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169 results on '"Scoditti, U."'

2. Mechanical thrombectomy in patients with heart failure: the Italian registry of Endovascular Treatment in Acute Stroke

Author

Gentile, L, Pracucci, G, Saia, V, Falcou, A, Biraschi, F, Zini, A, Simonetti, L, Riva, L, Bigliardi, G, Vallone, S, Nencini, P, Limbucci, N, Diomedi, M, Da Ros, V, Longoni, M, Ruggiero, M, Tassinari, T, Allegretti, L, Cerrato, P, Rubino, E, Bergui, M, Cavallo, R, Naldi, A, Comelli, C, Cappellari, M, Zivelonghi, C, Plebani, M, De Vito, A, Merli, N, Saletti, A, Musolino, Rf, Ferraù, L, Vinci, Sl, Sacco, S, Orlandi, B, De Santis, F, Filauri, P, Ruiz, L, Sepe, Fn, Gallesio, I, Petruzzellis, M, Chiumarulo, L, Sangalli, D, Salmaggi, A, Filizzolo, M, Moller, J, Melis, M, Comelli, S, Magoni, M, Gilberti, N, Gasparotti, R, Invernizzi, P, Pavia, M, Pinto, V, Laspada, S, Marcheselli, S, Ajello, D, Viaro, F, Baracchini, C, Causin, F, Giannini, N, Caselli, Mc, Mancuso, M, Cosottini, M, Scoditti, U, Menozzi, R, Russo, M, Amistá, P, Napoletano, R, Romano, Dg, Tassi, R, Bracco, S, Carimati, F, Versino, M, Giorgianni, A, De Boni, A, Fasano, A, Barbarini, L, Paladini, A, Franchini, E, Dall'Ora, E, Comai, A, Giovanni, F, Pedicelli, A, Sallustio, F, Casetta, I, Fainardi, E, Mangiafico, S, and Toni, D

Subjects
Left ventricular ejection fraction, Acute ischemic stroke, Heart failure, Mechanical thrombectomy, Settore MED/37 - Neuroradiologia, Settore MED/26
Published
2023

3. Sex-related characteristics of cerebral vein thrombosis: A secondary analysis of a multicenter international cohort study

Author

Porceddu, E, Rezoagli, E, Poli, D, Magliocca, A, Scoditti, U, Di Minno, M, De Stefano, V, Siragusa, S, Ageno, W, Dentali, F, Porceddu E., Rezoagli E., Poli D., Magliocca A., Scoditti U., Di Minno M. N. D., De Stefano V., Siragusa S., Ageno W., Dentali F., Porceddu, E, Rezoagli, E, Poli, D, Magliocca, A, Scoditti, U, Di Minno, M, De Stefano, V, Siragusa, S, Ageno, W, Dentali, F, Porceddu E., Rezoagli E., Poli D., Magliocca A., Scoditti U., Di Minno M. N. D., De Stefano V., Siragusa S., Ageno W., and Dentali F.

Published
2020

4. Long‐term outcomes of patients with cerebral vein thrombosis: a multicenter study

Author

DENTALI, F., POLI, D., SCODITTI, U., MINNO, M. N. D. DI, STEFANO, V.D., SIRAGUSA, S., KOSTAL, M., PALARETI, G., SARTORI, M.T., GRANDONE, E., VEDOVATI, M.C., AGENO, W., Falanga, Anna, Lerede, Teresa, Bianchi, Marina, Testa, Sophie, Witt, Dan, McCool, Katie, Bucherini, Eugenio, Grifoni, Elisa, Coalizzo, Daniela, Benedetti, Raffaella, Marietta, Marco, Sessa, Maria, Guaschino, Clara, di Minno, Giovanni, Tufano, Antonella, Barbar, Sofia, Malato, Alessandra, Pini, Mario, Castellini, Paola, Barco, Stefano, Barone, Marisa, Paciaroni, Maurizio, Alberti, Andrea, Agnelli, Giancarlo, Giorgi Pierfranceschi, Matteo, Dulicek, Petr, Silingardi, Mauro, Federica, Landini, Ghirarduzzi, Angelo, Tiraferri, Eros, di Lazzaro, Vincenzo, Rossi, Elena, Ciminello, Angela, Pasca, Samantha, Barillari, Giovanni, Rezoagli, Emanuele, Galli, Matteo, Squizzato, Alessandro, and Tosetto, Alberto

Published
2012
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5. Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke

Author

Sallustio, Fabrizio, Pracucci, Giovanni, Cappellari, Manuel, Saia, Valentina, Mascolo, Alfredo Paolo, Marrama, Federico, Gandini, Roberto, Koch, Giacomo, Diomedi, Marina, D’Agostino, Federica, Rocco, Alessandro, Da Ros, Valerio, Wlderk, Andrea, Nezzo, Marco, Argirò, Renato, Morosetti, Daniele, Renieri, Leonardo, Nencini, Patrizia, Vallone, Stefano, Zini, Andrea, Bigliardi, Guido, Pitrone, Antonio, Grillo, Francesco, Bracco, Sandra, Tassi, Rossana, Bergui, Mauro, Naldi, Andrea, Carità, Giuseppe, Casetta, Ilaria, Gasparotti, Roberto, Magoni, Mauro, Simonetti, Luigi, Haznedari, Nicolò, Paolucci, Matteo, Mavilio, Nicola, Malfatto, Laura, Menozzi, Roberto, Genovese, Antonio, Cosottini, Mirco, Orlandi, Giovanni, Comai, Alessio, Franchini, Enrica, Pedicelli, Alessandro, Frisullo, Giovanni, Puglielli, Edoardo, Casalena, Alfonsina, Cester, Giacomo, Baracchini, Claudio, Castellano, Davide, Di Liberto, Alessandra, Ricciardi, Giuseppe Kenneth, Chiumarulo, Luigi, Petruzzellis, Marco, Lafe, Elvis, Persico, Alessandra, Cavasin, Nicola, Critelli, Adriana, Semeraro, Vittorio, Tinelli, Angelica, Giorgianni, Andrea, Carimati, Federico, Auteri, William, Rizzuto, Stefano, Biraschi, Francesco, Nicolini, Ettore, Ferrari, Antonio, Melis, Maurizio, Calia, Stefano, Tassinari, Tiziana, Nuzzi, Nunzio Paolo, Corato, Manuel, Sacco, Simona, Squassina, Guido, Invernizzi, Paolo, Gallesio, Ivan, Ruiz, Luigi, Dui, Giovanni, Carboni, Nicola, Amistà, Pietro, Russo, Monia, Maiore, Mario, Zanda, Bastianina, Craparo, Giuseppe, Mannino, Marina, Inzitari, Domenico, Toni, Danilo, Mangiafico, Salvatore, Gasparotti, R., Inzitari, D., Mangiafico, S., Toni, D., Vallone, S., Zini, A., Bergui, M., Causin, F., Ciccone, A., Nencini, P., Saletti, A., Sallustio, F., Tassi, R., Thyrion, F. Zappoli, Pracucci, G., Saia, V., Gandini, R., Da Ros, V., Greco, L., Morosetti, D., Diomedi, M., Nappini, S., Limbucci, N., Renieri, L., Fainardi, E., Verganti, L., Sacchetti, F., Zelent, G., Bigliardi, G., Dell’Acqua, M. L., Picchetto, L., Vandelli, L., Pentore, R., Maffei, S., Nichelli, P., Longo, M., Pitrone, A., Vinci, S. L., Velo, M., Caragliano, A., Tessitore, A., Bonomo, O., Musolino, R., La Spina, P., Casella, C., Fazio, M. C., Grillo, F., Cotroneo, M., Dell’Aera, C., Francalanza, I., Bracco, S., Cioni, S., Gennari, P., Vallone, I. M., Cerase, A., Martini, G., Stura, G., Daniele, D., Cerrato, P., Naldi, A., Onofrio, M., De Vito, A., Azzini, C., Casetta, I., Mardighian, D., Frigerio, M., Magoni, M., Costa, A., Simonetti, L., Cirillo, L., Taglialatela, F., Isceri, S., Princiotta, C., Dall’Olio, M., Cellerini, M., Gentile, M., Piccolo, L., Migliaccio, L., Brancaleoni, L., Naldi, F., Romoli, M., Zaniboni, A., Ruggiero, M., Sanna, A., Haznedari, N., Commodaro, C., Longoni, M., Biguzzi, S., Cordici, F., Malatesta, E., Castellan, L., Mavilio, N., Salsano, G., Malfatto, L., Finocchi, C., Menozzi, R., Piazza, P., Epifani, E., Andreone, A., Scoditti, U., Castellini, P., Latte, L., Grisendi, I., Cosottini, M., Puglioli, M., Lazzarotti, G., Lauretti, D., Mancuso, M., Giannini, N., Maccarone, M., Orlandi, G., Comai, A., Bonatti, G., Nano, G., Ferro, F., Bonatti, M., Dall’Ora, E., Dossi, R. Currò, Turri, E., Turri, M., Colosimo, C., Pedicelli, A., D’Argento, F., Alexandre, A., Frisullo, G., Di Egidio, V., Puglielli, E. G., Ruggero, L., Assetta, M., Casalena, A., Cester, G., Baracchini, C., Viaro, F., Pieroni, A., Vaudano, G., Comelli, C., Di Maggio, L., Castellano, D., Cavallo, R., Duc, E., Chianale, G., Ciceri, E. F. M., Plebani, M., Augelli, R., Zampieri, P., Grazioli, A., Cappellari, M., Forlivesi, S., Tomelleri, G., Micheletti, N., Chiumarulo, L., Zimatore, D. S., Federico, F., Petruzzelli, M., Zappoli, F., Lafe, E., Sanfilippo, G., Sgreccia, A., Martignoni, A., Cavallini, A., Denaro, F., Persico, A., Cagliari, E., Cavasin, N., Quatrale, R., Critelli, A., Burdi, N., Semeraro, V., Lucarelli, N., Ganimede, M. P., Internò, S., Tinelli, A., Prontera, M. P., Pesare, A., Cotroneo, E., Pampana, E., Ricciardi, F., Gigli, R., Pezzella, F. R., Corsi, F., Giorgianni, A., Baruzzi, F., Pellegrino, C., Terrana, A., Versino, M., Delodovici, M. L., Carimati, F., Cariddi, L. Princiotta, Auteri, W., Di Benedetto, O., Silvagni, U., Perrotta, P., Crispino, E., Petrone, A., Stancati, F., Rizzuto, S., Pugliese, P., Pisani, E., Siniscalchi, A., Gaudiano, C., Pirritano, D., Del Giudice, F., Piano, M., Agostoni, E., Motto, C., Gatti, A., Guccione, A., Tortorella, R., Stecco, A., Guzzardi, G., Del Sette, B., Coppo, L., Baldan, J., Romano, D., Siani, A., Locatelli, G., Saponiero, R., Napolitano, R., De Gregorio, M., Volpe, G., Tenuta, M., Guidetti, G., Biraschi, F., Wulbek, A., Falcou, A., Anzini, A., Mancini, A., De Michele, M., Fausti, S., Di Mascio, M. T., Durastanti, L., Sbardella, E., Mellina, V., Nicolini, E., Comelli, S., Ganau, C., Corraine, S., Fusaro, F., Ferrari, A., Schirru, F., Ledda, V., Secci, S., Melis, M., Piras, V., Moller, J., Padolecchia, R., Allegretti, L., Caldiera, V., Calia, S., Ganci, G., Tassinari, T., Sugo, A., De Nicola, M., Giannoni, M., Bruni, S., Gambelli, E., Provinciali, L., Nuzzi, N. P., Marcheselli, S., Corato, M., Scomazzoni, F., Simionato, F., Roveri, L., Filauri, P., Sacco, S., Orlandi, B., De Santis, F., Tiseo, C., Notturno, F., Ornello, R., Pavia, M., Squassina, G., Cobelli, M., Morassi, M., Magni, E., Invernizzi, P., Pepe, F., Bigni, B., Costa, P., Crabbio, M., Griffini, S., Palmerini, F., Piras, M. P., Gallesio, I., Barbero, S., Ferrandi, D., Dui, G., Fancello, M. C., Zedda, S., Ticca, A., Saddi, M. V., Deiana, G., Rossi, R., Carboni, N., Mela, A., Amistà, P., Russo, M., Iannucci, G., Pinna, V., Di Clemente, L., Santi, M., De Boni, A., De Luca, C., Natrella, M., Fanelli, G., Cristoferi, M., Bottacchi, E., Corso, G., Tosi, P., Sessa, M., Giossi, A., Baietti, Null, Romano, G., Meineri, P., Armentano, A., Versace, P., Arcudi, L., Galvano, G., Petralia, B., Feraco, P., Luppi, G., Giometto, B., Bignamini, V., Piffer, S., Meloni, G. B., Fabio, C., Maiore, M., Pintus, F., Pischedda, A., Manca, A., Mongili, C., Zanda, B., Baule, A., Florio, F., Ciccarese, G., Leone, M., Di Viesti, P., Pappalardo, M. P., Craparo, G., Gallo, C., Monaco, S., Mannino, M., Muto, M., Guarnieri, Gl., Andreone, V., Passalacqua, G., Allegritti, M., Caproni, S., Filizzolo, M., Salmaggi, A., Giordano, A., Marini, C., Frattale, I., Lucente, G., Nozzoli, C., and Lupo, F. A.

Subjects
Stent, Acute stroke, Settore MED/37 - Neuroradiologia, Acute stroke Internal carotid artery diseases Stent Thrombectomy, Neurology (clinical), General Medicine, Settore MED/26, Internal carotid artery diseases, Thrombectomy
Abstract

The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

Published
2022

6. Oral anticoagulants in the oldest old with recent stroke and atrial fibrillation

Author

Polymeris, A. A., Macha, K., Paciaroni, M., Wilson, D., Koga, M., Cappellari, M., Schaedelin, S., Zietz, A., Peters, N., Seiffge, D. J., Haupenthal, D., Gassmann, L., De Marchis, G. M., Wang, R., Gensicke, H., Stoll, S., Thilemann, S., Avramiotis, N. S., Bonetti, B., Tsivgoulis, G., Ambler, G., Alberti, A., Yoshimura, S., Brown, M. M., Shiozawa, M., Lip, G. Y. H., Venti, M., Acciarresi, M., Tanaka, K., Mosconi, M. G., Takagi, M., Jager, R. H., Muir, K., Inoue, M., Schwab, S., Bonati, L. H., Lyrer, P. A., Toyoda, K., Caso, V., Werring, D. J., Kallmunzer, B., Engelter, S. T., Traenka, C., Hert, L., Wagner, B., Schaub, F., Meya, L., Fladt, J., Dittrich, T., Fisch, U., Volbers, B., Siedler, G., Bovi, P., Tomelleri, G., Micheletti, N., Zivelonghi, C., Emiliani, A., Parry-Jones, A., Patterson, C., Price, C., Elmarimi, A., Parry, A., Nallasivam, A., Nor, A. M., Esis, B., Bruce, D., Bhaskaran, B., Roffe, C., Cullen, C., Holmes, C., Cohen, D., Hargroves, D., Mangion, D., Chadha, D., Vahidassr, D., Manawadu, D., Giallombardo, E., Warburton, E., Flossman, E., Gunathilagan, G., Proschel, H., Emsley, H., Anwar, I., Burger, I., Okwera, J., Putterill, J., O'Connell, J., Bamford, J., Corrigan, J., Scott, J., Birns, J., Kee, K., Saastamoinen, K., Pasco, K., Dani, K., Sekaran, L., Choy, L., Iveson, L., Mamun, M., Sajid, M., Cooper, M., Burn, M., Smith, M., Power, M., Davis, M., Smyth, N., Veltkamp, R., Sharma, P., Guyler, P., O'Mahony, P., Wilkinson, P., Datta, P., Aghoram, P., Marsh, R., Luder, R., Meenakishundaram, S., Subramonian, S., Leach, S., Ispoglou, S., Andole, S., England, T., Manoj, A., Harrington, F., Rehman, H., Sword, J., Staals, J., Mahawish, K., Harkness, K., Shaw, L., Mccormich, M., Sprigg, N., Mansoor, S., Krishnamurthy, V., Giustozzi, M., Agnelli, G., Becattini, C., D'Amore, C., Cimini, L. A., Bandini, F., Liantinioti, C., Chondrogianni, M., Yaghi, S., Furie, K. L., Tadi, P., Zedde, M., Abdul-Rahim, A. H., Lees, K. R., Carletti, M., Rigatelli, A., Putaala, J., Tomppo, L., Tatlisumak, T., Marcheselli, S., Pezzini, A., Poli, L., Padovani, A., Vannucchi, V., Masotti, L., Sohn, S. -I., Lorenzini, G., Tassi, R., Guideri, F., Acampa, M., Martini, G., Ntaios, G., Athanasakis, G., Makaritsis, K., Karagkiozi, E., Vadikolias, K., Mumoli, N., Galati, F., Sacco, S., Tiseo, C., Corea, F., Ageno, W., Bellesini, M., Colombo, G., Silvestrelli, G., Ciccone, A., Lanari, A., Scoditti, U., Denti, L., Mancuso, M., Maccarrone, M., Ulivi, L., Orlandi, G., Giannini, N., Tassinari, T., De Lodovici, M. L., Rueckert, C., Baldi, A., Toni, D., Letteri, F., Pieroni, A., Giuntini, M., Lotti, E. M., Flomin, Y., Kargiotis, O., Karapanayiotides, T., Monaco, S., Baronello, M. M., Csiba, L., Szabo, L., Chiti, A., Giorli, E., Del Sette, M., Imberti, D., Zabzuni, D., Doronin, B., Volodina, V., Michel, P., Vanacker, P., Barlinn, K., Pallesen, L. -P., Barlinn, J., Deleu, D., Melikyan, G., Ibrahim, F., Akhtar, N., Gourbali, V., Todo, K., Kimura, K., Shibazaki, K., Yagita, Y., Furui, E., Itabashi, R., Terasaki, T., Shiokawa, Y., Hirano, T., Suzuki, R., Kamiyama, K., Nakagawara, J., Takizawa, S., Homma, K., Okuda, S., Okada, Y., Maeda, K., Kameda, T., Kario, K., Nagakane, Y., Hasegawa, Y., Akiyama, H., Shibuya, S., Mochizuki, H., Ito, Y., Nakashima, T., Matsuoka, H., Takamatsu, K., Nishiyama, K., Endo, K., Miyagi, T., Osaki, M., Kobayashi, J., Okata, T., Tanaka, E., Sakamoto, Y., Tokunaga, K., Takizawa, H., Takasugi, J., Matsubara, S., Higashida, K., Matsuki, T., Kinoshita, N., Ide, T., Yoshimoto, T., Ando, D., Fujita, K., Kumamoto, M., Kamimura, T., Kikuno, M., Mizoguchi, T., and Sato, T.

Subjects
Male, medicine.medical_specialty, Vitamin K, medicine.drug_class, 610 Medicine & health, Aged, 80 and over, Atrial Fibrillation, Factor Xa Inhibitors, Female, Humans, Stroke, Continuous variable, Internal medicine, 80 and over, medicine, Aged, Proportional hazards model, business.industry, Anticoagulant, Confounding, Atrial fibrillation, Patient data, medicine.disease, Oldest old, Neurology, Neurology (clinical), 610 Medizin und Gesundheit, business
Abstract

Objective: To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Methods: Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (≥85y = 0.65, 95%-CI [0.52, 0.81]) and < 85 years (HR = 0.79, 95%-CI [0.66, 0.95]) in simple (p interaction = 0.129), adjusted (p interaction = 0.094) or weighted (p interaction = 0.512) models. Analyses on recurrent stroke, ICH and death separately were consistent with the primary analysis, as were sensitivity analyses using age dichotomized at 90 years and as a continuous variable. DOAC had a similar net clinical benefit in patients aged ≥85 (+1.73 to +2.66) and < 85 years (+1.90 to +3.36 events/100 patient-years for ICH-weights 1.5 to 3.1). Interpretation: The favorable profile of DOAC over VKA in patients with AF and recent stroke was maintained in the oldest old. ANN NEUROL 2021.

Published
2022

7. Oral Anticoagulants in the Oldest Old with Recent Stroke and Atrial Fibrillation

Author

Polymeris, A.A. Macha, K. Paciaroni, M. Wilson, D. Koga, M. Cappellari, M. Schaedelin, S. Zietz, A. Peters, N. Seiffge, D.J. Haupenthal, D. Gassmann, L. De Marchis, G.M. Wang, R. Gensicke, H. Stoll, S. Thilemann, S. Avramiotis, N.S. Bonetti, B. Tsivgoulis, G. Ambler, G. Alberti, A. Yoshimura, S. Brown, M.M. Shiozawa, M. Lip, G.Y.H. Venti, M. Acciarresi, M. Tanaka, K. Mosconi, M.G. Takagi, M. Jäger, R.H. Muir, K. Inoue, M. Schwab, S. Bonati, L.H. Lyrer, P.A. Toyoda, K. Caso, V. Werring, D.J. Kallmünzer, B. Engelter, S.T. Engelter, S.T. Lyrer, P.A. Bonati, L.H. Seiffge, D.J. Traenka, C. Polymeris, A.A. Zietz, A. Peters, N. De Marchis, G.M. Thilemann, S. Avramiotis, N.S. Gensicke, H. Hert, L. Wagner, B. Schaub, F. Meya, L. Fladt, J. Dittrich, T. Fisch, U. Macha, K. Haupenthal, D. Gassmann, L. Wang, R. Stoll, S. Schwab, S. Volbers, B. Siedler, G. Kallmünzer, B. Cappellari, M. Bonetti, B. Bovi, P. Tomelleri, G. Micheletti, N. Zivelonghi, C. Emiliani, A. Parry-Jones, A. Patterson, C. Price, C. Elmarimi, A. Parry, A. Nallasivam, A. Nor, A.M. Esis, B. Bruce, D. Bhaskaran, B. Roffe, C. Cullen, C. Holmes, C. Cohen, D. Hargroves, D. Mangion, D. Chadha, D. Vahidassr, D. Manawadu, D. Giallombardo, E. Warburton, E. Flossman, E. Gunathilagan, G. Proschel, H. Emsley, H. Anwar, I. Burger, I. Okwera, J. Putterill, J. O’Connell, J. Bamford, J. Corrigan, J. Scott, J. Birns, J. Kee, K. Saastamoinen, K. Pasco, K. Dani, K. Sekaran, L. Choy, L. Iveson, L. Mamun, M. Sajid, M. Cooper, M. Burn, M. Smith, M. Power, M. Davis, M. Smyth, N. Veltkamp, R. Sharma, P. Guyler, P. O’Mahony, P. Wilkinson, P. Datta, P. Aghoram, P. Marsh, R. Luder, R. Meenakishundaram, S. Subramonian, S. Leach, S. Ispoglou, S. Andole, S. England, T. Manoj, A. Harrington, F. Rehman, H. Sword, J. Staals, J. Mahawish, K. Harkness, K. Shaw, L. McCormich, M. Sprigg, N. Mansoor, S. Krishnamurthy, V. Giustozzi, M. Acciarresi, M. Agnelli, G. Becattini, C. Alberti, A. D’Amore, C. Cimini, L.A. Bandini, F. Tsivgoulis, G. Liantinioti, C. Chondrogianni, M. Yaghi, S. Furie, K.L. Tadi, P. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Vannucchi, V. Masotti, L. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Mumoli, N. Galati, F. Sacco, S. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Colombo, G. Silvestrelli, G. Ciccone, A. Lanari, A. Scoditti, U. Denti, L. Mancuso, M. Maccarrone, M. Ulivi, L. Orlandi, G. Giannini, N. Tassinari, T. De Lodovici, M.L. Rueckert, C. Baldi, A. Toni, D. Letteri, F. Pieroni, A. Giuntini, M. Lotti, E.M. Flomin, Y. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Pallesen, L.-P. Barlinn, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Todo, K. Kimura, K. Shibazaki, K. Yagita, Y. Furui, E. Itabashi, R. Terasaki, T. Shiokawa, Y. Hirano, T. Suzuki, R. Kamiyama, K. Nakagawara, J. Takizawa, S. Homma, K. Okuda, S. Okada, Y. Maeda, K. Kameda, T. Kario, K. Nagakane, Y. Hasegawa, Y. Akiyama, H. Shibuya, S. Mochizuki, H. Ito, Y. Nakashima, T. Matsuoka, H. Takamatsu, K. Nishiyama, K. Tanaka, K. Endo, K. Miyagi, T. Osaki, M. Kobayashi, J. Okata, T. Tanaka, E. Sakamoto, Y. Tokunaga, K. Takizawa, H. Takasugi, J. Matsubara, S. Higashida, K. Matsuki, T. Kinoshita, N. Shiozawa, M. Ide, T. Yoshimoto, T. Ando, D. Fujita, K. Kumamoto, M. Kamimura, T. Kikuno, M. Mizoguchi, T. Sato, T. NOACISP-LONGTERM, Erlangen Registry, CROMIS-2, RAF, RAF-DOAC, SAMURAI-NVAF Verona Registry Collaborators

Abstract

Objective: To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Methods: Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (

Published
2022

8. The effect of recanalization on long-term neurological outcome after cerebral venous thrombosis

Author

Rezoagli, E, Martinelli, I, Poli, D, Scoditti, U, Passamonti, S, Bucciarelli, P, Ageno, W, Dentali, F, Rezoagli E., Martinelli I., Poli D., Scoditti U., Passamonti S. M., Bucciarelli P., Ageno W., Dentali F., Rezoagli, E, Martinelli, I, Poli, D, Scoditti, U, Passamonti, S, Bucciarelli, P, Ageno, W, Dentali, F, Rezoagli E., Martinelli I., Poli D., Scoditti U., Passamonti S. M., Bucciarelli P., Ageno W., and Dentali F.

Abstract

Essentials The role of cerebral venous thrombosis (CVT) recanalization on neurologic outcome is still debated. We studied a large cohort of 508 CVT patients with 419 patient years of radiological follow-up. Recanalization rate is high during the first months after CVT and neurologic outcome is favorable. High recanalization grade of CVT independently predicts good neurological outcome. Summary: Background Studies with limited sample size and with discordant results described the recanalization time-course of cerebral venous thrombosis (CVT). The neurological outcome after a first episode of CVT is good, but the role of recanalization on neurological dependence is still debated. Objectives The aim of the study is to assess the recanalization rate after cerebral venous thrombosis (CVT) and its prognostic role in long-term neurological outcome. Patients/Methods In a retrospective observational multicenter cohort study, patients with an acute first episode of CVT with at least one available imaging test during follow-up were enrolled. Patency status of the vessels was categorized as complete, partial or not recanalized. Neurological outcome was defined using the modified Rankin scale (mRS) as good (mRS = 0–1) or poor (mRS = 2–6). Results Five-hundred and eight patients (median [IQR] age, 39 [28.5–49] years; 26% male) were included. Complete or partial recanalization was not differently represented in patients undergoing scans at different periods of time (from 28-day to 3 month-period up to a 1–3 year-period). mRS at the time of follow-up imaging was available in 483 patients; 92.8% of them had a mRS of 0-1. CVT recanalization (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.59–4.13) was positively associated, whereas cancer (OR, 0.29; 95% CI, 0.09–0.88), and personal history of venous thromboembolism (VTE) (OR, 0.36; 95% CI, 0.14–0.92) were negatively associated as independent predictors of favorable (mRS = 0–1) outcome at follow-up. Conclusions Most patients wi

Published
2018

9. Safety of Anticoagulation in Patients Treated with Urgent Reperfusion for Ischemic Stroke Related to Atrial Fibrillation

Author

Giustozzi, M. Acciarresi, M. Agnelli, G. Caso, V. Bandini, F. Tsivgoulis, G. Yaghi, S. Furie, K.L. Tadi, P. Becattini, C. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. D'Amore, C. Giulia Mosconi, M. Anna Cimini, L. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Liantinioti, C. Theodorou, A. Halvatsiotis, P. Mumoli, N. Galati, F. Sacco, S. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Silvestrelli, G. Ciccone, A. Lanari, A. Scoditti, U. Denti, L. Mancuso, M. Ferrari, E. Ulivi, L. Orlandi, G. Giannini, N. Tassinari, T. Luisa De Lodovici, M. Rueckert, C. Baldi, A. Toni, D. Letteri, F. Giuntini, M. Maria Lotti, E. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Maimone Baronello, M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Barlinn, J. Deleu, D. Gourbali, V. Paciaroni, M. Masotti, L.

Abstract

Background and Purpose: The optimal timing for starting oral anticoagulant after an ischemic stroke related to atrial fibrillation remains a challenge, mainly in patients treated with systemic thrombolysis or mechanical thrombectomy. We aimed at assessing the incidence of early recurrence and major bleeding in patients with acute ischemic stroke and atrial fibrillation treated with thrombolytic therapy and/or thrombectomy, who then received oral anticoagulants for secondary prevention. Methods: We combined the dataset of the RAF and the RAF-NOACs (Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin K Oral Anticoagulants) studies, which were prospective observational studies carried out from January 2012 to March 2014 and April 2014 to June 2016, respectively. We included consecutive patients with acute ischemic stroke and atrial fibrillation treated with either Vitamin K antagonists or nonVitamin K oral anticoagulants. Primary outcome was the composite of stroke, transient ischemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding within 90 days from the inclusion. Treated-patients were propensity matched to untreated-patients in a 1:1 ratio after stratification by baseline clinical features. Results: A total of 2159 patients were included, 564 (26%) patients received acute reperfusion therapies. After the index event, 505 (90%) patients treated with acute reperfusion therapies and 1287 of 1595 (81%) patients untreated started oral anticoagulation. Timing of starting oral anticoagulant was similar in reperfusion-treated and untreated patients (median 7.5 versus 7.0 days, respectively). At 90 days, the primary study outcome occurred in 37 (7%) patients treated with reperfusion and in 146 (9%) untreated patients (odds ratio, 0.74 [95% CI, 0.50-1.07]). After propensity score matching, risk of primary outcome was comparable between the 2 groups (odds ratio, 1.06 [95% CI, 0.53-2.02]). Conclusions: Acute reperfusion treatment did not influence the risk of early recurrence and major bleeding in patients with atrial fibrillation-related acute ischemic stroke, who started on oral anticoagulant. © 2020 The Authors.

Published
2020

10. Timing of initiation of oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation comparing posterior and anterior circulation strokes

Author

Paciaroni, M. Agnelli, G. Giustozzi, M. Tsivgoulis, G. Yaghi, S. Grory, B.M. Furie, K.L. Tadi, P. Zedde, M. Abdul-Rahim, A.H. Dawson, J. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. D’Amore, C. Mosconi, M.G. Bogini, V. Cappellari, M. Rigatelli, A. Bonetti, B. Putaala, J. Tomppo, L. Tatlisumak, T. Bandini, F. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Masotti, L. Grifoni, E. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Liantinioti, C. Palaiodimou, L. Mumoli, N. Porta, C. Galati, F. Sacco, S. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Silvestrelli, G. Ciccone, A. Scoditti, U. Denti, L. Mancuso, M. Caselli, M.C. Maccarrone, M. Ulivi, L. Orlandi, G. Giannini, N. Tassinari, T. Lodovici, M.L.D. Rueckert, C. Baldi, A. Toni, D. Gentile, L. Letteri, F. Giuntini, M. Lotti, E.M. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Mannino, M. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Sette, M.D. Schirinzi, E. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Eskandari, A. Vanacker, P. Barlinn, K. Barlinn, J. Deleu, D. Gourbali, V. Caso, V.

Abstract

Introduction: The aim of this study in patients with acute posterior ischaemic stroke (PS) and atrial fibrillation (AF) was to evaluate (1) the risks of recurrent ischaemic event and severe bleeding and (2) these risks in relation with oral anticoagulant therapy (OAT) and its timing. Materials and Methods: Patients with PS were prospectively included; the outcome events of these patients were compared with those of patients with anterior stroke (AS) which were taken from previous registries. The primary outcome was the composite of stroke recurrence, transient ischaemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding occurring within 90 days from acute stroke. Results: A total of 2470 patients were available for the analysis: 473 (19.1%) with PS and 1997 (80.9%) with AS. Over 90 days, 213 (8.6%) primary outcome events were recorded: 175 (8.7%) in patients with AS and 38 (8.0%) in those with PS. In patients who initiated OAT within 2 days, the primary outcome occurred in 5 out of 95 patients (5.3%) with PS compared to 21 out of 373 patients (4.3%) with AS (OR 1.07; 95% CI 0.39–2.94). In patients who initiated OAT between days 3 and 7, the primary outcome occurred in 3 out of 103 patients (2.9%) with PS compared to 26 out of 490 patients (5.3%) with AS (OR 0.54; 95% CI 0.16–1.80). Discussion: our findings suggest that, when deciding the time to initiate oral anticoagulation, the location of stroke, either anterior or posterior, does not predict the risk of outcome events. Conclusions: Patients with PS or AS and AF appear to have similar risks of ischaemic or haemorrhagic events at 90 days with no difference concerning the timing of initiation of OAT. © European Stroke Organisation 2020.

Published
2020

11. Endovascular Thrombectomy for Acute Ischemic Stroke beyond 6 Hours from Onset: A Real-World Experience

Author

Casetta, I., Fainardi, E., Saia, V., Pracucci, G., Padroni, M., Renieri, L., Nencini, P., Inzitari, D., Morosetti, D., Sallustio, F., Vallone, S., Bigliardi, G., Zini, A., Longo, M., Francalanza, I., Bracco, S., Vallone, I. M., Tassi, R., Bergui, M., Naldi, A., Saletti, A., De Vito, A., Gasparotti, R., Magoni, M., Castellan, L., Serrati, C., Menozzi, R., Scoditti, U., Causin, F., Pieroni, A., Puglielli, E., Casalena, A., Sanna, A., Ruggiero, M., Cordici, F., Di Maggio, L., Duc, E., Cosottini, M., Giannini, N., Sanfilippo, G., Zappoli, F., Toni, D., Cavasin, N., Critelli, A., Ciceri, E., Plebani, M., Cappellari, M., Chiumarulo, L., Petruzzellis, M., Terrana, A., Cariddi, L. P., Burdi, N., Tinelli, A., Auteri, W., Silvagni, U., Biraschi, F., Nicolini, E., Padolecchia, R., Tassinari, T., Filauri, P., Sacco, S., Pavia, M., Invernizzi, P., Nuzzi, N. P., Marcheselli, S., Amista, P., Russo, M., Gallesio, I., Craparo, G., Mannino, M., and Mangiafico, S.

Subjects
Male, medicine.medical_specialty, Middle Cerebral Artery, Time Factors, cerebral blood volume, collateral circulation, groin, intracranial hemorrhage, middle cerebral artery, thrombectomy, Ischemia, Brain Ischemia, Brain ischemia, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine.artery, medicine, Humans, 030212 general & internal medicine, Acute ischemic stroke, Stroke, Aged, Advanced and Specialized Nursing, medicine.diagnostic_test, Groin, business.industry, Endovascular Procedures, Ambientale, Middle Aged, medicine.disease, Collateral circulation, Intracranial Hemorrhages/*surgery Ischemia/surgery Male Middle Aged Middle Cerebral Artery/physiopathology/surgery Stroke/*surgery Thrombectomy/methods Time Factors cerebral blood volume collateral circulation, Cerebral Angiography, medicine.anatomical_structure, Middle cerebral artery, Cardiology, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Intracranial Hemorrhages, 030217 neurology & neurosurgery, Thrombectomy, Cerebral angiography
Abstract

Background and Purpose: To evaluate outcome and safety of endovascular treatment beyond 6 hours of onset of ischemic stroke due to large vessel occlusion in the anterior circulation, in routine clinical practice. Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke of known onset beyond 6 hours. Additional inclusion criteria were prestroke modified Rankin Scale score ≤2 and ASPECTS score ≥6. Patients were selected on individual basis by a combination of CT perfusion mismatch (difference between total hypoperfusion and infarct core sizes) and CT collateral score. The primary outcome measure was the score on modified Rankin Scale at 90 days. Safety outcomes were 90-day mortality and the occurrence of symptomatic intracranial hemorrhage. Data were compared with those from patients treated within 6 hours. Results: Out of 3057 patients, 327 were treated beyond 6 hours. Their mean age was 66.8±14.9 years, the median baseline National Institutes of Health Stroke Scale 16, and the median onset to groin puncture time 430 minutes. The most frequent site of occlusion was middle cerebral artery (45.1%). Functional independence (90-day modified Rankin Scale score, 0–2) was achieved by 41.3% of cases. Symptomatic intracranial hemorrhage occurred in 6.7% of patients, and 3-month case fatality rate was 17.1%. The probability of surviving with modified Rankin Scale score, 0–2 (odds ratio, 0.58 [95% CI, 0.43–0.77]) was significantly lower in patients treated beyond 6 hours as compared with patients treated earlier No differences were found regarding recanalization rates and safety outcomes between patients treated within and beyond 6 hours. There were no differences in outcome between people treated 6-12 hours from onset (278 patients) and those treated 12 to 24 hours from onset (49 patients). Conclusions: This real-world study suggests that in patients with large vessel occlusion selected on the basis of CT perfusion and collateral circulation assessment, endovascular treatment beyond 6 hours is feasible and safe with no increase in symptomatic intracranial hemorrhage.

Published
2020

17. Anticoagulation after Stroke in Patients with Atrial Fibrillation: To Bridge or Not with Low-Molecular-Weight Heparin?

Author

Altavilla, R. Caso, V. Bandini, F. Agnelli, G. Tsivgoulis, G. Yaghi, S. Furie, K.L. Tadi, P. Becattini, C. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. D'Amore, C. Giulia Mosconi, M. Anna Cimini, L. Fusaro, J. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Masotti, L. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Liantinioti, C. Chondrogianni, M. Mumoli, N. Consoli, D. Galati, F. Sacco, S. Carolei, A. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Silvestrelli, G. Ciccone, A. Lanari, A. Scoditti, U. Denti, L. Mancuso, M. MacCarrone, M. Ulivi, L. Orlandi, G. Giannini, N. Gialdini, G. Tassinari, T. De Lodovici, M.L. Bono, G. Rueckert, C. Baldi, A. D'Anna, S. Toni, D. Letteri, F. Giuntini, M. Lotti, E.M. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Pallesen, L.-P. Barlinn, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Paciaroni, M.

Abstract

Background and Purpose-Bridging therapy with low-molecular-weight heparin reportedly leads to a worse outcome for acute cardioembolic stroke patients because of a higher incidence of intracerebral bleeding. However, this practice is common in clinical settings. This observational study aimed to compare (1) the clinical profiles of patients receiving and not receiving bridging therapy, (2) overall group outcomes, and (3) outcomes according to the type of anticoagulant prescribed. Methods-We analyzed data of patients from the prospective RAF and RAF-NOACs studies. The primary outcome was defined as the composite of ischemic stroke, transient ischemic attack, systemic embolism, symptomatic cerebral bleeding, and major extracerebral bleeding observed at 90 days after the acute stroke. Results-Of 1810 patients who initiated oral anticoagulant therapy, 371 (20%) underwent bridging therapy with full-dose low-molecular-weight heparin. Older age and the presence of leukoaraiosis were inversely correlated with the use of bridging therapy. Forty-two bridged patients (11.3%) reached the combined outcome versus 72 (5.0%) of the nonbridged patients (P=0.0001). At multivariable analysis, bridging therapy was associated with the composite end point (odds ratio, 2.3; 95% CI, 1.4-3.7; P

Published
2019

18. Early recurrence in paroxysmal versus sustained atrial fibrillation in patients with acute ischaemic stroke

Author

Paciaroni, M. Angelini, F. Agnelli, G. Tsivgoulis, G. Furie, K.L. Tadi, P. Becattini, C. Falocci, N. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. Altavilla, R. D’Amore, C. Mosconi, M.G. Cimini, L.A. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Bandini, F. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Masotti, L. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Karagkiozi, E. Athanasakis, G. Makaritsis, K. Vadikolias, K. Liantinioti, C. Chondrogianni, M. Mumoli, N. Consoli, D. Galati, F. Sacco, S. Carolei, A. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Silvestrelli, G. Ciccone, A. Scoditti, U. Denti, L. Mancuso, M. Maccarrone, M. Orlandi, G. Giannini, N. Gialdini, G. Tassinari, T. Lodovici, M.L.D. Bono, G. Rueckert, C. Baldi, A. Toni, D. Letteri, F. Giuntini, M. Lotti, E.M. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Sette, M.D. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel Pd-Mer, P. Vanacker, P. Barlinn, K. Pallesen, L.P. Kepplinger, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Yaghi, S. Caso, V.

Subjects
cardiovascular system, macromolecular substances, cardiovascular diseases
Abstract

Background: The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear. Purpose: In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation. Methods: In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke. Results: A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24–2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74–2.04)). Conclusions: After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence. © European Stroke Organisation 2018.

Published
2019

20. IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

Author

Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., Magni E (ORCID:0000-0002-2235-2280), Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., and Magni E (ORCID:0000-0002-2235-2280)

Abstract

Background and Purpose - As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods - We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results - National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions - The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

Published
2019

23. Hemorrhagic transformation in patients with acute ischemic stroke and atrial fibrillation: Time to initiation of oral anticoagulant therapy and outcomes

Author

Paciaroni, M. Bandini, F. Agnelli, G. Tsivgoulis, G. Yaghi, S. Furie, K.L. Tadi, P. Becattini, C. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. D’Amore, C. Mosconi, M.G. Cimini, L.A. Altavilla, R. Volpi, G. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Masotti, L. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Athanasakis, G. Makaritsis, K. Karagkiozi, E. Vadikolias, K. Liantinioti, C. Chondrogianni, M. Mumoli, N. Consoli, D. Galati, F. Sacco, S. Carolei, A. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Colombo, G. Silvestrelli, G. Ciccone, A. Lanari, A. Scoditti, U. Denti, L. Mancuso, M. Maccarrone, M. Ulivi, L. Orlandi, G. Giannini, N. Gialdini, G. Tassinari, T. De Lodovici, M.L. Bono, G. Rueckert, C. Baldi, A. D'Anna, S. Toni, D. Letteri, F. Giuntini, M. Lotti, E.M. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Pallesen, L.-P. Barlinn, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Caso, V.

Abstract

Background—In patients with acute ischemic stroke and atrial fibrillation, early anticoagulation prevents ischemic recurrence but with the risk of hemorrhagic transformation (HT). The aims of this study were to evaluate in consecutive patients with acute stroke and atrial fibrillation (1) the incidence of early HT, (2) the time to initiation of anticoagulation in patients with HT, (3) the association of HT with ischemic recurrences, and (4) the association of HT with clinical outcome at 90 days. Methods and Results—HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset. The incidence of ischemic recurrences as well as mortality or disability (modified Rankin Scale scores >2) were evaluated at 90 days. Ischemic recurrences were the composite of ischemic stroke, transient ischemic attack, or systemic embolism. Among the 2183 patients included in the study, 241 (11.0%) had HT. Patients with and without HT initiated anticoagulant therapy after a mean 23.3 and 11.6 days, respectively, from index stroke. At 90 days, 4.6% (95% confidence interval, 2.3-8.0) of the patients with HT had ischemic recurrences compared with 4.9% (95% confidence interval, 4.0-6.0) of those without HT; 53.1% of patients with HT were deceased or disabled compared with 35.8% of those without HT. On multivariable analysis, HT was associated with mortality or disability (odds ratio, 1.71; 95% confidence interval, 1.24-2.35). Conclusions—In patients with HT, anticoagulation was initiated about 12 days later than patients without HT. This delay was not associated with increased detection of ischemic recurrence. HT was associated with increased mortality or disability. © 2018 The Authors.

Published
2018

24. Development of an education campaign to reduce delays in pre-hospital response to stroke

Author

Caminiti, C., Schulz, P., Marcomini, B., Iezzi, E., Riva, Silvia, Scoditti, U., Zini, A., Malferrari, G., Zedde, M.L., Guidetti, D., Montanari, E., Baratti, M., Denti, L., Castellini, P., Zanferrari, C., Tanzi, A., Diodati, F., Olivato, S., Barbi, F., Bigliardi, G., Dell'Acqua, M.L., Vandelli, L., Rosafio, F., Pentore, R., Picchetto, L., Monaco, D., Perticaroli, E., Iafelice, I., Imovilli, P., Vaghi, L., and Guareschi, A.

Abstract

Background: Systematic reviews call for well-designed trials with clearly described intervention components to\ud support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein\ud describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness.\ud Methods: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was\ud articulated in two phases: needs assessment and intervention development. In phase 1, two cross-sectional surveys\ud were performed, one aiming to measure stroke awareness in the target population and the other to analyze the\ud behavioral determinants of prehospital delay. In phase 2, a matrix of proximal program objectives was developed,\ud theory-based intervention methods and practical strategies were selected and program components and materials\ud produced.\ud Results: In phase 1, the survey on 202 citizens highlighted underestimation of symptom severity, as in only 44% of\ud stroke situations respondents would choose to call the emergency service (EMS). In the survey on 393 consecutive\ud patients, 55% presented over 2 hours after symptom onset; major determinants were deciding to call the general\ud practitioner first and the reaction of the first person the patient called. In phase 2, adult individuals were identified\ud as the target of the intervention, both as potential “patients” and witnesses of stroke. The low educational level\ud found in the patient survey called for a narrative approach in cartoon form. The family setting was chosen for the\ud message because 42% of patients who presented within 2 hours had been advised by a family member to call\ud EMS. To act on people’s tendency to view stroke as an untreatable disease, it was decided to avoid fear-arousal\ud appeals and use a positive message providing instructions and hope. Focus groups were used to test educational\ud products and identify the most suitable sites for message dissemination.\ud Conclusions: The IM approach allowed to develop a stroke campaign integrating theories, scientific evidence and\ud information collected from the target population, and enabled to provide clear explanations for the reasons behind\ud key decisions during the intervention development process.\ud Trial registration: NCT01881152. Retrospectively registered June 7 2013\ud Keywords: Stroke, Public campaign, Pre-hospital delay, Media, Cartoon, Intervention mapping

Published
2017

25. Prediction of Early Recurrent Thromboembolic Event and Major Bleeding in Patients with Acute Stroke and Atrial Fibrillation by a Risk Stratification Schema: The ALESSA Score Study

Author

Paciaroni, M. Agnelli, G. Caso, V. Tsivgoulis, G. Furie, K.L. Tadi, P. Becattini, C. Falocci, N. Zedde, M. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. D'Amore, C. Mosconi, M.G. Cimini, L.A. Procopio, A. Bovi, P. Carletti, M. Rigatelli, A. Cappellari, M. Putaala, J. Tomppo, L. Tatlisumak, T. Bandini, F. Marcheselli, S. Pezzini, A. Poli, L. Padovani, A. Masotti, L. Vannucchi, V. Sohn, S.-I. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Ntaios, G. Karagkiozi, E. Athanasakis, G. Makaritsis, K. Vadikolias, K. Liantinioti, C. Chondrogianni, M. Mumoli, N. Consoli, D. Galati, F. Sacco, S. Carolei, A. Tiseo, C. Corea, F. Ageno, W. Bellesini, M. Colombo, G. Silvestrelli, G. Ciccone, A. Scoditti, U. Denti, L. Mancuso, M. Maccarrone, M. Orlandi, G. Giannini, N. Gialdini, G. Tassinari, T. De Lodovici, M.L. Bono, G. Rueckert, C. Baldi, A. D'Anna, S. Toni, D. Letteri, F. Giuntini, M. Lotti, E.M. Flomin, Y. Pieroni, A. Kargiotis, O. Karapanayiotides, T. Monaco, S. Baronello, M.M. Csiba, L. Szabó, L. Chiti, A. Giorli, E. Del Sette, M. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Michel, P. Vanacker, P. Barlinn, K. Pallesen, L.-P. Kepplinger, J. Bodechtel, U. Gerber, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Gourbali, V. Yaghi, S.

Abstract

Background and Purposes - This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation. Methods - The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.06 for each additional year; 95% confidence interval, 1.00-1.11) and severe atrial enlargement (hazard ratio, 2.05; 95% confidence interval, 1.08-2.87) were predictors for ischemic outcome events (stroke, transient ischemic attack, and systemic embolism) at 90 days from acute stroke. Small lesions (≤1.5 cm) were inversely correlated with both major bleeding (hazard ratio, 0.39; P=0.03) and ischemic outcome events (hazard ratio, 0.55; 95% confidence interval, 0.30-1.00). We assigned to age ≥80 years 2 points and between 70 and 79 years 1 point; ischemic index lesion >1.5 cm, 1 point; severe atrial enlargement, 1 point (ALESSA score). A logistic regression with the receiver-operating characteristic graph procedure (C statistic) showed an area under the curve of 0.697 (0.632-0.763; P=0.0001) for ischemic outcome events and 0.585 (0.493-0.678; P=0.10) for major bleedings. Results - The validation cohort consisted of 994 patients included in prospective series between April 2014 and June 2016. Logistic regression with the receiver-operating characteristic graph procedure showed an area under the curve of 0.646 (0.529-0.763; P=0.009) for ischemic outcome events and 0.407 (0.275-0.540; P=0.14) for hemorrhagic outcome events. Conclusions - In acute stroke patients with atrial fibrillation, high ALESSA scores were associated with a high risk of ischemic events but not of major bleedings. © 2017 American Heart Association, Inc.

Published
2017

26. Early recurrence and major bleeding in patients with acute ischemic stroke and atrial fibrillation treated with Non-Vitamin-K oral anticoagulants (RAF-NOACs) Study

Author

Paciaroni, M. Agnelli, G. Falocci, N. Tsivgoulis, G. Vadikolias, K. Liantinioti, C. Chondrogianni, M. Bovi, P. Carletti, M. Cappellari, M. Zedde, M. Ntaios, G. Karagkiozi, E. Athanasakis, G. Makaritsis, K. Silvestrelli, G. Lanari, A. Ciccone, A. Putaala, J. Tomppo, L. Tatlisumak, T. Abdul-Rahim, A.H. Lees, K.R. Alberti, A. Venti, M. Acciarresi, M. D'Amore, C. Becattini, C. Mosconi, M.G. Cimini, L.A. Soloperto, R. Masotti, L. Vannucchi, V. Lorenzini, G. Tassi, R. Guideri, F. Acampa, M. Martini, G. Sohn, S.-I. Marcheselli, S. Mumoli, N. De Lodovici, M.L. Bono, G. Furie, K.L. Tadi, P. Yaghi, S. Toni, D. Letteri, F. Tassinari, T. Kargiotis, O. Lotti, E.M. Flomin, Y. Mancuso, M. Maccarrone, M. Giannini, N. Bandini, F. Pezzini, A. Poli, L. Padovani, A. Scoditti, U. Denti, L. Consoli, D. Galati, F. Sacco, S. Carolei, A. Tiseo, C. Gourbali, V. Orlandi, G. Giuntini, M. Chiti, A. Giorli, E. Gialdini, G. Corea, F. Ageno, W. Bellesini, M. Colombo, G. Monaco, S. Baronello, M.M. Karapanayiotides, T. Caso, V.

Abstract

Background--The optimal timing to administer non-vitamin K oral anticoagulants (NOACs) in patients with acute ischemic stroke and atrial fibrillation is unclear. This prospective observational multicenter study evaluated the rates of early recurrence and major bleeding (within90 days)and their timing in patients with acute ischemic stroke and atrial fibrillation who received NOACs for secondary prevention. Methods and Results--Recurrence was defined as the composite of ischemic stroke, transient ischemic attack, and symptomatic systemic embolism, and major bleeding was defined as symptomatic cerebral and major extracranial bleeding. For the analysis, 1127 patients were eligible: 381 (33.8%) were treated with dabigatran, 366 (32.5%) with rivaroxaban, and 380 (33.7%) with apixaban. Patients who received dabigatran were younger and had lower admission National Institutes of Health Stroke Scale score and less commonly had a CHA2DS2-VASc score > 4 and less reduced renal function. Thirty-two patients (2.8%) had early recurrence, and 27 (2.4%) had major bleeding. The rates of early recurrence and major bleeding were, respectively, 1.8% and 0.5% in patients receiving dabigatran, 1.6% and 2.5% in those receiving rivaroxaban, and 4.0% and 2.9% in those receiving apixaban. Patients who initiated NOACs within 2 days after acute stroke had a composite rate of recurrence and major bleeding of 12.4%; composite rates were 2.1% for those who initiated NOACs between 3 and 14 days and 9.1% for those who initiated > 14 days after acute stroke. Conclusions--In patients with acute ischemic stroke and atrial fibrillation, treatment with NOACs was associated with a combined 5% rate of ischemic embolic recurrence and severe bleeding within 90 days. © 2017 The Authors.

Published
2017

27. Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: results from the RAF-study (Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation)

Author

Antonenko, K, Paciaroni, M, Agnelli, G, Falocci, N, Becattini, C, Marcheselli, S, Rueckert, C, Pezzini, A, Poli, L, Padovani, A, Csiba, L, Szabó, L, Sohn, Si, Tassinari, T, Abdul Rahim, A, Michel, P, Cordier, M, Vanacker, P, Remillard, S, Alberti, A, Venti, M, Acciarresi, M, D’Amore, C, Scoditti, U, Denti, L, Orlandi, G, Chiti, A, Gialdini, G, Bovi, P, Carletti, M, Rigatelli, A, Putaala, J, Tatlisumak, T, Masotti, L, Lorenzini, G, Tassi, R, Guideri, F, Martini, G, Tsivgoulis, G, Vadikolias, K, Papageorgiou, Sg, Corea, F, Del Sette, M, Ageno, W, De Lodovici, Ml, Bono, G, Baldi, A, D’Anna, S, Sacco, Simona, Carolei, A, Tiseo, C, Imberti, D, Zabzuni, D, Doronin, B, Volodina, V, Consoli, D, Galati, F, Pieroni, A, Toni, D, Monaco, S, Maimone Baronello, M, Barlinn, K, Pallesen, Lp, Kepplinger, J, Bodechtel, U, Gerber, J, Deleu, D, Melikyan, G, Ibrahim, F, Akhtar, N, Mosconi, Mg, Lees, Kr, and Caso, V.

Published
2017

28. Prestroke CHA2DS2-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation: Findings from RAF Study

Author

Acciarresi, M. Paciaroni, M. Agnelli, G. Falocci, N. Caso, V. Becattini, C. Marcheselli, S. Rueckert, C. Pezzini, A. Morotti, A. Costa, P. Padovani, A. Csiba, L. Szabó, L. Sohn, S.-I. Tassinari, T. Abdul-Rahim, A.H. Michel, P. Cordier, M. Vanacker, P. Remillard, S. Alberti, A. Venti, M. D'Amore, C. Scoditti, U. Denti, L. Orlandi, G. Chiti, A. Gialdini, G. Bovi, P. Carletti, M. Rigatelli, A. Putaala, J. Tatlisumak, T. Masotti, L. Lorenzini, G. Tassi, R. Guideri, F. Martini, G. Tsivgoulis, G. Vadikolias, K. Liantinioti, C. Corea, F. Del Sette, M. Ageno, W. De Lodovici, M.L. Bono, G. Baldi, A. D'Anna, S. Sacco, S. Carolei, A. Tiseo, C. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Consoli, D. Galati, F. Pieroni, A. Toni, D. Monaco, S. Baronello, M.M. Barlinn, K. Pallesen, L.-P. Kepplinger, J. Bodechtel, U. Gerber, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Mosconi, M.G. Lees, K.R.

Subjects
cardiovascular diseases
Abstract

Background and Purpose The aim of this study was to investigate for a possible association between both prestroke CHA2DS2-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). Methods This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS ≥10). Disability and mortality at 90 days were assessed by the modified Rankin Scale (mRS

Published
2017

29. Sex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation)

Author

Antonenko, K. Paciaroni, M. Agnelli, G. Falocci, N. Becattini, C. Marcheselli, S. Rueckert, C. Pezzini, A. Poli, L. Padovani, A. Csiba, L. Szabó, L. Sohn, S.-I. Tassinari, T. Abdul-Rahim, A.H. Michel, P. Cordier, M. Vanacker, P. Remillard, S. Alberti, A. Venti, M. Acciarresi, M. D’Amore, C. Scoditti, U. Denti, L. Orlandi, G. Chiti, A. Gialdini, G. Bovi, P. Carletti, M. Rigatelli, A. Putaala, J. Tatlisumak, T. Masotti, L. Lorenzini, G. Tassi, R. Guideri, F. Martini, G. Tsivgoulis, G. Vadikolias, K. Papageorgiou, S.G. Corea, F. Sette, M.D. Ageno, W. Lodovici, M.L.D. Bono, G. Baldi, A. D’Anna, S. Sacco, S. Carolei, A. Tiseo, C. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Consoli, D. Galati, F. Pieroni, A. Toni, D. Monaco, S. Baronello, M.M. Barlinn, K. Pallesen, L.-P. Kepplinger, J. Bodechtel, U. Gerber, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Mosconi, M.G. Lees, K.R. Caso, V.

Subjects
cardiovascular diseases
Abstract

Introduction: Atrial fibrillation is an independent risk factor of thromboembolism. Women with atrial fibrillation are at a higher overall risk for stroke compared to men with atrial fibrillation. The aim of this study was to evaluate for sex differences in patients with acute stroke and atrial fibrillation, regarding risk factors, treatments received and outcomes. Methods: Data were analyzed from the “Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation” (RAF-study), a prospective, multicenter, international study including only patients with acute stroke and atrial fibrillation. Patients were followed up for 90 days. Disability was measured by the modified Rankin Scale (0–2 favorable outcome, 3–6 unfavorable outcome). Results: Of the 1029 patients enrolled, 561 were women (54.5%) (p < 0.001) and younger (p < 0.001) compared to men. In patients with known atrial fibrillation, women were less likely to receive oral anticoagulants before index stroke (p = 0.026) and were less likely to receive anticoagulants after stroke (71.3% versus 78.4%, p = 0.01). There was no observed sex difference regarding the time of starting anticoagulant therapy between the two groups (6.4 ± 11.7 days for men versus 6.5 ± 12.4 days for women, p = 0.902). Men presented with more severe strokes at onset (mean NIHSS 9.2 ± 6.9 versus 8.1 ± 7.5, p < 0.001). Within 90 days, 46 (8.2%) recurrent ischemic events (stroke/TIA/systemic embolism) and 19 (3.4%) symptomatic cerebral bleedings were found in women compared to 30 (6.4%) and 18 (3.8%) in men (p = 0.28 and p = 0.74). At 90 days, 57.7% of women were disabled or deceased, compared to 41.1% of the men (p < 0.001). Multivariate analysis did not confirm this significance. Conclusions: Women with atrial fibrillation were less likely to receive oral anticoagulants prior to and after stroke compared to men with atrial fibrillation, and when stroke occurred, regardless of the fact that in our study women were younger and with less severe stroke, outcomes did not differ between the sexes. © 2016, © European Stroke Organisation 2016.

Published
2017

30. Prognostic value of trans-thoracic echocardiography in patients with acute stroke and atrial fibrillation: findings from the RAF study

Author

Paciaroni, M. Agnelli, G. Falocci, N. Caso, V. Becattini, C. Marcheselli, S. Rueckert, C. Pezzini, A. Poli, L. Padovani, A. Csiba, L. Szabó, L. Sohn, S.-I. Tassinari, T. Abdul-Rahim, A.H. Michel, P. Cordier, M. Vanacker, P. Remillard, S. Alberti, A. Venti, M. Acciarresi, M. D’Amore, C. Mosconi, M.G. Scoditti, U. Denti, L. Orlandi, G. Chiti, A. Gialdini, G. Bovi, P. Carletti, M. Rigatelli, A. Putaala, J. Tatlisumak, T. Masotti, L. Lorenzini, G. Tassi, R. Guideri, F. Martini, G. Tsivgoulis, G. Vadikolias, K. Liantinioti, C. Corea, F. Del Sette, M. Ageno, W. De Lodovici, M.L. Bono, G. Baldi, A. D’Anna, S. Sacco, S. Carolei, A. Tiseo, C. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Consoli, D. Galati, F. Pieroni, A. Toni, D. Monaco, S. Baronello, M.M. Barlinn, K. Pallesen, L.-P. Kepplinger, J. Bodechtel, U. Gerber, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Lees, K.R.

Subjects
cardiovascular diseases
Abstract

Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). The identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4 %) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3 %) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2 %) among whom 51 (9.3 %) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7 %. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95 % CI 1.06–4.29, p = 0.033) and CHA2DS2-VASc score (OR 1.22; 95 % CI 1.04–1.45, p = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon. © 2015, Springer-Verlag Berlin Heidelberg.

Published
2016

31. Early recurrence and cerebral bleeding in patients with acute ischemic stroke and atrial fibrillation: Effect of anticoagulation and its timing: The RAF study

Author

Paciaroni, M. Agnelli, G. Falocci, N. Caso, V. Becattini, C. Marcheselli, S. Rueckert, C. Pezzini, A. Poli, L. Padovani, A. Csiba, L. Szabó, L. Sohn, S.-I. Tassinari, T. Abdul-Rahim, A.H. Michel, P. Cordier, M. Vanacker, P. Remillard, S. Alberti, A. Venti, M. Scoditti, U. Denti, L. Orlandi, G. Chiti, A. Gialdini, G. Bovi, P. Carletti, M. Rigatelli, A. Putaala, J. Tatlisumak, T. Masotti, L. Lorenzini, G. Tassi, R. Guideri, F. Martini, G. Tsivgoulis, G. Vadikolias, K. Liantinioti, C. Corea, F. Del Sette, M. Ageno, W. De Lodovici, M.L. Bono, G. Baldi, A. D'Anna, S. Sacco, S. Carolei, A. Tiseo, C. Acciarresi, M. D'Amore, C. Imberti, D. Zabzuni, D. Doronin, B. Volodina, V. Consoli, D. Galati, F. Pieroni, A. Toni, D. Monaco, S. Baronello, M.M. Barlinn, K. Pallesen, L.-P. Kepplinger, J. Bodechtel, U. Gerber, J. Deleu, D. Melikyan, G. Ibrahim, F. Akhtar, N. Mosconi, M.G. Bubba, V. Silvestri, I. Lees, K.R.

Abstract

Background and Purpose - The best time for administering anticoagulation therapy in acute cardioembolic stroke remains unclear. This prospective cohort study of patients with acute stroke and atrial fibrillation, evaluated (1) the risk of recurrent ischemic event and severe bleeding; (2) the risk factors for recurrence and bleeding; and (3) the risks of recurrence and bleeding associated with anticoagulant therapy and its starting time after the acute stroke. Methods - The primary outcome of this multicenter study was the composite of stroke, transient ischemic attack, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding within 90 days from acute stroke. Results - Of the 1029 patients enrolled, 123 had 128 events (12.6%): 77 (7.6%) ischemic stroke or transient ischemic attack or systemic embolism, 37 (3.6%) symptomatic cerebral bleeding, and 14 (1.4%) major extracranial bleeding. At 90 days, 50% of the patients were either deceased or disabled (modified Rankin score ≥3), and 10.9% were deceased. High CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesion and type of anticoagulant were predictive factors for primary study outcome. At adjusted Cox regression analysis, initiating anticoagulants 4 to 14 days from stroke onset was associated with a significant reduction in primary study outcome, compared with initiating treatment before 4 or after 14 days: hazard ratio 0.53 (95% confidence interval 0.30-0.93). About 7% of the patients treated with oral anticoagulants alone had an outcome event compared with 16.8% and 12.3% of the patients treated with low molecular weight heparins alone or followed by oral anticoagulants, respectively (P=0.003). Conclusions - Acute stroke in atrial fibrillation patients is associated with high rates of ischemic recurrence and major bleeding at 90 days. This study has observed that high CHA2DS2-VASc score, high National Institutes of Health Stroke Scale, large ischemic lesions, and type of anticoagulant administered each independently led to a greater risk of recurrence and bleedings. Also, data showed that the best time for initiating anticoagulation treatment for secondary stroke prevention is 4 to 14 days from stroke onset. Moreover, patients treated with oral anticoagulants alone had better outcomes compared with patients treated with low molecular weight heparins alone or before oral anticoagulants. © 2015 American Heart Association, Inc.

Published
2015

32. Erratum to: The Italian Registry of Endovascular Treatment in Acute Stroke: rationale, design and baseline features of patients (Neurol Sci (2015), 36, (985-993), 10.1007/s10072-014-2053-5)

Author

Mangiafico, S., Pracucci, G., Saia, V., Nencini, P., Inzitari, D., Nappini, S., Vallone, S., Zini, A., Fuschi, M., Cerone, D., Bergui, M., Cerrato, P., Gandini, R., Sallustio, F., Saletti, A., De Vito, A., Romano, D. G., Tassi, R., Causin, F., Baracchini, C., Piano, M., Motto, C., Ciccone, A., Gasparotti, R., Magoni, M., Giorgianni, A., Delodovici, M., Cavasin, N., Critelli, A., Gallucci, M., Carolei, A., Meloni, T., Corso, G., Vaudano, G., Duc, E., Zappoli, F., Cavallini, A., Padolecchia, R., Tassinari, T., Longoni, M., Salmaggi, A., Zampieri, P. G., Bovi, P., Puglioli, M., Chiti, A., Guidetti, G., Simonetti, L., Procaccianti, G., Menozzi, R., Scoditti, U., Ricciardi, F., Pezzella, F. R., Guarnieri, G., Andreone, V., and Toni, D.

Published
2015

33. Intravenous thrombolysis or endovascular therapy for acute ischemic stroke associated with cervical internal carotid artery occlusion: the ICARO-3 study

Author

Paciaroni, M. Inzitari, D. Agnelli, G. Caso, V. Balucani, C. Grotta, J.C. Sarraj, A. Sung-Il, S. Chamorro, A. Urra, X. Leys, D. Henon, H. Cordonnier, C. Dequatre, N. Aguettaz, P. Alberti, A. Venti, M. Acciarresi, M. D’Amore, C. Zini, A. Vallone, S. Dell’Acqua, M.L. Menetti, F. Nencini, P. Mangiafico, S. Barlinn, K. Kepplinger, J. Bodechtel, U. Gerber, J. Bovi, P. Cappellari, M. Linfante, I. Dabus, G. Marcheselli, S. Pezzini, A. Padovani, A. Alexandrov, A.V. Shahripour, R.B. Sessa, M. Giacalone, G. Silvestrelli, G. Lanari, A. Ciccone, A. De Vito, A. Azzini, C. Saletti, A. Fainardi, E. Orlandi, G. Chiti, A. Gialdini, G. Silvestrini, M. Ferrarese, C. Beretta, S. Tassi, R. Martini, G. Tsivgoulis, G. Vasdekis, S.N. Consoli, D. Baldi, A. D’Anna, S. Luda, E. Varbella, F. Galletti, G. Invernizzi, P. Donati, E. De Lodovici, M.L. Bono, G. Corea, F. Sette, M.D. Monaco, S. Riva, M. Tassinari, T. Scoditti, U. Toni, D.

Abstract

The aim of the ICARO-3 study was to evaluate whether intra-arterial treatment, compared to intravenous thrombolysis, increases the rate of favourable functional outcome at 3 months in acute ischemic stroke and extracranial ICA occlusion. ICARO-3 was a non-randomized therapeutic trial that performed a non-blind assessment of outcomes using retrospective data collected prospectively from 37 centres in 7 countries. Patients treated with endovascular treatment within 6 h from stroke onset (cases) were matched with patients treated with intravenous thrombolysis within 4.5 h from symptom onset (controls). Patients receiving either intravenous or endovascular therapy were included among the cases. The efficacy outcome was disability at 90 days assessed by the modified Rankin Scale (mRS), dichotomized as favourable (score of 0–2) or unfavourable (score of 3–6). Safety outcomes were death and any intracranial bleeding. Included in the analysis were 324 cases and 324 controls: 105 cases (32.4 %) had a favourable outcome as compared with 89 controls (27.4 %) [adjusted odds ratio (OR) 1.25, 95 % confidence interval (CI) 0.88–1.79, p = 0.1]. In the adjusted analysis, treatment with intra-arterial procedures was significantly associated with a reduction of mortality (OR 0.61, 95 % CI 0.40–0.93, p = 0.022). The rates of patients with severe disability or death (mRS 5–6) were similar in cases and controls (30.5 versus 32.4 %, p = 0.67). For the ordinal analysis, adjusted for age, sex, NIHSS, presence of diabetes mellitus and atrial fibrillation, the common odds ratio was 1.15 (95 % IC 0.86–1.54), p = 0.33. There were more cases of intracranial bleeding (37.0 versus 17.3 %, p = 0.0001) in the intra-arterial procedure group than in the intravenous group. After the exclusion of the 135 cases treated with the combination of I.V. thrombolysis and I.A. procedures, 67/189 of those treated with I.A. procedures (35.3 %) had a favourable outcome, compared to 89/324 of those treated with I.V. thrombolysis (27.4 %) (adjusted OR 1.75, 95 % CI 1.00–3.03, p = 0.05). Endovascular treatment of patients with acute ICA occlusion did not result in a better functional outcome than treatment with intravenous thrombolysis, but was associated with a higher rate of intracranial bleeding. Overall mortality was significantly reduced in patients treated with endovascular treatment but the rates of patients with severe disability or death were similar. When excluding all patients treated with the combination of I.V. thrombolysis and I.A. procedures, a potential benefit of I.A. treatment alone compared to I.V. thrombolysis was observed. © 2014, Springer-Verlag Berlin Heidelberg.

Published
2015

34. Meningeal involvement in apparently ANCA-negative Wegener's granulomatosis: A role for PR3 capture-ELISA? [1]

Author

Greco, P, Palmisano, A, Vaglio, A, Scoditti, U, Antonelli, M, Crisi, G, Buzio, C., SINICO, RENATO ALBERTO, Greco, P, Palmisano, A, Vaglio, A, Scoditti, U, Antonelli, M, Crisi, G, Sinico, R, and Buzio, C

Subjects
Male, Neuroscience (all), Myeloblastin, Brain, Enzyme-Linked Immunosorbent Assay, Biomarker, Middle Aged, False Negative Reaction, Magnetic Resonance Imaging, Antibodies, Antineutrophil Cytoplasmic, Meningiti, Rheumatology, Granulomatosis with Polyangiiti, Human
Published
2007

35. Intravenous thrombolysis or endovascular therapy for acute ischemic stroke associated with cervical internal carotid artery occlusion: the ICARO-3 study

Author

Paciaroni, M, Inzitari, D, Agnelli, G, Caso, V, Balucani, C, Grotta, J, Sarraj, A, Sung Il, S, Chamorro, A, Urra, X, Leys, D, Henon, H, Cordonnier, C, Dequatre, N, Aguettaz, P, Alberti, A, Venti, M, Acciarresi, M, D'Amore, C, Zini, A, Vallone, S, Dell'Acqua, M, Menetti, F, Nencini, P, Mangiafico, S, Barlinn, K, Kepplinger, J, Bodechtel, U, Gerber, J, Bovi, P, Cappellari, M, Linfante, I, Dabus, G, Marcheselli, S, Pezzini, A, Padovani, A, Alexandrov, A, Shahripour, R, Sessa, M, Giacalone, G, Silvestrelli, G, Lanari, A, Ciccone, A, De Vito, A, Azzini, C, Saletti, A, Fainardi, E, Orlandi, G, Chiti, A, Gialdini, G, Silvestrini, M, Ferrarese, C, Beretta, S, Tassi, R, Martini, G, Tsivgoulis, G, Vasdekis, S, Consoli, D, Baldi, A, D'Anna, S, Luda, E, Varbella, F, Galletti, G, Invernizzi, P, Donati, E, De Lodovici, M, Bono, G, Corea, F, Sette, M, Monaco, S, Riva, M, Tassinari, T, Scoditti, U, Toni, D, FERRARESE, CARLO, RIVA, MARTA, Toni, D., Paciaroni, M, Inzitari, D, Agnelli, G, Caso, V, Balucani, C, Grotta, J, Sarraj, A, Sung Il, S, Chamorro, A, Urra, X, Leys, D, Henon, H, Cordonnier, C, Dequatre, N, Aguettaz, P, Alberti, A, Venti, M, Acciarresi, M, D'Amore, C, Zini, A, Vallone, S, Dell'Acqua, M, Menetti, F, Nencini, P, Mangiafico, S, Barlinn, K, Kepplinger, J, Bodechtel, U, Gerber, J, Bovi, P, Cappellari, M, Linfante, I, Dabus, G, Marcheselli, S, Pezzini, A, Padovani, A, Alexandrov, A, Shahripour, R, Sessa, M, Giacalone, G, Silvestrelli, G, Lanari, A, Ciccone, A, De Vito, A, Azzini, C, Saletti, A, Fainardi, E, Orlandi, G, Chiti, A, Gialdini, G, Silvestrini, M, Ferrarese, C, Beretta, S, Tassi, R, Martini, G, Tsivgoulis, G, Vasdekis, S, Consoli, D, Baldi, A, D'Anna, S, Luda, E, Varbella, F, Galletti, G, Invernizzi, P, Donati, E, De Lodovici, M, Bono, G, Corea, F, Sette, M, Monaco, S, Riva, M, Tassinari, T, Scoditti, U, Toni, D, FERRARESE, CARLO, RIVA, MARTA, and Toni, D.

Abstract

The aim of the ICARO-3 study was to evaluate whether intra-arterial treatment, compared to intravenous thrombolysis, increases the rate of favourable functional outcome at 3 months in acute ischemic stroke and extracranial ICA occlusion. ICARO-3 was a non-randomized therapeutic trial that performed a non-blind assessment of outcomes using retrospective data collected prospectively from 37 centres in 7 countries. Patients treated with endovascular treatment within 6 h from stroke onset (cases) were matched with patients treated with intravenous thrombolysis within 4.5 h from symptom onset (controls). Patients receiving either intravenous or endovascular therapy were included among the cases. The efficacy outcome was disability at 90 days assessed by the modified Rankin Scale (mRS), dichotomized as favourable (score of 0–2) or unfavourable (score of 3–6). Safety outcomes were death and any intracranial bleeding. Included in the analysis were 324 cases and 324 controls: 105 cases (32.4 %) had a favourable outcome as compared with 89 controls (27.4 %) [adjusted odds ratio (OR) 1.25, 95 % confidence interval (CI) 0.88–1.79, p = 0.1]. In the adjusted analysis, treatment with intra-arterial procedures was significantly associated with a reduction of mortality (OR 0.61, 95 % CI 0.40–0.93, p = 0.022). The rates of patients with severe disability or death (mRS 5–6) were similar in cases and controls (30.5 versus 32.4 %, p = 0.67). For the ordinal analysis, adjusted for age, sex, NIHSS, presence of diabetes mellitus and atrial fibrillation, the common odds ratio was 1.15 (95 % IC 0.86–1.54), p = 0.33. There were more cases of intracranial bleeding (37.0 versus 17.3 %, p = 0.0001) in the intra-arterial procedure group than in the intravenous group. After the exclusion of the 135 cases treated with the combination of I.V. thrombolysis and I.A. procedures, 67/189 of those trea

Published
2015

38. Cerebral venous thrombosis and myeloproliferative neoplasms: results from two large databases

Author

Dentali, F, Ageno, W, Rumi, E, Casetti, I, Poli, D, Scoditti, U, Maffioli, M, Di Minno, Mnd, Caramazza, D, Pietra, D, De Stefano, Valerio, Passamonti, F., De Stefano, Valerio (ORCID:0000-0002-5178-5827), Dentali, F, Ageno, W, Rumi, E, Casetti, I, Poli, D, Scoditti, U, Maffioli, M, Di Minno, Mnd, Caramazza, D, Pietra, D, De Stefano, Valerio, Passamonti, F., and De Stefano, Valerio (ORCID:0000-0002-5178-5827)

Abstract

Myeloproliferative neoplasms (MPNs) include polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Patients with MPNs are prone to develop arterial and venous thrombosis either at diagnosis or during follow-up; in particular splancnic vein is strongly associated with MPN. Conversely, presence of MPN is uncommon in patients with deep vein thrombosis of the lower extremities and with pulmonary embolism. Only few studies with conflicting results have evaluated the prevalence of an underlying MPN in patients with cerebral venous thrombosis (CVT), and limited evidence exists on the incidence of CVT in patients with established MPN.

Published
2014

39. RANDOMIZED CONTROLLED TRIAL OF STREPTOKINASE, ASPIRIN, AND COMBINATION OF BOTH IN TREATMENT OF ACUTE ISCHEMIC STROKE

Author

CANDELISE L, ARITZU E, CICCONE A, RICCI S, WARDLAW J, TOGNONI G, RONCAGLIONI MC, NEGRI E, COLOMBO F, BOCCARDI E, DEGRANDI C, SCIALFA G, ARGENTINO C, BERTELE V, MAGGIONI AP, PERRONE P, BARNETT HJM, BOGOUSSLAVSKY J, DELFAVERO A, LOI U, PETO R, WARLOW C, CANZI S, COMPARETTI S, CLERICI F, PALUMBO A, SGARONI G, POLONARA S, REGINELLI R, CERAVOLO MG, PROVINCIALI L, DELGOBBO M, SCARPINO O, BOTTACCHI E, DALESSANDRO G, DIGIOVANNI M, BLANC S, ROVEYAZ L, RALLI L, VANNI D, REFI C, FEDERICO F, CONTE C, INCHINGOLO V, INSABATO R, SALSA F, LORIZIO A, ROTTOLI MR, BRUNI L, DEFANTI CA, FERA L, CAMERLINGO M, CASTO L, CENSORI B, MAMOLI A, PORAZZI D, GRAMPA G, LASPINA I, GIGLIA L, AVENIA V, GUELI S, LOLLI V, MIELE V, SANTANGELO M, COPPOLA G, TRIANNI G, MARRA M, GRECO E, TONTI D, PRETOLANI E, STELLIO M, ARNABOLDI M, CIOLA R, DANIELI G, REZZONICO M, GUIDOTTI M, PELLEGRINI G, RAUDINO F, DELFAVERO C, FRATTINI T, RICCARDI T, LEVIMINZI C, LOCATELLI F, PASSERI F, LOMBARDO G, COCCO F, PRATESI M, SANTINI S, CARDOPATRI F, TAFANI O, LANDINI GC, PIERAGNOLI E, BELLESI R, BAGNOLI L, GHETTI A, MARRAZZA OB, MENEGAZZO P, SPOLVERI S, CAPPELLETTI C, CANDELIERE G, COSTANTINO G, DACUNO F, LOMUZIO T, RIZZITELLI FP, BOVIO G, GRILLI GP, ZOCCHI M, MAZZANTI I, PISAPIA G, NUZZI R, RUSSO G, LAMA G, BALDASSARRI G, BETTINI R, CANI E, CERIOLI E, DEGIORGI M, GARAGNANI A, PASQUALI S, CHIOMA V, FINI C, MARZARA G, BALOTTA A, BERTUZZI D, MASINA M, MATACENA C, MICHELINI M, PIRAZZOLI G, SACCHET C, MAROTTA P, CALVI L, SCACCABAROZZI C, MENOZZI C, SASANELLI F, BASCELLI C, PONTRELLI V, SCHIERONI F, BELVEDERE D, DECAPITANI E, DICOSTANZO M, RASCAROLI M, CITTERIO O, MILANI R, CAPIALBI R, ARENA G, MUSOLINO R, DIPERRI R, BONAVENTI C, FINZI F, MESSINA A, ROMANAZZI V, STERZI R, BOTTINI G, SANTILLI I, BRUCATO A, DEJULI E, PALMIERI G, RAGAINI S, THIELLA G, ALLI C, CAROSELLA L, RIZZATO G, BIANCHI M, MOTTO C, PINARDI G, SCARLATO G, BETTINELLI A, PORRO F, RANDAZZO A, MARINI U, LATTUADA P, PIETRA A, FRANCESCHI M, VOLOUTE MA, MALFERRARI G, BONDI M, GARUTI W, MELINI L, COLOMBO A, ALBORINI G, PANZETTI P, SCARPA M, SORGATO P, CRISI G, BONASERA N, BASSO F, NATALI E, MONACO P, GASPARRO AM, TRIOLO F, LECHI A, COLONNA F, DASCOLA I, GIORGI C, SCODITTI U, BASSI P, MENOZZI R, PIAZZA P, DEGLIANTONI G, DESIMONI M, GIANNINI A, MICILI G, BOSONE D, CAVALLINI A, MARTELLI A, BARZIZZA F, POLI M, BIAGINI S, CAPOCCHI G, CELANI MG, PICCHIARELLI A, RIGHETTI E, ZAMPOLINI M, CAPUTO N, BARTOLINI S, SANTONI M, SITA D, TAGLIOLI M, VOLPI G, ROSSI F, ALOY F, CASTELLANO AE, MINOTTA F, GATTA A, VINATTIERI A, CANTINI A, REBUCCI GG, BISSI G, DEBLASI F, PASCARELLI E, TURIAMO F, GUIDETTI D, BARATTI M, FERRARINI G, GHIDONI E, GRECO G, MARCELLO N, MOTTI L, SOLIME F, TERENZIANI S, ZUCCO R, TROISO A, VENEZIANI M, IORI I, CURATOLA L, BOLLETTINI G, CARBONI T, GOBBATO R, INFRICCIOLO P, SABATINI D, SFRAPPINI M, FANCELLU A, CASU G, DELEDDA MG, SPANU MA, PIRISI A, MARRAS FA, ROSATI G, BRAMBILLA A, ERLI GC, FELICE B, GRANDI R, MIRABILE D, ZADRA M, CAVESTRI R, GORI D, LONGHINI E, MIELE N, DIVIZIA G, GRASSELLI S, PEZZELLA F, ZUCCARI F, SALLUSTO L, LINCESSO F, SCARPATI C, IANNONE G, BARTOCCI A, COSTANTINI F, DESANTIS L, LANCIA G, MOSCHINI E, PACI A, SENSIDONI A, TRENTA A, BARTOLINI N, OTTAVIANO P, BISCOTTINI B, ALUNNI G, BARTOLINI I, BELLADONNA D, BOCCALI A, CRUCIANI M, IBBA R, LUCCIOLI R, MARCECA A, PACINI M, PALLONE M, GIRARDI P, ORRICO D, LANZA E, BALLINI A, GRANDI FC, MUSCO G, STEIDL L, SANTORO G, VEMCO A, DUDINE P, MILONE FF, MUNARI L, PERRETI A, PORTA M, LONGONI C, FERANI R, WATT M, SANDERCOCK P, FENNETRY A, BANNISTER P, CLARKE CE, BAMFORD J, VENABLES G, CORREIA M, CANDELISE L, ARITZU E, CICCONE A, RICCI S, WARDLAW J, TOGNONI G, RONCAGLIONI MC, NEGRI E, COLOMBO F, BOCCARDI E, DEGRANDI C, SCIALFA G, ARGENTINO C, BERTELE V, MAGGIONI AP, PERRONE P, BARNETT HJM, BOGOUSSLAVSKY J, DELFAVERO A, LOI U, PETO R, WARLOW C, CANZI S, COMPARETTI S, CLERICI F, PALUMBO A, SGARONI G, POLONARA S, REGINELLI R, CERAVOLO MG, PROVINCIALI L, DELGOBBO M, SCARPINO O, BOTTACCHI E, DALESSANDRO G, DIGIOVANNI M, BLANC S, ROVEYAZ L, RALLI L, VANNI D, REFI C, FEDERICO F, CONTE C, INCHINGOLO V, INSABATO R, SALSA F, LORIZIO A, ROTTOLI MR, BRUNI L, DEFANTI CA, FERA L, CAMERLINGO M, CASTO L, CENSORI B, MAMOLI A, PORAZZI D, GRAMPA G, LASPINA I, GIGLIA L, AVENIA V, GUELI S, LOLLI V, MIELE V, SANTANGELO M, COPPOLA G, TRIANNI G, MARRA M, GRECO E, TONTI D, PRETOLANI E, STELLIO M, ARNABOLDI M, CIOLA R, DANIELI G, REZZONICO M, GUIDOTTI M, PELLEGRINI G, RAUDINO F, DELFAVERO C, FRATTINI T, RICCARDI T, LEVIMINZI C, LOCATELLI F, PASSERI F, LOMBARDO G, COCCO F, PRATESI M, SANTINI S, CARDOPATRI F, TAFANI O, LANDINI GC, PIERAGNOLI E, BELLESI R, BAGNOLI L, GHETTI A, MARRAZZA OB, MENEGAZZO P, SPOLVERI S, CAPPELLETTI C, CANDELIERE G, COSTANTINO G, DACUNO F, LOMUZIO T, RIZZITELLI FP, BOVIO G, GRILLI GP, ZOCCHI M, MAZZANTI I, PISAPIA G, NUZZI R, RUSSO G, LAMA G, BALDASSARRI G, BETTINI R, CANI E, CERIOLI E, DEGIORGI M, GARAGNANI A, PASQUALI S, CHIOMA V, FINI C, MARZARA G, BALOTTA A, BERTUZZI D, MASINA M, MATACENA C, MICHELINI M, PIRAZZOLI G, SACCHET C, MAROTTA P, CALVI L, SCACCABAROZZI C, MENOZZI C, SASANELLI F, BASCELLI C, PONTRELLI V, SCHIERONI F, BELVEDERE D, DECAPITANI E, DICOSTANZO M, RASCAROLI M, CITTERIO O, MILANI R, CAPIALBI R, ARENA G, MUSOLINO R, DIPERRI R, BONAVENTI C, FINZI F, MESSINA A, ROMANAZZI V, STERZI R, BOTTINI G, SANTILLI I, BRUCATO A, DEJULI E, PALMIERI G, RAGAINI S, THIELLA G, ALLI C, CAROSELLA L, RIZZATO G, BIANCHI M, MOTTO C, PINARDI G, SCARLATO G, BETTINELLI A, PORRO F, RANDAZZO A, MARINI U, LATTUADA P, PIETRA A, FRANCESCHI M, VOLOUTE MA, MALFERRARI G, BONDI M, GARUTI W, MELINI L, COLOMBO A, ALBORINI G, PANZETTI P, SCARPA M, SORGATO P, CRISI G, BONASERA N, BASSO F, NATALI E, MONACO P, GASPARRO AM, TRIOLO F, LECHI A, COLONNA F, DASCOLA I, GIORGI C, SCODITTI U, BASSI P, MENOZZI R, PIAZZA P, DEGLIANTONI G, DESIMONI M, GIANNINI A, MICILI G, BOSONE D, CAVALLINI A, MARTELLI A, BARZIZZA F, POLI M, BIAGINI S, CAPOCCHI G, CELANI MG, PICCHIARELLI A, RIGHETTI E, ZAMPOLINI M, CAPUTO N, BARTOLINI S, SANTONI M, SITA D, TAGLIOLI M, VOLPI G, ROSSI F, ALOY F, CASTELLANO AE, MINOTTA F, GATTA A, VINATTIERI A, CANTINI A, REBUCCI GG, BISSI G, DEBLASI F, PASCARELLI E, TURIAMO F, GUIDETTI D, BARATTI M, FERRARINI G, GHIDONI E, GRECO G, MARCELLO N, MOTTI L, SOLIME F, TERENZIANI S, ZUCCO R, TROISO A, VENEZIANI M, IORI I, CURATOLA L, BOLLETTINI G, CARBONI T, GOBBATO R, INFRICCIOLO P, SABATINI D, SFRAPPINI M, FANCELLU A, CASU G, DELEDDA MG, SPANU MA, PIRISI A, MARRAS FA, ROSATI G, BRAMBILLA A, ERLI GC, FELICE B, GRANDI R, MIRABILE D, ZADRA M, CAVESTRI R, GORI D, LONGHINI E, MIELE N, DIVIZIA G, GRASSELLI S, PEZZELLA F, ZUCCARI F, SALLUSTO L, LINCESSO F, SCARPATI C, IANNONE G, BARTOCCI A, COSTANTINI F, DESANTIS L, LANCIA G, MOSCHINI E, PACI A, SENSIDONI A, TRENTA A, BARTOLINI N, OTTAVIANO P, BISCOTTINI B, ALUNNI G, BARTOLINI I, BELLADONNA D, BOCCALI A, CRUCIANI M, IBBA R, LUCCIOLI R, MARCECA A, PACINI M, PALLONE M, GIRARDI P, ORRICO D, LANZA E, BALLINI A, GRANDI FC, MUSCO G, STEIDL L, SANTORO G, VEMCO A, DUDINE P, MILONE FF, MUNARI L, PERRETI A, PORTA M, LONGONI C, FERANI R, WATT M, SANDERCOCK P, FENNETRY A, BANNISTER P, CLARKE CE, BAMFORD J, VENABLES G, and CORREIA M

Abstract

In ischaemic stroke, thrombolytic drugs speed the recanalisation of intracerebral arteries. The effects of aspirin are not known. A trial was conducted to determine whether, separately or together, streptokinase and aspirin have clinical benefits in acute ischaemic stroke similar to those in acute myocardial infarction. 622 patients with acute ischaemic stroke within 6 hours of symptom onset were randomised with a 2x2 factorial design to (i) a 1-hour intravenous infusion of 1 . 5 MU streptokinase, (ii) 300 mg/day buffered aspirin for 10 days, (iii) both active treatments, or (iv) neither. Early results raised a question whether the trial should be continued. Streptokinase (alone or with aspirin) was associated with an excess of 10-day case fatality (odds ratio 2 . 7; 95% confidence interval 1 . 7-4 . 3; 2p

Published
1995

41. The THRombolysis and STatins (THRaST) study

Author

Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., BERETTA, SIMONE, Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., and BERETTA, SIMONE

Abstract

Objective: To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis. Methods: Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death. Results: Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007). Conclusion: Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome. © 2013 American Academy of Neurology.

Published
2013

42. Long-term outcomes of patients with cerebral vein thrombosis: a multicenter study

Author

Dentali, F, Poli, D, Scoditti, U, Di Minno, M, De Stefano, V, Stefano, V, Siragusa, S, Kostal, M, Palareti, G, Sartori, M, Grandone, E, Vedovati, M, Ageno, W, Falanga, A, Lerede, T, Bianchi, M, Testa, S, Witt, D, Mccool, K, Bucherini, E, Grifoni, E, Coalizzo, D, Benedetti, R, Marietta, M, Sessa, M, Guaschino, C, di Minno, G, Tufano, A, Barbar, S, Malato, A, Pini, M, Castellini, P, Barco, S, Barone, M, Paciaroni, M, Alberti, A, Agnelli, G, Giorgi Pierfranceschi, M, Dulicek, P, Silingardi, M, Federica, L, Ghirarduzzi, A, Tiraferri, E, di Lazzaro, V, Rossi, E, Ciminello, A, Pasca, S, Barillari, G, Rezoagli, E, Galli, M, Squizzato, A, Tosetto, A, Di Minno, M N D, Stefano, V D, Sartori, M T, Vedovati, M C, Falanga, Anna, Lerede, Teresa, Bianchi, Marina, Testa, Sophie, Witt, Dan, McCool, Katie, Bucherini, Eugenio, Grifoni, Elisa, Coalizzo, Daniela, Benedetti, Raffaella, Marietta, Marco, Sessa, Maria, Guaschino, Clara, di Minno, Giovanni, Tufano, Antonella, Barbar, Sofia, Malato, Alessandra, Pini, Mario, Castellini, Paola, Barco, Stefano, Barone, Marisa, Paciaroni, Maurizio, Alberti, Andrea, Agnelli, Giancarlo, Giorgi Pierfranceschi, Matteo, Dulicek, Petr, Silingardi, Mauro, Federica, Landini, Ghirarduzzi, Angelo, Tiraferri, Eros, di Lazzaro, Vincenzo, Rossi, Elena, Ciminello, Angela, Pasca, Samantha, Barillari, Giovanni, Rezoagli, Emanuele, Galli, Matteo, Squizzato, Alessandro, Tosetto, Alberto, Dentali, F, Poli, D, Scoditti, U, Di Minno, M, De Stefano, V, Stefano, V, Siragusa, S, Kostal, M, Palareti, G, Sartori, M, Grandone, E, Vedovati, M, Ageno, W, Falanga, A, Lerede, T, Bianchi, M, Testa, S, Witt, D, Mccool, K, Bucherini, E, Grifoni, E, Coalizzo, D, Benedetti, R, Marietta, M, Sessa, M, Guaschino, C, di Minno, G, Tufano, A, Barbar, S, Malato, A, Pini, M, Castellini, P, Barco, S, Barone, M, Paciaroni, M, Alberti, A, Agnelli, G, Giorgi Pierfranceschi, M, Dulicek, P, Silingardi, M, Federica, L, Ghirarduzzi, A, Tiraferri, E, di Lazzaro, V, Rossi, E, Ciminello, A, Pasca, S, Barillari, G, Rezoagli, E, Galli, M, Squizzato, A, Tosetto, A, Di Minno, M N D, Stefano, V D, Sartori, M T, Vedovati, M C, Falanga, Anna, Lerede, Teresa, Bianchi, Marina, Testa, Sophie, Witt, Dan, McCool, Katie, Bucherini, Eugenio, Grifoni, Elisa, Coalizzo, Daniela, Benedetti, Raffaella, Marietta, Marco, Sessa, Maria, Guaschino, Clara, di Minno, Giovanni, Tufano, Antonella, Barbar, Sofia, Malato, Alessandra, Pini, Mario, Castellini, Paola, Barco, Stefano, Barone, Marisa, Paciaroni, Maurizio, Alberti, Andrea, Agnelli, Giancarlo, Giorgi Pierfranceschi, Matteo, Dulicek, Petr, Silingardi, Mauro, Federica, Landini, Ghirarduzzi, Angelo, Tiraferri, Eros, di Lazzaro, Vincenzo, Rossi, Elena, Ciminello, Angela, Pasca, Samantha, Barillari, Giovanni, Rezoagli, Emanuele, Galli, Matteo, Squizzato, Alessandro, and Tosetto, Alberto

Abstract

Background: Little information is available on the long-term clinical outcome of cerebral vein thrombosis (CVT). Objectives and methods: In an international, retrospective cohort study, we assessed the long-term rates of mortality, residual disability and recurrent venous thromboembolism (VTE) in a cohort of patients with a first CVT episode. Results: Seven hundred and six patients (73.7% females) with CVT were included. Patients were followed for a total of 3171 patient-years. Median follow-up was 40months (range 6, 297months). At the end of follow-up, 20 patients had died (2.8%). The outcome was generally good: 89.1% of patients had a complete recovery (modified Rankin Score [mRS] 0-1) and 3.8% had a partial recovery and were independent (mRS 2). Eighty-four per cent of patients were treated with oral anticoagulants and the mean treatment duration was 12months. CVT recurred in 31 patients (4.4%), and 46 patients (6.5%) had a VTE in a different site, for an overall incidence of recurrence of 23.6 events per 1000 patient-years (95% confidence Interval [CI] 17.8, 28.7) and of 35.1 events/1000 patient-years (95% CI, 27.7, 44.4) after anticoagulant therapy withdrawal. A previous VTE was the only significant predictor of recurrence at multivariate analysis (hazard ratio [HR] 2.70; 95% CI 1.25, 5.83). Conclusions: The long-term risk of mortality and recurrent VTE appears to be low in patients who survived the acute phase of CVT. A previous VTE history independently predicts recurrent events.

Published
2012

43. The THRombolysis and STatins (THRaST) study

Author

Cappellari, M., primary, Bovi, P., additional, Moretto, G., additional, Zini, A., additional, Nencini, P., additional, Sessa, M., additional, Furlan, M., additional, Pezzini, A., additional, Orlandi, G., additional, Paciaroni, M., additional, Tassinari, T., additional, Procaccianti, G., additional, Di Lazzaro, V., additional, Bettoni, L., additional, Gandolfo, C., additional, Silvestrelli, G., additional, Rasura, M., additional, Martini, G., additional, Melis, M., additional, Calloni, M. V., additional, Chiodo-Grandi, F., additional, Beretta, S., additional, Guarino, M., additional, Altavista, M. C., additional, Marcheselli, S., additional, Galletti, G., additional, Adobbati, L., additional, Del Sette, M., additional, Mancini, A., additional, Orrico, D., additional, Monaco, S., additional, Cavallini, A., additional, Sciolla, R., additional, Federico, F., additional, Scoditti, U., additional, Brusaferri, F., additional, Grassa, C., additional, Specchio, L., additional, Bongioanni, M. R., additional, Sparaco, M., additional, Zampolini, M., additional, Greco, G., additional, Colombo, R., additional, Passarella, B., additional, Adami, A., additional, Consoli, D., additional, and Toni, D., additional

Published
2013
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45. RANDOMIZED CONTROLLED TRIAL OF STREPTOKINASE, ASPIRIN, AND COMBINATION OF BOTH IN TREATMENT OF ACUTE ISCHEMIC STROKE

Author

CANDELISE, L, ARITZU, E, CICCONE, A, RICCI, S, WARDLAW, J, TOGNONI, G, RONCAGLIONI, M, NEGRI, E, COLOMBO, F, BOCCARDI, E, DEGRANDI, C, SCIALFA, G, ARGENTINO, C, BERTELE, V, MAGGIONI, A, PERRONE, P, BARNETT, H, BOGOUSSLAVSKY, J, DELFAVERO, A, LOI, U, PETO, R, WARLOW, C, CANZI, S, COMPARETTI, S, CLERICI, F, PALUMBO, A, SGARONI, G, POLONARA, S, REGINELLI, R, CERAVOLO, M, PROVINCIALI, L, DELGOBBO, M, SCARPINO, O, BOTTACCHI, E, DALESSANDRO, G, DIGIOVANNI, M, BLANC, S, ROVEYAZ, L, RALLI, L, VANNI, D, REFI, C, FEDERICO, F, CONTE, C, INCHINGOLO, V, INSABATO, R, SALSA, F, LORIZIO, A, ROTTOLI, M, BRUNI, L, DEFANTI, C, FERA, L, CAMERLINGO, M, CASTO, L, CENSORI, B, MAMOLI, A, PORAZZI, D, GRAMPA, G, LASPINA, I, GIGLIA, L, AVENIA, V, GUELI, S, LOLLI, V, MIELE, V, SANTANGELO, M, COPPOLA, G, TRIANNI, G, MARRA, M, GRECO, E, TONTI, D, PRETOLANI, E, STELLIO, M, ARNABOLDI, M, CIOLA, R, DANIELI, G, REZZONICO, M, GUIDOTTI, M, PELLEGRINI, G, RAUDINO, F, DELFAVERO, C, FRATTINI, T, RICCARDI, T, LEVIMINZI, C, LOCATELLI, F, PASSERI, F, LOMBARDO, G, COCCO, F, PRATESI, M, SANTINI, S, CARDOPATRI, F, TAFANI, O, LANDINI, G, PIERAGNOLI, E, BELLESI, R, BAGNOLI, L, GHETTI, A, MARRAZZA, O, MENEGAZZO, P, SPOLVERI, S, CAPPELLETTI, C, CANDELIERE, G, COSTANTINO, G, DACUNO, F, LOMUZIO, T, RIZZITELLI, F, BOVIO, G, GRILLI, G, ZOCCHI, M, MAZZANTI, I, PISAPIA, G, NUZZI, R, RUSSO, G, LAMA, G, BALDASSARRI, G, BETTINI, R, CANI, E, CERIOLI, E, DEGIORGI, M, GARAGNANI, A, PASQUALI, S, CHIOMA, V, FINI, C, MARZARA, G, BALOTTA, A, BERTUZZI, D, MASINA, M, MATACENA, C, MICHELINI, M, PIRAZZOLI, G, SACCHET, C, MAROTTA, P, CALVI, L, SCACCABAROZZI, C, MENOZZI, C, SASANELLI, F, BASCELLI, C, PONTRELLI, V, SCHIERONI, F, BELVEDERE, D, DECAPITANI, E, DICOSTANZO, M, RASCAROLI, M, CITTERIO, O, MILANI, R, CAPIALBI, R, ARENA, G, MUSOLINO, R, DIPERRI, R, BONAVENTI, C, FINZI, F, MESSINA, A, ROMANAZZI, V, STERZI, R, BOTTINI, G, SANTILLI, I, BRUCATO, A, DEJULI, E, PALMIERI, G, RAGAINI, S, THIELLA, G, ALLI, C, CAROSELLA, L, RIZZATO, G, BIANCHI, M, MOTTO, C, PINARDI, G, SCARLATO, G, BETTINELLI, A, PORRO, F, RANDAZZO, A, MARINI, U, LATTUADA, P, PIETRA, A, FRANCESCHI, M, VOLOUTE, M, MALFERRARI, G, BONDI, M, GARUTI, W, MELINI, L, COLOMBO, A, ALBORINI, G, PANZETTI, P, SCARPA, M, SORGATO, P, CRISI, G, BONASERA, N, BASSO, F, NATALI, E, MONACO, P, GASPARRO, A, TRIOLO, F, LECHI, A, COLONNA, F, DASCOLA, I, GIORGI, C, SCODITTI, U, BASSI, P, MENOZZI, R, PIAZZA, P, DEGLIANTONI, G, DESIMONI, M, GIANNINI, A, MICILI, G, BOSONE, D, CAVALLINI, A, MARTELLI, A, BARZIZZA, F, POLI, M, BIAGINI, S, CAPOCCHI, G, CELANI, M, PICCHIARELLI, A, RIGHETTI, E, ZAMPOLINI, M, CAPUTO, N, BARTOLINI, S, SANTONI, M, SITA, D, TAGLIOLI, M, VOLPI, G, ROSSI, F, ALOY, F, CASTELLANO, A, MINOTTA, F, GATTA, A, VINATTIERI, A, CANTINI, A, REBUCCI, G, BISSI, G, DEBLASI, F, PASCARELLI, E, TURIAMO, F, GUIDETTI, D, BARATTI, M, FERRARINI, G, GHIDONI, E, GRECO, G, MARCELLO, N, MOTTI, L, SOLIME, F, TERENZIANI, S, ZUCCO, R, TROISO, A, VENEZIANI, M, IORI, I, CURATOLA, L, BOLLETTINI, G, CARBONI, T, GOBBATO, R, INFRICCIOLO, P, SABATINI, D, SFRAPPINI, M, FANCELLU, A, CASU, G, DELEDDA, M, SPANU, M, PIRISI, A, MARRAS, F, ROSATI, G, BRAMBILLA, A, ERLI, G, FELICE, B, GRANDI, R, MIRABILE, D, ZADRA, M, CAVESTRI, R, GORI, D, LONGHINI, E, MIELE, N, DIVIZIA, G, GRASSELLI, S, PEZZELLA, F, ZUCCARI, F, SALLUSTO, L, LINCESSO, F, SCARPATI, C, IANNONE, G, BARTOCCI, A, COSTANTINI, F, DESANTIS, L, LANCIA, G, MOSCHINI, E, PACI, A, SENSIDONI, A, TRENTA, A, BARTOLINI, N, OTTAVIANO, P, BISCOTTINI, B, ALUNNI, G, BARTOLINI, I, BELLADONNA, D, BOCCALI, A, CRUCIANI, M, IBBA, R, LUCCIOLI, R, MARCECA, A, PACINI, M, PALLONE, M, GIRARDI, P, ORRICO, D, LANZA, E, BALLINI, A, GRANDI, F, MUSCO, G, STEIDL, L, SANTORO, G, VEMCO, A, DUDINE, P, MILONE, F, MUNARI, L, PERRETI, A, PORTA, M, LONGONI, C, FERANI, R, WATT, M, SANDERCOCK, P, FENNETRY, A, BANNISTER, P, CLARKE, C, BAMFORD, J, VENABLES, G, and CORREIA, M

Published
1995

46. Focal cerebral ischemia in young adults: a collaborative case-control study. The National Research Council Study Group

Author

Marini, C., Carolei, A., Roberts, R. S., Prencipe, M., Gandolfo, Carlo, Inzitari, D., Landi, G., Zanche, L. D., Scoditti, U., and Fieschi, C.

Subjects
Adult, Male, Adolescent, Alcohol Drinking, complications, Heart Diseases, Arteriosclerosis, Ischemic Attack, Transient, etiology, Brain Ischemia, Cerebrovascular Disorders, Italy, Risk Factors, Case-Control Studies, epidemiology/etiology, adverse effects, Humans, Female, epidemiology, Adolescent, Adult, Alcohol Drinking, adverse effects, Arteriosclerosis, complications, Brain Ischemia, epidemiology/etiology, Case-Control Studies, Cerebrovascular Disorders, etiology, Female, Heart Diseases, complications, Humans, Ischemic Attack, epidemiology, Italy, epidemiology, Life Style, Male, Risk Factors, Life Style
Published
1993

Catalog

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