, Fiszer, U, Fraczek, A, Friedman, A, Fryze, W, Gasecki, D, Gębura, K, Geremek, M, Glabinski, A, Gluszkiewicz, M, Goździk, I, Grzesik, M, Jasek, L, Kaczorowska, B, Kalinowska, K, Kaminska, K, Kapica-Topczewska, K, Karlinski, M, Kobayashi, A, Kosarz-Lanczek, K, Kowalczyk, K, Kowalska, M, Kraska, J, Krzyzanowska, M, Kulakowska, A, Kurkowska-Jastrzebska, I, Lasek-Bal, A, Litwin, T, Morton, M, Myśliwy, W, Nosek, K, Nowak, B, Nowakowska-Śledź, E, Odyniec, A, Oleszek, J, Ozdoba-Rot, J, Palasik, W, Pawelczyk, M, Rozanski, D, Rozniecki, J, Sawicka, M, Sieczkowska, E, Skowron, P, Skowronska, M, Sliwinska, B, Sobolewski, P, Sobota, A, Stoiński, J, Szczuchniak, W, Szczyrba, S, Szewczyk, Z, Szlufik, S, Tarasiuk, J, Tutaj, A, Uchwat, U, Wach-Klink, A, Winska-Tereszkiewicz, A, Wisniewska, A, Włodek, A, Wojnarowska-Arendt, A, Zalewska, J, Zielinska-Turek, J, Ziomek, M, Zwiernik, J, Abreu, P, E Silva A, Amaral, Azevedo, E, Barroso, C, Calejo, M, Campillo, J, Campos Costa, E, Coelho, J, Correia, M, Correia, C, Gregorio, T, Lopes, D, Machado, C, Mendonca, T, Pereira, L, Pidal, A, Pineiro, S, Pinto, A, Ribeiro, J, Rodrigues, M, Salgado, P, Salgado, A, Santo, G, Sargento, J, Varela, R, Abroskina, M, Badalyan, K, Balueva, T, Barulin, A, Bazhenova, O, Belkin, A, Bogdanov, E, Daineko, A, Druzenko, I, Fedin, A, Fidler, M, Gogoleva, E, Golikov, K, Gonysheva, Y, Greshnova, I, Guryanova, N, Gusev, V, Kashaeva, E, Kaygorodtseva, S, Khairutdinova, D, Kholopov, M, Kirpicheva, S, Koltsov, I, Konkov, I, Kurenkova, N, Kurtenkova, N, Kurushina, O, Kustova, M, Lagutenko, M, Lenskaya, L, Lupinogina, L, Lvova, A, Melnikova, E, Meshkova, K, Morozova, E, Mozhejko, E, Nikoforova, M, Obrezan, A, Ondar, V, Pizova, N, Polyakov, A, Popov, D, Prazdnichkova, E, Prokopenko, S, Pudov, E, Salnikov, M, Samoshkina, O, Semushina, D, Shchukin, I, Shepeleva, E, Shmonin, A, Smolkin, A, Soldatov, M, Soloveva, L, Solovyeva, E, Stakhovskaya, L, Tcvetkova, S, Varvyanskaya, N, Voznyuk, I, Zhirnova, O, Ahmed, F, Basson, M, Engelbrecht, J, Hobson, B, Jansen, J, Nel, J, Nell, H, Njovane, X, Pretorius, M, Roos, J, Salig, S, Siebert, M, Amaro, S, Arenillas Lara, J, Arias Rivas, S, Baez Martinez, E, Bas, M, Bashir, S, Bragado, I, Cajaraville, S, Camps, P, Cardona Portela, P, Casado-Naranjo, I, Castellanos, M, Cayuela Caudevilla, N, Chamorro, A, Constantino Silva, A, Cortijo Garcia, E, De La Torre, J, De Torres, R, Diaz Otero, F, Diez-Tejedor, E, Escribano, B, Escudero, I, Fernandez, M, Font, M, Fortea, G, Freijo, M, Fuentes Gimeno, B, Gamero, M, Garcia, J, Garcia Pastor, A, Garcia Sanchez, S, Geniz Clavijo, M, Gil Nunez, A, Giralt, E, Gomez-Choco, M, Gomis, M, Gutiérrez, R, Iglesias Mohedano, A, Lago, A, Lara Lezama, L, Lara Rodriguez, B, Llull, L, Lopez Fernandez, M, Lorenzo, A, Maestre-Moreno, J, Marta Moreno, J, Marti-Fabregas, J, Martínez Sánchez, P, Mauri Cabdevila, G, Mengual Chirifie, J, Molina, C, Molina, J, Moniche, F, Morales, L, Morales, A, Nombela, F, Núñez, F, Pagola, J, Perez, S, Portilla, J, Prats, L, Purroy, F, Quesada Garcia, H, Ramirez Moreno, J, Redondo Robles, L, Renu, A, Riveira Rodriguez, C, Roa, A, Rodriguez Campello, A, Rodriguez Pardo De Donlebun, J, Rodriguez Yanez, M, Rudilosso, S, Ruiz Ares, G, Sànchez Cerón, M, Santamaria Cadavid, M, Sanz Cuesta, B, Serena, J, Silva, Y, Soriano Soriano, C, Tejada Garcia, J, Tejada Meza, H, Tembl, J, Terceno, M, Trillo, S, Urra, X, Usero Ruiz, M, Vazquez, P, Vilar, C, Villanueva Osorio, J, Ximenez-Carrillo, A, Zapata, E, Esbjornsson, M, Karlsson, J, Kremer, C, Kuris, A, Staaf, G, Stiehm, M, Timberg, I, Tossavainen, C, Wester, P, Arnold, M, Baumgartner, P, Beer, J, Bicker, H, Boos, L, Cereda, C, Chaloulos-Iakovidis, P, Christian, L, Engelter, S, Fisch, L, Fischer, U, Frey, S, Frick, M, Hauk, M, Hoffmann, M, Kahles, T, Manno, C, Medlin, F, Mircea, D, Nedeltchev, K, Panos, L, Polymeris, A, Schillinger, N, Stocker, R, Sztajzel, R, Alaydin, H, Batur Caglayan, H, Colakoglu, S, Demirci, N, Duman, T, Eren, F, Gokce, M, Inanc, Y, Nazliel, B, Ongun, G, Ozcekic Demirhan, S, Ozyurt, E, Selcuk, D, Sorgun, M, Tezcan, S, Togay Isikay, C, Tokgoz, O, Ulku Acar, R, Uluduz Ugurlu, D, Abdul-Saheb, M, Ahmad, N, Ali, A, Alwis, L, Balogun, I, Bathula, R, Behnam, Y, Bhandari, M, Bhargavah, M, Black, T, Blank, C, Bruce, D, Burn, M, Canepa, C, Chakrabarti, A, Chandrasena, D, Chembala, J, Cheripelli, B, Clarke, R, Cohen, D, Collas, D, Constantin, C, Dani, K, Del Giudice, A, Dennis, M, Devine, J, Dima, S, Doubal, F, Duodu, Y, Dutta, D, El Ta Wil, S, Elyas, S, Evans, N, Eveson, D, Fotherby, K, France, E, Furnace, J, Grabowski, S, Gunathilagan, G, Gutierrez, R, Guyler, P, Hargroves, D, Harkness, K, Harvey, M, Hayhoe, H, Hicken, L, Hussain, M, Kelly, S, Lam, M, Lindert, R, Louw, S, Luder, R, Macleod, M, Majid, A, Mangion, D, Markova, S, Markus, H, Marsh, R, Mcarthur, K, Menon, N, Metcalf, K, Minhas, J, Minns, M, Mistri, A, Moreton, F, Mpelembue, M, Muddegowda, G, Mudhar, O, Musarrat, K, Myint, M, Natarajan, I, Naylor, D, Ngeh, J, Papavasileiou, V, Perry, R, Piechowski-Jozwiak, B, Pradhan, M, Rani, A, Rashed, K, Robinson, T, Roffe, C, Saksena, R, Sattar, N, Sekaran, L, Selvarajah, J, Shah, S, Sinha, D, Sivakumar, R, Sztriha, L, Walters, D, Webb, T, Werring, D, Whiteley, W, Whiting, R, Abdelhamid, N, Abdul Rahman, D, Amin, H, Androulakis, M, Babikian, V, Baker, M, Barker Trejo, S, Benjamin, A, Birnbaum, L, Burke, J, Chen, S, Clark, W, Coull, B, De Havenon, A, Dearborn, J, Degeorgia, M, Essa, B, Fares, M, Favate, A, Furlan, A, Gebreyohanns, M, Goddeau, R, Green, D, Greer, D, Haralur Sreekantaiah, Y, Hasan, R, Hedna, V, Henninger, N, Holmstedt, C, Ishida, K, Jagolino, A, Johnson, M, Jun-Oconnell, A, Kaur, S, Khanna, A, Kirshner, H, Kittner, S, Kleindorfer, D, Leira, E, Loomis, C, Lord, A, Lowenkopf, T, Lutsep, H, Magadan, A, Majjhoo, A, Maud, A, Mayasi, Y, Mccullough, L, Mckinney, J, Mehta, S, Mehta, D, Mehta, B, Messe, S, Miller, B, Milling, T, Moonis, M, Navaratnam, D, Okpala, M, Patel, N, Pettigrew, L, Phinney, T, Ramos-Estebanez, C, Rasmussen, J, Rodriguez, G, Rybinnik, I, Santiago, P, Sarraj, A, Savitz, S, Sawyer, R, Scandura, T, Schindler, J, Sen, S, Shang, T, Sharrief, A, Sila, C, Simpkins, A, Sundararajan, S, Talahma, M, Tayal, A, Thaler, D, Tirschwell, D, Torres, J, Vora, N, Warnack, W, Waters, M, Wilson, C, Xiong, W, Zweifler, R, Zanferrari, C., St Marys Development Trust, Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Department of Neurology (Dep Neuro - BEIJING), Tiantan Hospital, Neurology department, Universidade de Coimbra [Coimbra], Department of Internal Medicine, University Hospital Basel [Basel], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Neurological Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Department of Neurology, Seoul National University Hospital, Institute of Neurosciences and Psychology [Glasgow], University of Glasgow, Neurology Department, Ichilov Medical Center, CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Yperzeele, Laetitia, NAVIGATE ESUS Investigators, and Selçuk Üniversitesi

Subjects
Stroke/etiology, Male, [SDV]Life Sciences [q-bio], Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Brain Ischemia, Brain ischemia, 0302 clinical medicine, DESIGN, Rivaroxaban, Hemorrhage/chemically induced, Secondary Prevention, Medicine, Factor Xa Inhibitors/adverse effects, Stroke, Rivaroxaban/adverse effects, ComputingMilieux_MISCELLANEOUS, 11 Medical and Health Sciences, Aspirin, Atrial fibrillation, General Medicine, FORAMEN OVALE CLOSURE, Middle Aged, TRIALS, Intracranial Embolism, SAFETY, Aged, Factor Xa Inhibitors, Female, Hemorrhage, Humans, Platelet Aggregation Inhibitors, Medicine (all), Cardiology, Foramen ovale closure, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Life Sciences & Biomedicine, medicine.drug, medicine.medical_specialty, Platelet Aggregation Inhibitors/adverse effects, ANTITHROMBOTIC THERAPY, Aspirin/adverse effects, WARFARIN, 03 medical and health sciences, Secondary Prevention/methods, Medicine, General & Internal, Internal medicine, Intracranial Embolism/drug therapy, General & Internal Medicine, NAVIGATE ESUS Investigators, METAANALYSIS, Science & Technology, CRYPTOGENIC STROKE, business.industry, Warfarin, medicine.disease, EFFICACY, ATRIAL-FIBRILLATION, Human medicine, business, Brain Ischemia/prevention & control, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

WOS: 000434263000007, PubMed: 29766772, BACKGROUND Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. METHODS We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding. RESULTS A total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P, BayerBayer AG; Janssen Research and Development, Supported by Bayer and Janssen Research and Development.

Published
2018
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49. Predictors of Endovascular Treatment Among Stroke Codes Activated Within 6 Hours From Symptom Onset

Author

Requena, M, de la Ossa, NP, Abilleira, S, Cardona, P, Urra, X, Marti-Fabregas, J, Rodriguez-Campello, A, Boned, S, Rubiera, M, Tomasello, A, Molina, CA, and Ribo, M

Subjects
magnetic resonance imaging, triage, patients, stroke, groin
Abstract

Background and Purpose-Prehospital stroke code activations help reducing workflow times during in-hospital triage. We aim to identify predictors of endovascular treatment (EVT) among stroke codes (SC) activated within 6 hours from symptom onset. Methods-CICAT (Codi Ictus Catalunya) is a prospective official mandatory registry of all SC in Catalunya. We studied all CICAT entries from 6 comprehensive stroke centers for 18 months. We recorded demographic, clinical, and imaging variables on admission. We explored the relationship between these variables and EVT Results-From 3944 SC, 2778 (70.4%) were admitted within 6 hours from symptom onset. Mean age was 72 +/- 15.3 years, median Rapid Arterial Occlusion Evaluation scale score 4 (interquartile range [IQR], 2-6), median onset-to-door time 89 minutes (IQR, 54-158), median National Institutes of Health Stroke Scale score 9 (IQR, 4-18), median Alberta Stroke Program Early CT Score 10 (1QR, 8-10). Final diagnosis was ischemic stroke in 1762 patients (63.4%), hemorrhagic stroke in 359 (13.0%), transient ischemic attack in 164 (5.9%), and stroke-mimic in 493 (17.7%). A large vessel occlusion was confirmed in 720 (25.6%) patients. Of all SC, 16% (n-414) received EVT, with a median door-to-groin time of 77 minutes (IQR, 55-102). Baseline variables associated with EVT were premorbid modified Rankin Scale score 4 (P=0.003), and National Institutes of Health Stroke Scale on admission >8 (P90% along time (0-3 hours, 95.1% versus 3-6 hours, 94.0%; P=0.25) and did not decrease over time. The chances to receive EVT and the presence of large vessel occlusion decreased over time. However, the rate of EVT was not different between patients admitted 0 to 3 hours (26.1%) and those admitted 3 to 6 hours (22.9%; P=0.2). Conclusions-Among SC within 6 hours from symptom onset, National Institutes of Health Stroke Scale on admission was the only factor independently associated with EVT. Only 5% of these patients show an Alberta Stroke Program Early CT Score

Published
2018

50. Association of residential air pollution, noise, and greenspace with initial ischemic stroke severity.

Author

Vivanco-Hidalgo, Rosa Maria, primary, Avellaneda-Gómez, Carla, additional, Dadvand, Payam, additional, Cirach, Marta, additional, Ois, Ángel, additional, Gómez González, Alejandra, additional, Rodriguez-Campello, Ana, additional, de Ceballos, Pablo, additional, Basagaña, Xavier, additional, Zabalza, Ana, additional, Cuadrado-Godia, Elisa, additional, Sunyer, Jordi, additional, Roquer, Jaume, additional, and Wellenius, Gregory A., additional

Published
2019
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