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1. Neuroprotective Effects of Inhaled Xenon Gas on Brain Structural Gray Matter Changes After Out-of-Hospital Cardiac Arrest Evaluated by Morphometric Analysis: A Substudy of the Randomized Xe-Hypotheca Trial

Author

Hollmén, Carita, Parkkola, Riitta, Vorobyev, Victor, Saunavaara, Jani, Laitio, Ruut, Arola, Olli, Hynninen, Marja, Bäcklund, Minna, Martola, Juha, Ylikoski, Emmi, Roine, Risto O., Tiainen, Marjaana, Scheinin, Harry, Maze, Mervyn, Vahlberg, Tero, and Laitio, Timo T.

Published
2024
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2. Comparison of the prognostic value of early-phase proton magnetic resonance spectroscopy and diffusion tensor imaging with serum neuron-specific enolase at 72 h in comatose survivors of out-of-hospital cardiac arrest—a substudy of the XeHypotheca trial

Author

Koskensalo, Kalle, Virtanen, Sami, Saunavaara, Jani, Parkkola, Riitta, Laitio, Ruut, Arola, Olli, Hynninen, Marja, Silvasti, Päivi, Nukarinen, Eija, Martola, Juha, Silvennoinen, Heli M, Tiainen, Marjaana, Roine, Risto O, Scheinin, Harry, Saraste, Antti, Maze, Mervyn, Vahlberg, Tero, and Laitio, Timo T

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Cardiovascular, Biomedical Imaging, Clinical Research, Humans, Biomarkers, Coma, Diffusion Tensor Imaging, Out-of-Hospital Cardiac Arrest, Phosphopyruvate Hydratase, Prognosis, Proton Magnetic Resonance Spectroscopy, Seizures, Survivors, Diffusion tensor imaging, 1H-MRS, Neuron-specific enolase, Cardiac arrest, Brain hypoxia-ischemia, Prognostication, XeHYPOTHECA Research Group, Brain hypoxia–ischemia, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

PurposeWe compared the predictive accuracy of early-phase brain diffusion tensor imaging (DTI), proton magnetic resonance spectroscopy (1H-MRS), and serum neuron-specific enolase (NSE) against the motor score and epileptic seizures (ES) for poor neurological outcome after out-of-hospital cardiac arrest (OHCA).MethodsThe predictive accuracy of DTI, 1H-MRS, and NSE along with motor score at 72 h and ES for the poor neurological outcome (modified Rankin Scale, mRS, 3 - 6) in 92 comatose OHCA patients at 6 months was assessed by area under the receiver operating characteristic curve (AUROC). Combined models of the variables were included as exploratory.ResultsThe predictive accuracy of fractional anisotropy (FA) of DTI (AUROC 0.73, 95% CI 0.62-0.84), total N-acetyl aspartate/total creatine (tNAA/tCr) of 1H-MRS (0.78 (0.68 - 0.88)), or NSE at 72 h (0.85 (0.76 - 0.93)) was not significantly better than motor score at 72 h (0.88 (95% CI 0.80-0.96)). The addition of FA and tNAA/tCr to a combination of NSE, motor score, and ES provided a small but statistically significant improvement in predictive accuracy (AUROC 0.92 (0.85-0.98) vs 0.98 (0.96-1.00), p = 0.037).ConclusionNone of the variables (FA, tNAA/tCr, ES, NSE at 72 h, and motor score at 72 h) differed significantly in predicting poor outcomes in this patient group. Early-phase quantitative neuroimaging provided a statistically significant improvement for the predictive value when combined with ES and motor score with or without NSE. However, in clinical practice, the additional value is small, and considering the costs and challenges of imaging in this patient group, early-phase DTI/MRS cannot be recommended for routine use.Trial registrationClinicalTrials.gov NCT00879892, April 13, 2009.

Published
2023

3. Effect of Inhaled Xenon on Cardiac Function in Comatose Survivors of Out-of-Hospital Cardiac Arrest—A Substudy of the Xenon in Combination With Hypothermia After Cardiac Arrest Trial

Author

Saraste, Antti, Ballo, Haitham, Arola, Olli, Laitio, Ruut, Airaksinen, Juhani, Hynninen, Marja, Bäcklund, Minna, Ylikoski, Emmi, Wennervirta, Johanna, Pietilä, Mikko, Roine, Risto O, Harjola, Veli-Pekka, Niiranen, Jussi, Korpi, Kirsi, Varpula, Marjut, Scheinin, Harry, Maze, Mervyn, Vahlberg, Tero, Laitio, Timo, Virtanen, Sami, Parkkola, Riitta, Saunavaara, Jani, Martola, Juha, Silvennoinen, Heli, Tiainen, Marjaana, Grönlund, Juha, Inkinen, Outi, Silvasti, Päivi, Nukarinen, Eija, and Olkkola, Klaus T

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Cardiovascular, Clinical Research, Heart Disease, Clinical Trials and Supportive Activities, cardiac arrest, cardiac function, cardioprotection, echocardiography, ejection fraction, myocardial strain, Clinical sciences
Abstract

This explorative substudy aimed at determining the effect of inhaled xenon on left ventricular function by echocardiography in comatose survivors of out-of-hospital cardiac arrest.DesignA randomized two-group single-blinded phase 2 clinical drug trial.SettingA multipurpose ICU in two university hospitals.PatientsOf the 110 randomized comatose survivors after out-of-hospital cardiac arrest with a shockable rhythm in the xenon in combination with hypothermia after cardiac arrest trial, 38 patients (24-76 yr old) with complete echocardiography were included in this study.InterventionsPatients were randomized to receive either inhaled xenon combined with hypothermia (33°C) for 24 hours or hypothermia treatment alone. Echocardiography was performed at hospital admission and 24 ± 4 hours after hypothermia.Measurements and main resultsLeft ventricular ejection fraction, myocardial longitudinal systolic strain, and diastolic function were analyzed blinded to treatment. There were 17 xenon and 21 control patients in whom echocardiography was completed. Clinical characteristics did not differ significantly between the groups. At admission, ejection fraction was similar in xenon and control patients (39% ± 10% vs 38% ± 11%; p = 0.711) but higher in xenon than control patients after hypothermia (50% ± 10% vs 42% ± 10%; p = 0.014). Global longitudinal systolic strain was similar in xenon and control patients at admission (-9.0% ± 3.8% vs -8.1% ± 3.6%; p = 0.555) but better in xenon than control patients after hypothermia (-14.4.0% ± 4.0% vs -10.5% ± 4.0%; p = 0.006). In patients with coronary artery disease, longitudinal strain improved in the nonischemic myocardial segments in xenon patients. There were no changes in diastolic function between the groups.ConclusionsAmong comatose survivors of a cardiac cause out-of-hospital cardiac arrest, inhaled xenon combined with hypothermia was associated with greater recovery of left ventricular systolic function in comparison with hypothermia alone.

Published
2021

4. Obesity and the Risk of Cryptogenic Ischemic Stroke in Young Adults

Author

Jaakonmäki, Nina, Zedde, Marialuisa, Sarkanen, Tomi, Martinez-Majander, Nicolas, Tuohinen, Suvi, Sinisalo, Juha, Ryödi, Essi, Autere, Jaana, Hedman, Marja, Junttola, Ulla, Huhtakangas, Jaana K., Grimaldi, Teresa, Pascarella, Rosario, Nordanstig, Annika, Bech-Hanssen, Odd, Holbe, Christine, Busch, Raila, Fromm, Annette, Ylikotila, Pauli, Turgut, Esme Ekizoglu, Amorim, Isabel, Ryliskiene, Kristina, Tulkki, Lauri, Pascasio, Laura Amaya, Licenik, Radim, Ferdinand, Phillip, Tsivgoulis, Georgios, Jatužis, Dalius, Kõrv, Liisa, Kõrv, Janika, Pezzini, Alessandro, Fonseca, Ana Catarina, Yesilot, Nilufer, Roine, Risto O., Waje-Andreassen, Ulrike, von Sarnowski, Bettina, Redfors, Petra, Huhtakangas, Juha, Numminen, Heikki, Jäkälä, Pekka, and Putaala, Jukka

Published
2022
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5. Prognostic Value of Early Phase 1H Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging in Comatose Survivors of Out-of-Hospital Cardiac Arrest - A Sub-Study of the Xe-Hypotheca Trial

Author

Laitio, Timo, Koskensalo, Kalle, Virtanen, Sami, Saunavaara, Jani, Parkkola, Riitta, Laitio, Ruut, Arola, Olli, Hynninen, Marja, Silvasti, Päivi, Nukarinen, Eija, Martola, Juha, Silvennoinen, Heli M, Tiainen, Marjaana, Roine, Risto O, Scheinin, Harry, Maze, Mervyn, and Vahlberg, Tero

Subjects
Diffusion tensor imaging, 1H-MRS, cardiac arrest, prognostication
Published
2018

6. Inhaled Xenon Attenuates Myocardial Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest The Xe-Hypotheca Trial

Author

Arola, Olli, Saraste, Antti, Laitio, Ruut, Airaksinen, Juhani, Hynninen, Marja, Bäcklund, Minna, Ylikoski, Emmi, Wennervirta, Johanna, Pietilä, Mikko, Roine, Risto O, Harjola, Veli-Pekka, Niiranen, Jussi, Korpi, Kirsi, Varpula, Marjut, Scheinin, Harry, Maze, Mervyn, Vahlberg, Tero, Laitio, Timo, Group, Xe-HYPOTHECA Study, Virtanen, Sami, Parkkola, Riitta, Saunavaara, Jani, Martola, Juha, Silvennoinen, Heli, Tiainen, Marjaana, Grönlund, Juha, Inkinen, Outi, Silvasti, Päivi, Nukarinen, Eija, and Olkkola, Klaus T

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Heart Disease, Clinical Research, Cardiovascular, Heart Disease - Coronary Heart Disease, Administration, Inhalation, Aged, Cardiopulmonary Resuscitation, Coma, Female, Finland, Heart, Hemodynamics, Humans, Hypothermia, Induced, Intensive Care Units, Male, Middle Aged, Myocardium, Out-of-Hospital Cardiac Arrest, Percutaneous Coronary Intervention, Treatment Outcome, Troponin T, Xenon, cardioprotection, hypothermia, out-of-hospital cardiac arrest, xenon, Xe-HYPOTHECA Study Group, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BACKGROUND:The authors previously reported that inhaled xenon combined with hypothermia attenuates brain white matter injury in comatose survivors of out-of-hospital cardiac arrest (OHCA). OBJECTIVES:A pre-defined secondary objective was to assess the effect of inhaled xenon on myocardial ischemic damage in the same study population. METHODS:A total of 110 comatose patients who had experienced OHCA from a cardiac cause were randomized to receive either inhaled xenon (40% end-tidal concentration) combined with hypothermia (33°C) for 24 h (n = 55; xenon group) or hypothermia treatment alone (n = 55; control group). Troponin-T levels were measured at hospital admission, and at 24 h, 48 h, and 72 h post-cardiac arrest. All available cases were analyzed for troponin-T release. RESULTS:Troponin-T measurements were available from 54 xenon patients and 54 control patients. The baseline characteristics did not differ significantly between the groups. After adjustments for age, sex, study site, primary coronary percutaneous intervention (PCI), and norepinephrine dose, the mean ± SD post-arrival incremental change of the ln-transformed troponin-T at 72 h was 0.79 ± 1.54 in the xenon group and 1.56 ± 1.38 in the control group (adjusted mean difference -0.66; 95% confidence interval: -1.16 to -0.16; p = 0.01). The effect of xenon on the change in the troponin-T values did not differ in patients with or without PCI or in those with a diagnosis of ST-segment elevation myocardial infarction (group by PCI or ST-segment elevation myocardial infarction interaction effect; p = 0.86 and p = 0.71, respectively). CONCLUSIONS:Among comatose survivors of OHCA, in comparison with hypothermia alone, inhaled xenon combined with hypothermia suggested a less severe myocardial injury as demonstrated by the significantly reduced release of troponin-T.

Published
2017

8. Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial

Author

Laitio, Ruut, Hynninen, Marja, Arola, Olli, Virtanen, Sami, Parkkola, Riitta, Saunavaara, Jani, Roine, Risto O, Grönlund, Juha, Ylikoski, Emmi, Wennervirta, Johanna, Bäcklund, Minna, Silvasti, Päivi, Nukarinen, Eija, Tiainen, Marjaana, Saraste, Antti, Pietilä, Mikko, Airaksinen, Juhani, Valanne, Leena, Martola, Juha, Silvennoinen, Heli, Scheinin, Harry, Harjola, Veli-Pekka, Niiranen, Jussi, Korpi, Kirsi, Varpula, Marjut, Inkinen, Outi, Olkkola, Klaus T, Maze, Mervyn, Vahlberg, Tero, and Laitio, Timo

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Trials and Supportive Activities, Neurosciences, Rehabilitation, Clinical Research, Cardiovascular, Biomedical Imaging, Brain Disorders, Good Health and Well Being, Administration, Inhalation, Adult, Aged, Anisotropy, Cardiopulmonary Resuscitation, Coma, Diffusion Magnetic Resonance Imaging, Female, Finland, Humans, Hypothermia, Induced, Male, Middle Aged, Out-of-Hospital Cardiac Arrest, Single-Blind Method, Statistics, Nonparametric, Survival Analysis, Survivors, Time Factors, Treatment Outcome, White Matter, Xenon, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

ImportanceEvidence from preclinical models indicates that xenon gas can prevent the development of cerebral damage after acute global hypoxic-ischemic brain injury but, thus far, these putative neuroprotective properties have not been reported in human studies.ObjectiveTo determine the effect of inhaled xenon on ischemic white matter damage assessed with magnetic resonance imaging (MRI).Design, setting, and participantsA randomized single-blind phase 2 clinical drug trial conducted between August 2009 and March 2015 at 2 multipurpose intensive care units in Finland. One hundred ten comatose patients (aged 24-76 years) who had experienced out-of-hospital cardiac arrest were randomized.InterventionsPatients were randomly assigned to receive either inhaled xenon combined with hypothermia (33°C) for 24 hours (n = 55 in the xenon group) or hypothermia treatment alone (n = 55 in the control group).Main outcomes and measuresThe primary end point was cerebral white matter damage as evaluated by fractional anisotropy from diffusion tensor MRI scheduled to be performed between 36 and 52 hours after cardiac arrest. Secondary end points included neurological outcome assessed using the modified Rankin Scale (score 0 [no symptoms] through 6 [death]) and mortality at 6 months.ResultsAmong the 110 randomized patients (mean age, 61.5 years; 80 men [72.7%]), all completed the study. There were MRI data from 97 patients (88.2%) a median of 53 hours (interquartile range [IQR], 47-64 hours) after cardiac arrest. The mean global fractional anisotropy values were 0.433 (SD, 0.028) in the xenon group and 0.419 (SD, 0.033) in the control group. The age-, sex-, and site-adjusted mean global fractional anisotropy value was 3.8% higher (95% CI, 1.1%-6.4%) in the xenon group (adjusted mean difference, 0.016 [95% CI, 0.005-0.027], P = .006). At 6 months, 75 patients (68.2%) were alive. Secondary end points at 6 months did not reveal statistically significant differences between the groups. In ordinal analysis of the modified Rankin Scale, the median (IQR) value was 1 (1-6) in the xenon group and 1 (0-6) in the control group (median difference, 0 [95% CI, 0-0]; P = .68). The 6-month mortality rate was 27.3% (15/55) in the xenon group and 34.5% (19/55) in the control group (adjusted hazard ratio, 0.49 [95% CI, 0.23-1.01]; P = .053).Conclusions and relevanceAmong comatose survivors of out-of-hospital cardiac arrest, inhaled xenon combined with hypothermia compared with hypothermia alone resulted in less white matter damage as measured by fractional anisotropy of diffusion tensor MRI. However, there was no statistically significant difference in neurological outcomes or mortality at 6 months. These preliminary findings require further evaluation in an adequately powered clinical trial designed to assess clinical outcomes associated with inhaled xenon among survivors of out-of-hospital cardiac arrest.Trial registrationclinicaltrials.gov Identifier: NCT00879892.

Published
2016

9. A metabolic profile of xenon and metabolite associations with 6-month mortality after out-of-hospital cardiac arrest: A post-hoc study of the randomised Xe-Hypotheca trial.

Author

Nummela, Aleksi J., Scheinin, Harry, Perola, Markus, Joensuu, Anni, Laitio, Ruut, Arola, Olli, Grönlund, Juha, Roine, Risto O., Bäcklund, Minna, Vahlberg, Tero J., and Laitio, Timo

Subjects
CARDIAC arrest, NUCLEAR magnetic resonance spectroscopy, XENON, LACTATES, EXCITATORY amino acids, NEUROTRANSMITTERS, HDL cholesterol, AMINO acids
Abstract

Purpose: Out-of-hospital cardiac arrest (OHCA) carries a relatively poor prognosis and requires multimodal prognostication to guide clinical decisions. Identification of previously unrecognized metabolic routes associated with patient outcome may contribute to future biomarker discovery. In OHCA, inhaled xenon elicits neuro- and cardioprotection. However, the metabolic effects remain unknown. Materials and methods: In this post-hoc study of the randomised, 2-group, single-blind, phase 2 Xe-Hypotheca trial, 110 OHCA survivors were randomised 1:1 to receive targeted temperature management (TTM) at 33°C with or without inhaled xenon during 24 h. Blood samples for nuclear magnetic resonance spectroscopy metabolic profiling were drawn upon admission, at 24 and 72 h. Results: At 24 h, increased lactate, adjusted hazard-ratio 2.25, 95% CI [1.53; 3.30], p<0.001, and decreased branched-chain amino acids (BCAA) leucine 0.64 [0.5; 0.82], p = 0.007, and valine 0.37 [0.22; 0.63], p = 0.003, associated with 6-month mortality. At 72 h, increased lactate 2.77 [1.76; 4.36], p<0.001, and alanine 2.43 [1.56; 3.78], p = 0.001, and decreased small HDL cholesterol ester content (S-HDL-CE) 0.36 [0.19; 0.68], p = 0.021, associated with mortality. No difference was observed between xenon and control groups. Conclusions: In OHCA patients receiving TTM with or without xenon, high lactate and alanine and decreased BCAAs and S-HDL-CE associated with increased mortality. It remains to be established whether current observations on BCAAs, and possibly alanine and lactate, could reflect neural damage via their roles in the metabolism of the neurotransmitter glutamate. Xenon did not significantly alter the measured metabolic profile, a potentially beneficial attribute in the context of compromised ICU patients. Trial registration: Trial Registry number: ClinicalTrials.gov Identifier: NCT00879892. [ABSTRACT FROM AUTHOR]

Published
2024
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11. 24-hour ambulatory blood pressure and cryptogenic ischemic stroke in young adults.

Author

Tulkki, Lauri, Martinez-Majander, Nicolas, Haapalahti, Petri, Tolppanen, Heli, Sinisalo, Juha, Repo, Olli, Sarkanen, Tomi, Numminen, Heikki, Ryödi, Essi, Ylikotila, Pauli, Roine, Risto O., Lautamäki, Riikka, Saraste, Antti, Miettinen, Tuuli, Autere, Jaana, Jäkälä, Pekka, Hedman, Marja, Huhtakangas, Juha, Junttola, Ulla, and Putaala, Jukka

Subjects
ISCHEMIC stroke, BLOOD pressure, YOUNG adults, AMBULATORY blood pressure monitoring, DIASTOLIC blood pressure
Abstract

In young patients, up to 40% of ischemic strokes remain cryptogenic despite modern-day diagnostic work-up. There are limited data on blood pressure (BP) behavior in these patients. Thus, we aimed to compare ambulatory blood pressure (ABP) profiles between young patients with a recent cryptogenic ischemic stroke (CIS) and stroke-free controls. In this substudy of the international multicenter case–control study SECRETO (NCT01934725), 24-hour ambulatory blood pressure monitoring (ABPM) was performed in consecutive 18–49-year-old CIS patients and stroke-free controls. The inclusion criteria were met by 132 patients (median age, 41.9 years; 56.1% males) and 106 controls (41.9 years; 56.6% males). We assessed not only 24-hour, daytime, and nighttime ABP but also hypertension phenotypes and nocturnal dipping status. 24-hour and daytime ABP were higher among controls. After adjusting for relevant confounders, a non-dipping pattern of diastolic blood pressure (DBP) was associated with CIS in the entire sample (odds ratio, 3.85; 95% confidence interval, 1.20–12.42), in participants without antihypertensives (4.86; 1.07–22.02), and in participants without a patent foramen ovale (PFO) (7.37; 1.47–36.81). After excluding patients in the first tertile of the delay between the stroke and ABPM, a non-dipping pattern of DBP was not associated with CIS, but a non-dipping pattern of both systolic BP and DBP was (4.85; 1.37–17.10). In participants with a PFO and in those without hypertension by any definition, no associations between non-dipping patterns of BP and CIS emerged. Non-dipping patterns of BP were associated with CIS in the absence of a PFO but not in the absence of hypertension. This may reflect differing pathophysiology underlying CIS in patients with versus without a PFO. Due to limitations of the study, results regarding absolute ABP levels should be interpreted with caution. Nocturnal non-dipping patterns of blood pressure were associated with cryptogenic ischemic stroke except in participants with a patent foramen ovale and in those without hypertension by any definition, which may indicate differing pathophysiology underlying cryptogenic ischemic stroke in patients with and without a patent foramen ovale. It might be reasonable to include ambulatory blood pressure monitoring in the diagnostic work-up for young patients with ischemic stroke to detect not only the absolute ambulatory blood pressure levels but also their blood pressure behavior. [ABSTRACT FROM AUTHOR]

Published
2023
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12. 24-hour ambulatory blood pressure and cryptogenic ischemic stroke in young adults

Author

the SECRETO Study Group, Tulkki, Lauri, Martinez-Majander, Nicolas, Haapalahti, Petri, Tolppanen, Heli, Sinisalo, Juha, Repo, Olli, Sarkanen, Tomi, Numminen, Heikki, Ryödi, Essi, Ylikotila, Pauli, Roine, Risto O., Lautamäki, Riikka, Saraste, Antti, Miettinen, Tuuli, Autere, Jaana, Jäkälä, Pekka, Hedman, Marja, Huhtakangas, Juha, Junttola, Ulla, Putaala, Jukka, Pirinen, Jani, Tampere University, Clinical Medicine, Department of Neurosciences and Rehabilitation, and TAYS Heart Centre

Subjects
3126 Surgery, anesthesiology, intensive care, radiology, 3124 Neurology and psychiatry
Abstract

Background: In young patients, up to 40% of ischemic strokes remain cryptogenic despite modern-day diagnostic work-up. There are limited data on blood pressure (BP) behavior in these patients. Thus, we aimed to compare ambulatory blood pressure (ABP) profiles between young patients with a recent cryptogenic ischemic stroke (CIS) and stroke-free controls. Patients and Methods: In this substudy of the international multicenter case–control study SECRETO (NCT01934725), 24-hour ambulatory blood pressure monitoring (ABPM) was performed in consecutive 18–49-year-old CIS patients and stroke-free controls. The inclusion criteria were met by 132 patients (median age, 41.9 years; 56.1% males) and 106 controls (41.9 years; 56.6% males). We assessed not only 24-hour, daytime, and nighttime ABP but also hypertension phenotypes and nocturnal dipping status. Results: 24-hour and daytime ABP were higher among controls. After adjusting for relevant confounders, a non-dipping pattern of diastolic blood pressure (DBP) was associated with CIS in the entire sample (odds ratio, 3.85; 95% confidence interval, 1.20–12.42), in participants without antihypertensives (4.86; 1.07–22.02), and in participants without a patent foramen ovale (PFO) (7.37; 1.47–36.81). After excluding patients in the first tertile of the delay between the stroke and ABPM, a non-dipping pattern of DBP was not associated with CIS, but a non-dipping pattern of both systolic BP and DBP was (4.85; 1.37–17.10). In participants with a PFO and in those without hypertension by any definition, no associations between non-dipping patterns of BP and CIS emerged. Conclusions: Non-dipping patterns of BP were associated with CIS in the absence of a PFO but not in the absence of hypertension. This may reflect differing pathophysiology underlying CIS in patients with versus without a PFO. Due to limitations of the study, results regarding absolute ABP levels should be interpreted with caution.Key Messages Nocturnal non-dipping patterns of blood pressure were associated with cryptogenic ischemic stroke except in participants with a patent foramen ovale and in those without hypertension by any definition, which may indicate differing pathophysiology underlying cryptogenic ischemic stroke in patients with and without a patent foramen ovale. It might be reasonable to include ambulatory blood pressure monitoring in the diagnostic work-up for young patients with ischemic stroke to detect not only the absolute ambulatory blood pressure levels but also their blood pressure behavior. publishedVersion

Published
2023

13. Obesity and the Risk of Cryptogenic Ischemic Stroke in Young Adults

Author

the SECRETO Study Group, Jaakonmäki, Nina, Zedde, Marialuisa, Sarkanen, Tomi, Martinez-Majander, Nicolas, Tuohinen, Suvi, Sinisalo, Juha, Ryödi, Essi, Autere, Jaana, Hedman, Marja, Junttola, Ulla, Huhtakangas, Jaana K., Grimaldi, Teresa, Pascarella, Rosario, Nordanstig, Annika, Bech-Hanssen, Odd, Holbe, Christine, Busch, Raila, Fromm, Annette, Ylikotila, Pauli, Turgut, Esme Ekizoglu, Amorim, Isabel, Ryliskiene, Kristina, Tulkki, Lauri, Pascasio, Laura Amaya, Licenik, Radim, Ferdinand, Phillip, Tsivgoulis, Georgios, Jatužis, Dalius, Kõrv, Liisa, Kõrv, Janika, Pezzini, Alessandro, Fonseca, Ana Catarina, Yesilot, Nilufer, Roine, Risto O., Waje-Andreassen, Ulrike, von Sarnowski, Bettina, Redfors, Petra, Huhtakangas, Juha, Numminen, Heikki, Jäkälä, Pekka, Putaala, Jukka, Tampere University, Department of Neurosciences and Rehabilitation, Clinical Medicine, TAYS Heart Centre, HUS Neurocenter, Neurologian yksikkö, HUS Heart and Lung Center, Department of Medicine, Clinicum, University of Helsinki, Kardiologian yksikkö, Department of Neurosciences, and Repositório da Universidade de Lisboa

Subjects
Male, COUNTRIES, Migraine with Aura, SCREENING TOOL, Cryptogenic stroke, DISEASE, 3124 Neurology and psychiatry, Body Mass Index, Young Adult, Risk Factors, TO-HEIGHT RATIO, Humans, Prospective Studies, Obesity, cryptogenic stroke, ischemic stroke, obesity, waist-to-hip ratio, young adults, Ischemic stroke, Waist-Hip Ratio, Waist-to-hip ratio, Rehabilitation, 3112 Neurosciences, nutritional and metabolic diseases, PREVALENCE, ADIPOSE-TISSUE, Case-Control Studies, 3121 General medicine, internal medicine and other clinical medicine, &nbsp, Surgery, Female, Neurology (clinical), Waist Circumference, Cardiology and Cardiovascular Medicine, BURDEN, Young adults
Abstract

© 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), Objectives: We examined the association between obesity and early-onset cryptogenic ischemic stroke (CIS) and whether fat distribution or sex altered this association. Materials and methods: This prospective, multi-center, case-control study included 345 patients, aged 18-49 years, with first-ever, acute CIS. The control group included 345 age- and sex-matched stroke-free individuals. We measured height, weight, waist circumference, and hip circumference. Obesity metrics analyzed included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), and a body shape index (ABSI). Models were adjusted for age, level of education, vascular risk factors, and migraine with aura. Results: After adjusting for demographics, vascular risk factors, and migraine with aura, the highest tertile of WHR was associated with CIS (OR for highest versus lowest WHR tertile 2.81, 95%CI 1.43-5.51; P=0.003). In sex-specific analyses, WHR tertiles were not associated with CIS. However, using WHO WHR cutoff values (>0.85 for women, >0.90 for men), abdominally obese women were at increased risk of CIS (OR 2.09, 95%CI 1.02-4.27; P=0.045). After adjusting for confounders, WC, BMI, WSR, or ABSI were not associated with CIS. Conclusions: Abdominal obesity measured with WHR was an independent risk factor for CIS in young adults after rigorous adjustment for concomitant risk factors., The study was funded by the Helsinki and Uusimaa Hospital District, Academy of Finland, University of Helsinki, and Sahlgrenska University Hospital.

Published
2022

14. Atrial fibrillation after closure of patent foramen ovale in the REDUCE clinical study

Author

Andersen, Asger, Matzen, Kristina Laut, Andersen, Grethe, Settergren, Magnus, Sjostrand, Christina, Iversen, Helle K., Roine, Risto O., Hildick-Smith, David, Spence, J. David, Rhodes, John F., Kasner, Scott E., Sondergaard, Lars, Nielsen-Kudsk, Jens Erik, Andersen, Asger, Matzen, Kristina Laut, Andersen, Grethe, Settergren, Magnus, Sjostrand, Christina, Iversen, Helle K., Roine, Risto O., Hildick-Smith, David, Spence, J. David, Rhodes, John F., Kasner, Scott E., Sondergaard, Lars, and Nielsen-Kudsk, Jens Erik

Abstract

Objectives: To describe the occurrence of postprocedural atrial fibrillation (AF) among patients with cryptogenic stroke undergoing patent foramen ovale (PFO) closure in the REDUCE clinical study and analyze for potential risk factors for the development of postprocedural AF. Background: AF is an adverse event that might potentially counterbalance the stroke prevention benefit from PFO closure. Data on AF after transcatheter PFO closure are sparse. Methods: We evaluated data from patients having PFO closure (Gore HELEX or Gore Cardioform Septal Occluder) in the REDUCE clinical trial (n = 408) in at post hoc explorative analysis. Median follow-up was 5.0 years. Results: AF occurred in 30 patients (7.4%) after PFO closure with a total of 34 AF events. Most were reported as non-serious (68%), detected within 45 days post-procedure (79%), and resolved within 2 weeks of onset (63%). One subject with AF had recurrent stroke. Postprocedural AF occurred more frequently among subjects with higher age and large device sizes. Male sex was the only independent predictor of postprocedural AF. We found no association between the type of occluder (HELEX or Gore Cardioform Septal Occluder) or PFO anatomical characteristics and post-procedural AF. Conclusion: In the REDUCE clinical study, postprocedural atrial fibrillation was mostly early onset, transient and with no later recurrence. Postprocedural AF occurred more frequently among patients with higher age and larger devices. Male sex was the only independent predictor of postprocedural AF.

Published
2022

16. Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of ROCKET AF

Author

Hankey, Graeme J, Patel, Manesh R, Stevens, Susanna R, Becker, Richard C, Breithardt, Günter, Carolei, Antonio, Diener, Hans-Christoph, Donnan, Geoffrey A, Halperin, Jonathan L, Mahaffey, Kenneth W, Mas, Jean-Louis, Massaro, Ayrton, Norrving, Bo, Nessel, Christopher C, Paolini, John F, Roine, Risto O, Singer, Daniel E, Wong, Lawrence, Califf, Robert M, Fox, Keith AA, and Hacke, Werner

Published
2012
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17. List of Contributors

Author

Adams, Harold P., primary, El Ahmadieh, Tarek Y., additional, Albers, Gregory W., additional, Alexandrov, Andrei V., additional, Anrather, Josef, additional, Arai, Ken, additional, Aronowski, Jaroslaw (Jarek), additional, Auer, Roland N., additional, Awad, Issam A., additional, Ay, Hakan, additional, Baltan, Selva, additional, Batjer, Hunt H., additional, Benavente, Oscar R., additional, Bendok, Bernard R., additional, Bershad, Eric M., additional, Bonati, Leo H., additional, Bookland, Markus J., additional, Bousser, Marie-Germaine, additional, Braca, John A., additional, Broderick, Joseph P., additional, Brown, Martin M., additional, Brown, Wendy E., additional, Brust, John C.M., additional, Bushnell, Cheryl, additional, Bösel, Julian, additional, Canhão, Patrícia, additional, Caplan, Louis R., additional, Castellanos, Mar, additional, Chamorro, Angel, additional, Chandler, James P., additional, Chen, Jun, additional, Chopp, Michael, additional, Chrissobolis, Sophocles, additional, Chabriat, Hugues, additional, Cramer, Steven C., additional, Cucchiara, Brett L., additional, Dannenbaum, Mark J., additional, Davis, Patricia H., additional, Dawson, Ted M., additional, Dawson, Valina L., additional, Day, Arthur L., additional, del Zoppo, Gregory J., additional, Diener, Hans-Christoph, additional, Di Tullio, Marco R., additional, Dobkin, Bruce H., additional, Dzialowski, Imanuel, additional, Economos, Alexis, additional, Eddleman, Christopher S., additional, Elkind, Mitchell S.V., additional, Feigin, Valery L., additional, Ferro, José M., additional, Findlay, J. Max, additional, Furie, Karen L., additional, Fusco, Matthew R., additional, Field, Thalia S., additional, Geibprasert, Sasikhan, additional, Gensic, Anna P., additional, Gobin, Y. Pierre, additional, Goldberg, Mark P., additional, Goldstein, Larry B., additional, Gonzales, Nicole R., additional, Gounis, Matthew J., additional, Greenberg, Steven M., additional, Gregson, Barbara A., additional, Grotta, James C., additional, Gutierrez, Jose, additional, Hacke, Werner, additional, Hallenbeck, John M., additional, Haršány, Michal, additional, Heiferman, Daniel M., additional, Homma, Shunichi, additional, Howard, George, additional, Howard, Virginia J., additional, Hwang, Jee-Yeon, additional, Iadecola, Costantino, additional, Jahan, Reza, additional, Joutel, Anne, additional, Jüttler, Eric, additional, Kase, Carlos S., additional, Kasner, Scott E., additional, Katan, Mira, additional, Khader Eliyas, Javed, additional, Khan, Muhib, additional, Kim, Helen, additional, Kidwell, Chelsea S., additional, Kim, Jong S., additional, Krings, Timo, additional, Krishnamurthi, Rita, additional, Kurth, Tobias, additional, Lamy, Catherine, additional, Lansberg, Maarten G., additional, Levy, Elad I., additional, Liebeskind, David S., additional, Lo, Eng H., additional, Loftus, Christopher M., additional, Lyden, Patrick D., additional, Mas, Jean-Louis, additional, Massari, Francesco, additional, Meckler, Jason M., additional, Mendelow, A. David, additional, Meschia, James F., additional, Messé, Steven R., additional, Mitchel, Patrick, additional, Morgenstern, Lewis B., additional, Mokin, Maxim, additional, Moskowitz, Michael A., additional, Mullen, Michael T., additional, Nedergaard, Maiken, additional, Neugebauer, Hermann, additional, Newell, David W., additional, Norrving, Bo, additional, O'Donnell, Martin, additional, Ofengeim, Dimitry, additional, Ogata, Jun, additional, Ogilvy, Christopher S., additional, Pancioli, Arthur M., additional, Parsha, Kaushik, additional, Parsons, Mark W., additional, Pawlikowska, Ludmila, additional, Pérez, Adriana, additional, Perez-Pinzon, Miguel A., additional, Powers, William J., additional, Puetz, Volker, additional, Puri, Ajit S., additional, Ransom, Bruce R., additional, Roine, Risto O., additional, Rundek, Tatjana, additional, Russin, Jonathan J., additional, Sacco, Ralph L., additional, Spetzler, Robert F., additional, Sattenberg, Ronald J., additional, Saver, Jeffrey L., additional, Savitz, Sean I., additional, Schönenberger, Silvia, additional, Seshadri, Sudha, additional, Sharma, Vijay K., additional, Shi, Yejie, additional, Shoamanesh, Ashkan, additional, Silverboard, Gerald, additional, Singhal, Aneesh B., additional, Sobey, Christopher G., additional, Stapf, Christian, additional, Su, Hua, additional, Suarez, Jose I., additional, Sykora, Marek, additional, Tatlisumak, Turgut, additional, El Tecle, Najib, additional, terBrugge, Karel G., additional, Thompson, John W., additional, Tilley, Barbara C., additional, Tournier-Lasserve, Elisabeth, additional, Tsivgoulis, Georgios, additional, Vilela, Marcelo D., additional, von Kummer, Rüdiger, additional, Wakhloo, Ajay K., additional, Wagner, Kenneth R., additional, Warach, Steven, additional, Weksler, Babette B., additional, Werring, David, additional, Willey, Joshua Z., additional, Wintermark, Max, additional, Wolf, Philip A., additional, Wong, Lawrence K.S., additional, Woo, Daniel, additional, Wright, Clinton, additional, Xi, Guohua, additional, Yamaguchi, Takenori, additional, Yasaka, Masahiro, additional, Young, William L., additional, Zammar, Samer G., additional, Zahuranec, Darin B., additional, Zhang, Feng, additional, Zhang, Haiyue, additional, Zhang, John H., additional, Zhang, Zheng Gang, additional, Zukin, R. Suzzane, additional, and Zweifler, Richard M., additional

Published
2016
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22. Atrial fibrillation after closure of patent foramen ovale in the REDUCE clinical study

Author

Andersen, Asger, primary, Matzen, Kristina Laut, additional, Andersen, Grethe, additional, Settergren, Magnus, additional, Sjostrand, Christina, additional, Iversen, Helle K., additional, Roine, Risto O., additional, Hildick‐Smith, David, additional, Spence, J. David, additional, Rhodes, John F., additional, Kasner, Scott E., additional, Sondergaard, Lars, additional, and Nielsen‐Kudsk, Jens Erik, additional

Published
2021
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24. Eteisvärinää sairastavien potilaiden antikoagulaatiohoito ja palveluiden käyttö Suomessa

Author

Rissanen, Antti, Herse, Fredrik, Rossi, Jari, Säävuori, Niina, Roine, Risto O., Pakarinen, Sami, HUS Sydän- ja keuhkokeskus, and Lastentautien yksikkö

Subjects
+drug therapy, Brain Infarction, +economics, Primary Health Care, Office Visits, Pyridones, Anticoagulants, Cerebral Infarction, Comorbidity, Length of Stay, Home Care Services, Secondary Care, Drug Utilization, Dabigatran, 3121 Yleislääketiede, sisätaudit ja muut kliiniset lääketieteet, Rivaroxaban, Assisted Living Facilities, Atrial Fibrillation, +complications, Pyrazoles, Warfarin, Gastrointestinal Hemorrhage, Facilities and Services Utilization, Factor Xa Inhibitors
Abstract

Vertaisarvioitu. English summary. Lähtökohdat : Suoria antikoagulantteja ja varfariinia käytetään ei-läppäperäiseen eteisvärinään liittyvän aivohalvauksen estossa, mutta toistaiseksi eri antikoagulaatiolääkityksellä olevista suomalaisista potilaista on rajallisesti tosielämän tietoon perustuvia tutkimuksia. Menetelmät : utkimme rekisteritiedolla antikoagulaatiohoitoa saavien eteisvärinäpotilaiden palvelukäyttöä, lääkitystä sekä potilasprofiilia. Tarkastelimme lääkesegmenteittäin sosiaali- ja terveyspalvelujen käyttöä ja kustannuksia sekä aivotapahtumista ja ruoansulatuskanavan vuodoista johtuvia erikoissairaanhoidon ja ¬perusterveydenhuollon käyntejä ja hoitopäiviä potilailla, jotka olivat käyttäneet vähintään vuoden ¬samaa antikoagulanttia. Tulokset : Varfariinia ja apiksabaania määrätään keskimäärin vanhemmille ja korkeamman riskin potilaille kuin muita antikoagulantteja. Eteisvärinäpotilaiden yhteenlasketut sote-palveluiden kustannukset olivat vuonna 2018 noin 2 miljardia euroa. Haittatapahtumista aivoinfarktit ja aivotapahtumien jälkitilat aiheuttivat eteisvärinä¬potilaille eniten palvelukäyttöä. Päätelmät : Eteisvärinäpotilaiden hoidosta kertyy yhteiskunnalle suuria kustannuksia. Suoria antikoagulantteja ja varfariinia käyttävien potilaiden välillä on eroja potilasprofiilissa sekä palvelukäytössä ja sen kustannuksissa.

Published
2021

25. Patent Foramen Ovale Closure Decreases the Incidence but Not the Size of New Brain Infarction on Magnetic Resonance Imaging:An Analysis of the REDUCE Trial

Author

Messé, Steven R., Erus, Guray, Bilello, Michel, Davatzikos, Christos, Andersen, Grethe, Iversen, Helle K., Roine, Risto O., Sjöstrand, Christina, Rhodes, John F., Søndergaard, Lars, Kasner, Scott E., Messé, Steven R., Erus, Guray, Bilello, Michel, Davatzikos, Christos, Andersen, Grethe, Iversen, Helle K., Roine, Risto O., Sjöstrand, Christina, Rhodes, John F., Søndergaard, Lars, and Kasner, Scott E.

Abstract

Background and Purpose: Randomized patent foramen ovale closure trials have used open-label end point ascertainment which increases the risk of bias and undermines confidence in the conclusions. The Gore REDUCE trial prospectively performed baseline and follow-up magnetic resonance imaging (MRIs) for all subjects providing an objective measure of the effectiveness of closure. Methods: We performed blinded evaluations of the presence, location, and volume of new infarct on diffusion-weighted imaging of recurrent clinical stroke or new infarct (>3 mm) on T2/fluid attenuated inversion recovery from baseline to follow-up MRI at 2 years, comparing closure to medical therapy alone. We also examined the effect of shunt size and the development of atrial fibrillation on infarct burden at follow-up. Results: At follow-up, new clinical stroke or silent MRI infarct occurred in 18/383 (4.7%) patients who underwent closure and 19/177 (10.7%) medication-only patients (relative risk, 0.44 [95% CI, 0.24-0.81], P=0.02). Clinical strokes were less common in closure patients compared with medically treated patients, 5 (1.3%) versus 12 (6.8%), P=0.001, while silent MRI infarcts were similar, 13 (3.4%) versus 7 (4.0%), P=0.81. There were no differences in number, volumes, and distribution of new infarct comparing closure patients to those treated with medication alone. There were also no differences of number, volumes, and distribution comparing silent infarcts to clinical strokes. Infarct burden was also similar for patients who developed atrial fibrillation and for those with large shunts. Conclusions: The REDUCE trial demonstrates that patent foramen ovale closure prevents recurrent brain infarction based on the objective outcome of new infarcts on MRI. Only clinical strokes were reduced by closure while silent infarctions were similar between study arms, and there were no differences in infarct volume or location comparing silent infarcts to clinical strokes. Registration: URL

Published
2021

26. Five-Year Outcomes of PFO Closure or Antiplatelet Therapy for Cryptogenic Stroke

Author

Kasner, Scott E., Rhodes, John F., Andersen, Grethe, Iversen, Helle K., Nielsen-kudsk, Jens E., Settergren, Magnus, Sjöstrand, Christina, Roine, Risto O., Hildick-smith, David, Spence, J. David, Søndergaard, Lars, Kasner, Scott E., Rhodes, John F., Andersen, Grethe, Iversen, Helle K., Nielsen-kudsk, Jens E., Settergren, Magnus, Sjöstrand, Christina, Roine, Risto O., Hildick-smith, David, Spence, J. David, and Søndergaard, Lars

Published
2021

30. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage

Author

Steiner, Thorsten, Al-Shahi Salman, Rustam, Beer, Ronnie, Christensen, Hanne, Cordonnier, Charlotte, Csiba, Laszlo, Forsting, Michael, Harnof, Sagi, Klijn, Catharina J. M., Krieger, Derk, Mendelow, David A., Molina, Carlos, Montaner, Joan, Overgaard, Karsten, Petersson, Jesper, Roine, Risto O., Schmutzhard, Erich, Schwerdtfeger, Karsten, Stapf, Christian, Tatlisumak, Turgut, Thomas, Brenda M., Toni, Danilo, Unterberg, Andreas, and Wagner, Markus

Published
2014
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31. EuroHYP-1: European multicenter, randomized, phase III clinical trial of therapeutic hypothermia plus best medical treatment vs. best medical treatment alone for acute ischemic stroke

Author

van der Worp, Bart H., Macleod, Malcolm R., Bath, Philip M. W., Demotes, Jacques, Durand-Zaleski, Isabelle, Gebhardt, Bernd, Gluud, Christian, Kollmar, Rainer, Krieger, Derk W., Lees, Kennedy R., Molina, Carlos, Montaner, Joan, Roine, Risto O., Petersson, Jesper, Staykov, Dimitre, Szabo, Istvan, Wardlaw, Joanna M., and Schwab, Stefan

Published
2014
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32. Avoimen soikean aukon sulku aivoinfarktin sekundaaripreventiossa

Author

Sinisalo, Juha, Putaala, Jukka, Roine, Risto O., HUS Sydän- ja keuhkokeskus, Sisätautien osasto, Clinicum, Kardiologian yksikkö, Helsingin yliopisto, HUS Neurokeskus, Neurotieteiden osasto, and Neurologian yksikkö

Subjects
Brain Infarction, Atrial Septum, Patient Selection, 3126 Kirurgia, anestesiologia, tehohoito, radiologia, Anticoagulants, Foramen Ovale, Patent, Cerebral Infarction, +therapeutic use, Thromboembolism, +complications, Secondary Prevention, +prevention & control, +surgery, 3112 Neurotieteet, 3124 Neurologia ja psykiatria
Abstract

Teema : aivoinfarkti. English summary

Published
2020

33. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study

Author

Wahlgren, Nils, Ahmed, Niaz, Davalos, Antoni, Ford, Gary A., Grond, Martin, Hacke, Werner, Hennerici, Michael ., Kaste, Markku, Kuelkens, Sonja, Larrue, Vincent, Lees, Kennedy R., Roine, Risto O., Soinne, Lauri, Toni, Danilo, and Vanhooren, Geert

Subjects
Thrombolytic therapy -- Safety and security measures, Thrombolytic therapy -- Patient outcomes, Thrombolytic therapy -- Research, Stroke (Disease) -- Care and treatment, Tissue plasminogen activator -- Dosage and administration, Tissue plasminogen activator -- Research
Published
2007

35. Long-term outcome after intravenous thrombolysis of Basilar Artery Occlusion

Author

Lindsberg, Perttu J., Tatlisumak, Turgut, Kallela, Mikko, Kaste, Markku, Happola, Olli, Roine, Risto O., and Soinne, Lauri

Subjects
Basilar artery -- Care and treatment, Thrombolytic therapy -- Patient outcomes, Thrombolytic therapy -- Research
Abstract

Basilar artery occlusion is an infrequent disease with high morbidity and mortality. Outcome of patients with Basilar artery occlusion (BAO) treated with intravenous thrombolytic therapy is evaluated.

Published
2004

37. Contributors

Author

Abe, Takato, primary, Adams, Harold P., additional, Adeoye, Opeolu, additional, Agarwal, Sachin, additional, Aguilar, Maria I., additional, Al-Khoury, Lama, additional, Arboix, Adrià, additional, Auer, Roland N., additional, Awad, Issam A., additional, Baird, Alison E., additional, Baltan, Selva, additional, Barnett, Henry J.M., additional, Batjer, H. Hunt, additional, Benavente, Oscar R., additional, Bendok, Bernard R., additional, Bershad, Eric M., additional, Binder, Jeffrey R., additional, Boulos, Alan S., additional, Bousser, Marie-Germaine, additional, Bova, Frank J., additional, Brainin, Michael, additional, Brisman, Jonathan L., additional, Brown, Wendy, additional, Brust, John C.M., additional, Canhão, Patrícia, additional, Caplan, Louis R., additional, Castellanos, Mar, additional, Chabriat, Hugues, additional, Chamorro, Angel, additional, Choi, Jae H., additional, Chopp, Michael, additional, Connolly, E. Sander, additional, Coull, Bruce M., additional, Cucchiara, Brett L., additional, Dalkara, Turgay, additional, Dani, Krishna A., additional, Dannenbaum, Mark J., additional, Dashti, Shervin R., additional, Davis, Patricia H., additional, Dawson, Ted M., additional, Dawson, Valina L., additional, Day, Arthur L., additional, De Leo, Michael J., additional, del Zoppo, Gregory J., additional, Diedler, Jennifer, additional, Diener, Hans-Christoph, additional, Di Tullio, Marco R., additional, Dobkin, Bruce H., additional, Drake, Kendra, additional, Du, Rose, additional, Ducros, Anne, additional, Dzialowski, Imanuel, additional, Eddleman, Christopher S., additional, Elhammady, Mohamed Samy, additional, Elkind, Mitchell S.V., additional, Elliott, J. Paul, additional, Ferro, José M., additional, Findlay, J. Max, additional, Friedman, William A., additional, Furie, Karen L., additional, Furlan, Anthony J., additional, Geibprasert, Sasikhan, additional, Gobin, Y. Pierre, additional, Goldberg, Mark P., additional, Goldstein, Larry B., additional, Gonzales, Nicole R., additional, Gounis, Matthew J., additional, Greenberg, Steven M., additional, Greer, David M., additional, Grotta, James C., additional, Hacke, Werner, additional, Hallenbeck, John, additional, Hamann, Gerhard F., additional, Hartmann, Andreas, additional, Hennerici, Michael, additional, Heros, Roberto C., additional, Higashida, Randall, additional, Homma, Shunichi, additional, Hongo, Kazuhiro, additional, Hopkins, L. Nelson, additional, Horiuchi, Tetsuyoshi, additional, Howard, George, additional, Howard, Virginia J., additional, Huddle, Daniel, additional, Iadecola, Costantino, additional, Joutel, Anne, additional, Jüttler, Eric, additional, Kakarla, Udaya K., additional, Kalafut, Mary A., additional, Kannel, William B., additional, Kase, Carlos S., additional, Kasner, Scott E., additional, Kaste, Markku, additional, Khaw, Alexander, additional, Kidwell, Chelsea S., additional, Kim, Helen, additional, Kim, Louis J., additional, Kim, Stanley H., additional, Klijn, Catharina J.M. (Karin), additional, Kobayashi, Shigeaki, additional, Komotar, Ricardo J., additional, Krings, Timo, additional, Kunz, Alexander, additional, Kurth, Tobias, additional, Lamy, Catherine, additional, Lazar, Ronald M., additional, Levy, Elad I., additional, Liebeskind, David S., additional, Lyden, Patrick D., additional, Markham, Joanne, additional, Marshall, Randolph S., additional, Martí-Vilalta, J.L., additional, Mas, Jean-Louis, additional, Mast, Henning, additional, Masuda, Junichi, additional, Mathers, Colin D., additional, Mayberg, Marc R., additional, Meairs, Stephen, additional, Mendelow, Alexander David, additional, Meschia, James F., additional, Miller, Alyson A., additional, Miyawaki, Takahiro, additional, Mocco, J, additional, Mohr, J.P., additional, Morcos, Jacques J., additional, Morgenstern, Lewis B., additional, Moskowitz, Michael A., additional, Nahed, Brian V., additional, Newell, David W., additional, Ofengeim, Dimitry, additional, Ogata, Jun, additional, Ogilvy, Christopher S., additional, Palesch, Yuko Y., additional, Pancioli, Arthur, additional, Park, Min S., additional, Pawlikowska, Ludmila, additional, Pile-Spellman, John, additional, Powers, William J., additional, Puetz, Volker, additional, Ransom, Bruce R., additional, Roine, Risto O., additional, Ruigrok, Ynte M., additional, Rundek, Tatjana, additional, Sacco, Ralph L., additional, Sattenberg, Ronald J., additional, Saver, Jeffrey L., additional, Savitz, Sean I., additional, Seshadri, Sudha, additional, Sharma, Jitendra, additional, Silverboard, Gerald, additional, Singhal, Aneesh B., additional, Sobey, Christopher G., additional, Spetzler, Robert F., additional, Stapf, Christian, additional, Starke, Robert M., additional, Stiefel, Michael F., additional, Strong, Kathleen, additional, Suarez, José I., additional, Sykora, Marek, additional, Tafreshi, Gilda, additional, Brugge, Karel ter, additional, Tilley, Barbara C., additional, Toni, Danilo, additional, Tournier-Lasserve, Elisabeth, additional, Vilela, Marcelo D., additional, von Kummer, Rüdiger, additional, Wakhloo, Ajay K., additional, Warach, Steven, additional, Weksler, Babette B., additional, Willey, Joshua Z., additional, Wintermark, Max, additional, Wolf, Philip A., additional, Woo, Daniel, additional, Yamaguchi, Takenori, additional, Yasaka, Masahiro, additional, Young, William L., additional, Zahuranec, Darin B., additional, Zazulia, Allyson R., additional, Zhang, Zheng Gang, additional, Zukin, R. Suzanne, additional, and Zweifler, Richard M., additional

Published
2011
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39. European Research Priorities for Intracerebral Haemorrhage

Author

Steiner, Thorsten, Petersson, Jesper, Salman, Rustam Al-Shahi, Christensen, Hanne, Cordonnier, Charlotte, Csiba, Laszlo, Harnof, Sagi, Krieger, Derk, Mendelow, David, Molina, Carlos, Montaner, Joan, Overgaard, Karsten, Roine, Risto O., Schmutzhard, Erich, Tatlisumak, Turgut, Toni, Danilo, and Stapf, Christian

Published
2011
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42. Comparison of Prognostic Value of Early Phase 1H Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging With Neuron-Specific Enolase at 72 Hours in Comatose Survivors of Out-of-hospital Cardiac Arrest – A Sub-Study of the Xe-Hypotheca Trial

Author

Koskensalo, Kalle, primary, Virtanen, Sami, additional, Saunavaara, Jani, additional, Parkkola, Riitta, additional, Laitio, Ruut, additional, Arola, Olli, additional, Hynninen, Marja, additional, Silvasti, Päivi, additional, Nukarinen, Eija, additional, Martola, Juha, additional, Silvennoinen, Heli M, additional, Tiainen, Marjaana, additional, Roine, Risto O., additional, Scheinin, Harry, additional, Saraste, Antti, additional, Maze, Mervyn, additional, Vahlberg, Tero, additional, and Laitio, Timo, additional

Published
2020
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44. Abstract WMP110: Presence, Volume, and Location of New Ischemic Injury on MRI in Stroke Patients Who Undergo PFO Closure Compared to Patients Treated Medically: An Analysis of the REDUCE Trial

Author

Messe, Steven R, primary, Erus, Guray, additional, Bilello, Michel, additional, Davatzikos, Christos, additional, Andersen, Grethe, additional, Iversen, Helle, additional, Roine, Risto O, additional, Sjostrand, Christina, additional, Herrmann, Howard C, additional, Rhodes, John F, additional, Sondergaard, Lars, additional, and Kasner, Scott E, additional

Published
2020
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48. Contributors

Author

Acharya, Aninda B., primary, Adams, Harold P., additional, Al-Khoury, Lama, additional, Arboix, Adria, additional, Auer, Roland N., additional, Awad, Issam A., additional, Baird, Alison E., additional, Barnett, Henry J.M., additional, Benavente, Oscar, additional, Bendok, Bernard R., additional, Binder, Jeffrey R., additional, Bogousslavsky, Julien, additional, Boulos, Alan S., additional, Bousser, Marie-Germaine, additional, Brainin, Michael, additional, Brey, Robin L., additional, Broderick, Joseph P., additional, Brust, John C.M., additional, Calderone, Agata, additional, Caplan, Louis R., additional, Chabriat, H., additional, Chamorro, Angel, additional, Cho, Sunghee, additional, Choi, Dennis W., additional, Coull, Bruce M., additional, Cunningham, Edward J., additional, Dalkara, Turgay, additional, Davis, Patricia H., additional, Davis, Stephen M., additional, Dawson, Ted M., additional, Dawson, Valina L., additional, del Zoppo, Gregory J., additional, Diener, H.C., additional, Di Tullio, Marco R., additional, Dobkin, Bruce H., additional, Donnan, Geoffrey A., additional, Elkind, Mitchell S.V., additional, Elliott, J. Paul, additional, Erkinjuntti, Timo, additional, Faraci, Frank M., additional, Feuerstein, Giora, additional, Findlay, J. Max, additional, Fleetwood, Ian G., additional, Furie, Karen L., additional, Furlan, Anthony J., additional, Gautier, Jean Claude, additional, Georgiadis, Dimitrios, additional, Gobin, Y. Pierre, additional, Goldberg, Mark P., additional, Goldstein, Steven, additional, Greenberg, Steven M., additional, Grotta, James C., additional, Grubb, Robert L., additional, Guterman, Lee R., additional, Hacke, Werner, additional, Hallenbeck, John, additional, Hammann, Gerhard F., additional, Hartmann, Andreas, additional, Hashi, Kazuo, additional, Heistad, Donald D., additional, Hennerici, Michael, additional, Hernesniemi, Juha, additional, Hier, Daniel B., additional, Higashida, Randall T., additional, Homma, Shunichi, additional, Hongo, Kazuhiro, additional, Hopkins, L. Nelson, additional, Howard, George, additional, Howard, Virginia, additional, Huddle, Daniel, additional, Hupperts, Raymond M.M., additional, Iadecola, Costantino, additional, Infeld, Bernard, additional, Iyer, Sriram S., additional, Joutel, A., additional, Jover, Teresa, additional, Jungreis, Charles A., additional, Kalafut, Mary A., additional, Kase, Carlos S., additional, Kasner, Scott E., additional, Kaste, Markku, additional, Kidwell, Chelsea S., additional, Kim, Louis J., additional, Kim, Stanley H., additional, Kistler, J. Philip, additional, Kobayashi, Shigeaki, additional, Labiche, Lise A., additional, Lamy, Catherine, additional, Lau, C. Geoff, additional, Lawton, Michael T., additional, Lazar, Ronald M., additional, Lemole, G. Michael, additional, Le Roux, Peter D., additional, Levy, Elad I., additional, Lodder, Jan, additional, Lyden, Patrick D., additional, Ma, H., additional, Macdonald, R. Loch, additional, Maeder, Philippe, additional, Marchak, B. Elaine, additional, Markham, Joanne, additional, Marshall, Randolph S., additional, Marti-Vilalta, J.L., additional, Mas, Jean-Louis, additional, Mast, Henning, additional, Masuda, Junichi, additional, Mayberg, Marc R., additional, Meairs, Stephen, additional, Mendelow, Alexander David, additional, Mohr, J.P., additional, Morgenstern, Lewis B., additional, Moskowitz, Michael A., additional, Nitta, Junpei, additional, Ogata, Jun, additional, Oyelese, Adetokunbo A., additional, Palesch, Yuko Y., additional, Pancioli, Arthur M., additional, Parsa, Andrew T., additional, Piechowski-Jóźwiak, Bartlomiej, additional, Pile-Spellman, John, additional, Powers, William J., additional, Qureshi, Adnan I., additional, Ransom, Bruce R., additional, Riina, Howard A., additional, Roine, Risto O., additional, Ronkainen, Antti, additional, Roubin, Gary S., additional, Rundek, Tanja, additional, Sacco, Ralph L., additional, Sattenberg, Ronald J., additional, Saver, Jeffrey, additional, Schumacher, Herrmann-Christian, additional, Schwab, Stefan, additional, Sherman, David G., additional, Silverboard, Gerald, additional, Simionescu, Monica, additional, Sobey, Christopher G., additional, Solomon, Robert A., additional, Spetzler, Robert F., additional, Stapf, Christian, additional, Steinberg, Gary K., additional, Sudlow, Cathie, additional, Tilley, Barbara C., additional, Toni, Danilo, additional, Tournier-Lasserve, E., additional, Vahedi, K., additional, Vates, G. 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Published
2004
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50. Multivariable Analysis of Outcome Predictors and Adjustment of Main Outcome Results to Baseline Data Profile in Randomized Controlled Trials: Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy (SITS-MOST)

Author

Wahlgren, Nils, Ahmed, Niaz, Eriksson, Niclas, Aichner, Franz, Bluhmki, Erich, Dávalos, Antoni, Erilä, Terttu, Ford, Gary A., Grond, Martin, Hacke, Werner, Hennerici, Michael G., Kaste, Markku, Köhrmann, Martin, Larrue, Vincent, Lees, Kennedy R., Machnig, Thomas, Roine, Risto O., Toni, Danilo, and Vanhooren, Geert

Published
2008
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