1,088 results on '"Shoamanesh, A."'
Search Results
2. Predictors and Prognostic Impact of Hematoma Expansion in Infratentorial Cerebral Hemorrhage
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Pezzini, Debora, Nawabi, Jawed, Schlunk, Frieder, Li, Qi, Mazzacane, Federico, Busto, Giorgio, Scola, Elisa, Arba, Francesco, Brancaleoni, Laura, Giacomozzi, Sebastiano, Simonetti, Luigi, Laudisi, Michele, Cavallini, Anna, Katsanos, Aristeidis H., Shoamanesh, Ashkan, Zini, Andrea, Casetta, Ilaria, Fainardi, Enrico, Morotti, Andrea, and Padovani, Alessandro
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- 2024
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3. Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient‐Level Meta‐Analysis From COMBINE AF
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Linda S. Johnson, Alexander P. Benz, Ashkan Shoamanesh, John W. Eikelboom, Michael Ezekowitz, Robert P. Giugliano, Lars Wallentin, Christian T. Ruff, Renato D. Lopes, Sanjit Jolly, Richard Whitlock, Christopher B. Granger, Stuart Connolly, and Jeffrey S. Healey
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anticoagulation ,atrial fibrillation ,stroke ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Despite oral anticoagulation, patients with atrial fibrillation (AF) remain at risk of ischemic stroke and systemic embolism (SE) events. For patients whose residual risk is sufficiently high, additional therapies might be useful to mitigate stroke risk. Methods and Results Individual patient data from 5 landmark trials testing oral anticoagulation in AF were pooled in A Collaboration Between Multiple Institutions to Better Investigate Non‐Vitamin K Antagonist Oral Anticoagulant Use in AF (COMBINE AF). We calculated the rate of ischemic stroke/SE among oral anticoagulation–treated patients with a CHA2DS2‐VASc score≥2, across strata of CHA2DS2‐VASc score, stroke history, and AF type, as either paroxysmal or nonparoxysmal. We included 71 794 patients with AF (median age 72 years, interquartile range, 13 years, 61.3% male) randomized to a direct oral anticoagulant or vitamin K antagonist, and followed for a mean of 2.1 (±0.8) years. The median CHA2DS2‐VASc score was 4 (interquartile range, 3–5), 18.8% had a prior stroke, and 76.4% had nonparoxysmal AF. The overall rate of stroke/SE was 1.33%/y (95% CI, 1.27–1.39); 1.38%/y (95% CI, 1.31–1.45) for nonparoxysmal AF, and 1.15%/y (95% CI, 1.05–1.27) for paroxysmal AF. The rate of ischemic stroke/SE increased by a rate ratio of 1.36 (95% CI, 1.32–1.41) per 1‐point increase in CHA2DS2‐VASc, reaching 1.67%/y (95% CI, 1.59–1.75) ≥4 CHA2DS2‐VASc points. Patients with both nonparoxysmal AF and CHA2DS2‐VASc ≥4 had a stroke/SE rate of 1.75%/y (95% CI, 1.66–1.85). In patients with a prior stroke, the risk was 2.51%/y (95% CI, 2.33–2.71). Conclusions AF type, CHA2DS2‐VASc score, and stroke history can identify patients with AF, who despite oral anticoagulation have a residual stroke/SE risk of 1.5% to 2.5% per year. Evaluation of additional stroke/SE prevention strategies in high‐risk patients is warranted.
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- 2024
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4. Derivation of the Falls Decision Rule to exclude intracranial bleeding without head CT in older adults who have fallen
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de Wit, Kerstin, Mercuri, Mathew, Clayton, Natasha, Mercier, Eric, Morris, Judy, Jeanmonod, Rebecca, Eagles, Debra, Varner, Catherine, Barbic, David, Buchanan, Ian M., Ali, Mariyam, Kagoma, Yoan K., Shoamanesh, Ashkan, Engels, Paul, Sharma, Sunjay, Worster, Andrew, McLeod, Shelley, Emond, Marcel, Stiell, Ian, Papaioannou, Alexandra, and Parpia, Sameer
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Anticoagulants (Medicine) ,Head injuries ,CT imaging ,Health ,McMaster University - Abstract
Background: Ground-level falls are common among older adults and are the most frequent cause of traumatic intracranial bleeding. The aim of this study was to derive a clinical decision rule that safely excludes clinically important intracranial bleeding in older adults who present to the emergency department after a fall, without the need for a computed tomography (CT) scan of the head. Methods: This prospective cohort study in 11 emergency departments in Canada and the United States enrolled patients aged 65 years or older who presented after falling from standing on level ground, off a chair or toilet seat, or out of bed. We collected data on 17 potential predictor variables. The primary outcome was the diagnosis of clinically important intracranial bleeding within 42 days of the index emergency department visit. An independent adjudication committee, blinded to baseline data, determined the primary outcome. We derived a clinical decision rule using logistic regression. Results: The cohort included 4308 participants, with a median age of 83 years; 2770 (64%) were female, 1119 (26%) took anticoagulant medication and 1567 (36%) took antiplatelet medication. Of the participants, 139 (3.2%) received a diagnosis of clinically important intracranial bleeding. We developed a decision rule indicating that no head CT is required if there is no history of head injury on falling; no amnesia of the fall; no new abnormality on neurologic examination; and the Clinical Frailty Scale score is less than 5. Rule sensitivity was 98.6% (95% confidence interval [CI] 94.9%-99.6%), specificity was 20.3% (95% CI 19.1%-21.5%) and negative predictive value was 99.8% (95% CI 99.2%-99.9%). Interpretation: We derived a Falls Decision Rule, which requires external validation, followed by clinical impact assessment. Trial registration: ClinicalTrials. gov, no. NCT03745755., As populations age, emergency departments are managing a growing number of older adults who fall. (1-3) Falling on level ground is the most common cause of traumatic intracranial bleeding. (4-6) [...]
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- 2023
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5. Hemorrhagic Transformation in Noncardioembolic Acute Ischemic Stroke: MRI Analysis From PACIFIC-STROKE
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Chen, Chih-Hao, Shoamanesh, Ashkan, Colorado, Pablo, Saad, Feryal, Lemmens, Robin, De Marchis, Gian Marco, Caso, Valeria, Xu, Lizhen, Heenan, Laura, Masjuan, Jaime, Christensen, Hanne, Connolly, Stuart J., Khatri, Pooja, Mundl, Hardi, Hart, Robert G., and Smith, Eric E.
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- 2024
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6. Tenecteplase versus standard of care for minor ischaemic stroke with proven occlusion (TEMPO-2): a randomised, open label, phase 3 superiority trial
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Salluzzi, Marina, Blenkin, Nicole, Dueck, Ashley, Doram, Craig, Zhang, Qiao, Kenney, Carol, Ryckborst, Karla, Bohn, Shelly, Collier, Quentin, Taylor, Frances, Lethebe, B. Cord, Jambula, Anitha, Sage, Kayla, Toussaint, Lana, Save, Supryia, Lee, Jaclyn, Laham, N, Sultan, A.A., Deepak, A., Sitaram, A., Demchuk, Andrew M., Lockey, A., Micielli, A., Wadhwa, A., Arabambi, B., Graham, B., Bogiatzi, Chrysi, Doshi, Darshan, Chakraborty, D., Kim, Diana, Vasquez, D, Singh, D, Tse, Dominic, Harrison, E., Smith, E.E., Teleg, E., Klourfeld, E., Klein, G., Sebastian, I.A., Evans, J, Hegedus, J, Kromm, J, Lin, K, Ignacio, K, Ghavami, Kimia, Ismail, M., Moores, M., Panzini, M.A., Boyko, M., Almekhlafi, M.A., Newcommon, Nancy, Maraj, N., Imoukhuede, O., Volny, O., Stys, Peter, Couillard, Phillipe, Ojha, P., Eswaradass, P., Joundi, Raed, Singh, R., Asuncion, R.M., Muir, R.T., Dey, S., Mansoor, S., Wasyliw, S., Nagendra, S., Hu, Sherry, Althubait, S., Chen, S., Bal, S., Van Gaal, Stephen, Peters, Steven, Ray, Sucharita, Chaturvedi, S., Subramaniam, Suresh, Fu, Vivian, Villaluna, K., Maclean, G., King-Azote, P., Ma, C., Plecash, A., Murphy, C., Gorman, J., Wilson, L., Zhou, L., Benevente, O., Teal, P., Yip, S., Mann, S., Dewar, B., Demetroff, M., Shamloul, R., Beardshaw, R., Roberts, S., Blaquiere, D., Stotts, G., Shamy, M., Bereznyakova, O., Fahed, R., Alesefir, W., Lavoie, Suzy, Hache, A., Collard, K, Mackey, A., Gosselin-Lefebvre, S., Verreault, S., Beauchamp, B., Lambourn, L., Khaw, A., Mai, L., Sposato, L., Bres Bullrich, M., Azarpazhooh, R., Fridman, S., Kapoor, A., Southwell, A., Bardi, E., Fatakdawala, I., Kamra, M, Lopes, K., Popel, N., Norouzi, V., Liu, A., Liddy, A.M., Ghoari, B., Hawkes, C., Enriquez, C.A., Gladstone, D.J., Manosalva Alzate, H.A., Khosravani, H., Hopyan, J.J., Sivakumar, K., Son, M., Boulos, M.I., Hamind, M.A., Swartz, R.H., Murphy, R., Reiter, S., Fitzpatrick, T., Bhandari, V., Good, J., Penn, M., Naylor, M., Frost, S., Cayley, A., Akthar, F., Williams, J., Kalman, L., Crellin, L., Wiegner, R., Singh, R.S., Stewart, T., To, W., Singh, S., Pikula, A., Jaigobin, C., Carpani, F., Silver, F., Janssen, H., Schaafsma, J., del Campo, M., Alskaini, M., Rajendram, P., Fairall, P., Granfield, B., Crawford, D., Jabs, J., White, L., Sivakumar, L., Piquette, L., Nguyen, T., Nomani, A., Wagner, A., Alrohimi, A., Butt, A., D'Souza, A., Gajurel, B., Vekhande, C., Kamble, H., Kalashyan, H., Lloret, M., Benguzzi, M., Arsalan, N., Ishaque, N., Ashayeriahmadabad, R., Samiento, R., Hosseini, S., Kazi, S., Das, S., Sugumar, T., Selchen, D., Kostyrko, P., Muccilli, A., Saposnik, A.G., Vandervelde, C., Ratnayake, K., McMillan, S., Katsanos, A., Shoamanesh, A., Sahlas, D.J., Naidoo, V., Todorov, V., Toma, H., Brar, J., Lee, J., Horton, M., Shand, E., Weatherby, S., Jin, A., Durafourt, B., Jalini, S., Gardner, A., Tyson, C., Junk, E., Foster, K., Bolt, K., Sylvain, N., Maley, S., Urroz, L., Peeling, L., Kelly, M., Whelan, R., Cooley, R., Teitelbaum, J., Boutayeb, A., Moore, A., Cole, E., Waxman, L., Ben-Amor, N., Sanchez, R., Khalil, S., Nehme, A., Legault, C., Tampieri, D., Ehrensperger, E., Vieira, L., Cortes, M., Angle, M., Hannouche, M., Badawy, M., Werner, K., Wieszmuellner, S., Langer, A., Gisold, A., Zach, H., Rommer, P., Macher, S., Blechinger, S., Marik, W., Series, W., Baumgartinger, M., Krebs, S., Koski, J., Eirola, S., Ivanoff, T., Erakanto, A., Kupari, L., Sibolt, G., Panula, J., Tomppo, L., Tiainen, M., Ahlstrom, M., Martinez Majander, N., Suomalainen, O., Raty, S., Levi, C., Kerr, E., Allen, J., Kaauwai, L.P., Belevski, L., Russell, M., Ormond, S., Chew, A., Loiselle, A., Royan, A., Hughes, B., Garcia Esperon, C., Pepper, E., Miteff, F., He, J., Lycett, M., Min, M., Murray, N., Pavey, N., Starling de Barros, R., Gangadharan, S., Dunkerton, S., Waller, S., Canento Sanchez, T., Wellings, T., Edmonds, G., Whittaker, K.A., Ewing, M., Lee, P., Singkang, R., McDonald, A., Dos Santos, A., Shin, C., Jackson, D., Tsoleridis, J., Fisicchia, L., Parsons, N., Shenoy, N., Smith, S., Sharobeam, A., Balabanski, A., Park, A., Williams, C., Pavlin-Premri, D., Rodrigues, E., Alemseged, F., Ng, F., Zhao, H., Beharry, J., Ng, J.L., Williamson, J., Wong, J.Z.W., Li, K., Kwan, M.K., Valente, M., Yassi, N., Yogendrakumar, V., McNamara, B., Buchanan, C., McCarthy, C., Thomas, G., Stephens, K., Chung, M., Chung, M.F., Tang, M., Busch, T., Frost, T., Lee, R., Stuart, N., Pachani, N., Menon, A., Borojevic, B., Linton, C.M., Garcia, G., Callaly, E.P., Dewey, H., Liu, J., Chen, J., Wong, J., Nowak, K., To, K., Lizak, N.S., Bhalala, O., Park, P., Tan, P., Martins, R., Cody, R., Forbes, R., Chen, S.K., Ooi, S., Tu, S., Dang, Y.L., Ling, Z., Cranefield, J., Drew, R., Tan, A., Kurunawai, C., Harvey, J., Mahadevan, J.J., Cagi, L., Palanikumar, L., Chia, L.N., Goh, R., El-Masri, S., Urbi, B., Rapier, C., Berrill, H., McEvoy, H., Dunning, R., Kuriakose, S., Chad, T., Sapaen, V., Sabet, A., Shah, D., Yeow, D., Lilley, K., Ward, K., Mozhy Mahizhnan, M., Tan, M., Lynch, C., Coveney, S., Tobin, K., McCabe, J., Marnane, M., Murphy, S., Large, M., Moynihan, B., Boyle, K., Sanjuan, E., Sanchis, M., Boned, S., Pancorbo, O., Sala, V., Garcia, L., Garcia-Tornel, A., Juega, J., Pagola, J., Santana, K., Requena, M., Muchada, M., Olive, M., Lozano, P.J., Rubiera, M., Deck, M., Rodriguez, N., Gomez, B., Reyes Munoz, F.J., Gomez, A.S., Sanz, A.C., Garcia, E.C., Penacoba, G., Ramos, M.E., de Lera Alfonso, M., Feliu, A, Pardo, L., Ramirez, P., Murillo, A., Lopez Dominguez, D., Rodriguez, J., Terceno Izaga, M., Reina, M., Viturro, S.B., Bojaryn, U., Vera Monge, V.A., Silva Blas, Y., R Siew, R., Agustin, S J, Seet, C., Tianming, T., d'Emden, A., Murray, A., Welch, A., Hatherley, K., Day, N., Smith, W., MacRae, E., Mitchell, E.S., Mahmood, A., Elliot, J., Neilson, S., Biswas, V., Brown, C., Lewis, A., Ashton, A., Werring, D., Perry, R., Muhammad, R., Lee, Y.C., Black, A., Robinson, A., Williams, A., Banaras, A., Cahoy, C., Raingold, G., Marinescu, M., Atang, N., Bason, N., Francia, N., Obarey, S., Feerick, S., Joseph, J., Schulz, U., Irons, R., Benjamin, J., Quinn, L., Jhoots, M., Teal, R., Ford, G., Harston, G., Bains, H., Gbinigie, I., Mathieson, P., Sim, C.H., Hayter, E., Kennedy, K., Binnie, L., Priestley, N., Williams, R., Ghatala, R., Stratton, S., Blight, A., Zhang, L., Davies, A., Duffy, H., Roberts, J., Homer, J., Roberts, K., Dodd, K., Cawley, K., Martin, M., Leason, S., Cotgreave, S., Taylor, T., Nallasivan, A., Haider, S., Chakraborty, T., Webster, T., Gil, A., Martin, B., Joseph, B., Cabrera, C., Jose, D., Man, J., Aquino, J., Sebastian, S., Osterdahl, M., Kwan, M., Matthew, M., Ike, N., Bello, P., Wilding, P., Fuentes, R., Shah, R., Mashate, S., Patel, T., Nwanguma, U., Dave, V., Haber, A., Lee, A., O'Sullivan, A., Drumm, B., Dawson, A.C., Matar, T., Roberts, D., Taylor, E., Rounis, E., El-Masry, A., O'Hare, C., Kalladka, D., Jamil, S., Auger, S., Raha, O., Evans, M., Vonberg, F., Kalam, S., Ali Sheikh, A., Jenkins, I.H., George, J., Kwan, J., Blagojevic, J., Saeed, M., Haji-Coll, M., Tsuda, M., Sayed, M., Winterkron, N., Thanbirajah, N., Vittay, O., Karim, R., Smail, R.C., Gauhar, S., Elmamoun, S., Malani, S., Pralhad Kelavkar, S., Hiden, J., Ferdinand, P., Sanyal, R., Varquez, R., Smith, B., Okechukwu, C., Fox, E., Collins, E., Courtney, K., Tauro, S., Patterson, C., McShane, D., Roberts, G., McIImoyle, J., McGuire, K., Fearon, P., Gordon, P., Isaacs, K., Lucas, K., Smith, L., Dews, L., Bates, M., Lawrence, S., Heeley, S., Patel, V., Chin, Y.M., Sims, D., Littleton, E., Khaira, J., Nadar, K., Kieliszkowska, A., Sari, B., Domingos Belo, C., Smith, E., Manolo, E.Y., Aeron-Thomas, J., Doheny, M., Garcia Pardo, M., Recaman, M., Tibajia, M.C., Aissa, M., Mah, Y., Yu, T., Meenakshisundaram, S., Heller, S., Alsukhni, R., Williams, O., Farag, M., Benger, M., Engineer, A., Bayhonan, S., Conway, S., Bhalla, A., Nouvakis, D., Theochari, E., Boyle, F., Teo, J., King-Robson, J., Law, K.Y., Sztriha, L., McGovern, A., Day, D., Mitchell-Douglas, J., Francis, J., Iqbal, A., Punjabivaryani, P., Anonuevo Reyes, J., Anonuevo Reyes, M., Pauls, M., Buch, A., Hedstrom, A., Hutchinson, C., Kirkland, C., Newham, J., Wilkes, G., Fleming, L., Fleck, N., Franca, A., Chwal, B., Oldoni, C., Mantovani, G., Noll, G., Zanella, L., Soma, M., Secchi, T., Borelli, W., Rimoli, B.P., da Cunha Silva, G.H., Machado Galvao Mondin, L.A., Barbosa Cerantola, R., Imthon, A.K., Esaki, A.S., Camilo, M., Vincenzi, O.C., ds Cruz, R.R., Morillos, M.B., Riccioppa Rodrigues, G.G., Santos Ferreira, K., Pazini, A.M., Pena Pereira, M.A., de Albuquerque, A.L.A., Massote Fontanini, C.E., Matinez Rubio, C.F., dos Santos, D.T., Dias, F.A., Alves, F.F.A., Milani, C., Pegorer Santos, B., Winckler, F., De Souza, J.T., Bonome, L.A.M., Cury Silva, V.A., Teodoro, R.S., Modolo, G.P., Ferreira, N.C., Barbosa dos Santos, D.F., dos Santos Moreira, J.C., Cruz Guedes de Morais, A.B., Vieira, J., Mendes, G., de Queiroz, J.P., Coutts, Shelagh B, Ankolekar, Sandeep, Appireddy, Ramana, Arenillas, Juan F, Assis, Zarina, Bailey, Peter, Barber, Philip A, Bazan, Rodrigo, Buck, Brian H, Butcher, Ken S, Camden, Marie-Christine, Campbell, Bruce C V, Casaubon, Leanne K, Catanese, Luciana, Chatterjee, Kausik, Choi, Philip M C, Clarke, Brian, Dowlatshahi, Dar, Ferrari, Julia, Field, Thalia S, Ganesh, Aravind, Ghia, Darshan, Goyal, Mayank, Greisenegger, Stefan, Halse, Omid, Horn, Mackenzie, Hunter, Gary, Imoukhuede, Oje, Kelly, Peter J, Kennedy, James, Kleinig, Timothy J, Krishnan, Kailash, Lima, Fabricio, Mandzia, Jennifer L, Marko, Martha, Martins, Sheila O, Medvedev, George, Menon, Bijoy K, Mishra, Sachin M, Molina, Carlos, Moussaddy, Aimen, Muir, Keith W, Parsons, Mark W, Penn, Andrew M W, Pille, Arthur, Pontes-Neto, Octávio M, Roffe, Christine, Serena, Joaquin, Simister, Robert, Singh, Nishita, Spratt, Neil, Strbian, Daniel, Tham, Carol H, Wiggam, M Ivan, Williams, David J, Willmot, Mark R, Wu, Teddy, Yu, Amy Y X, Zachariah, George, Zafar, Atif, Zerna, Charlotte, and Hill, Michael D
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- 2024
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7. Key design elements of successful acute ischemic stroke treatment trials
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Yperzeele, L., Shoamanesh, A., Venugopalan, Y. V., Chapman, S., Mazya, M. V., Charalambous, M., Caso, V., Hacke, W., Bath, P. M., and Koltsov, I.
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- 2023
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8. Total intracranial hemorrhage volume measurement summating all compartments best in traumatic and nontraumatic intracranial bleeding
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MacKenzie Horn, Ankur Banerjee, Linda Kasickova, Ondrej Volny, Hyun Seok Choi, Federica Letteri, Tomoyuki Ohara, Koji Tanaka, Stuart Connolly, Per Ladenvall, Mark Crowther, Jan Beyer‐Westendorf, Ashkan Shoamanesh, Andrew M. Demchuk, Abdulaziz S. Al Sultan, and for the ANNEXa‐4 Investigators
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neuroimaging ,neuroscience ,neurology ,stroke ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Abstract Background and purpose The ANNEXA‐4 trial measured hemostatic efficacy of andexanet alfa in patients with major bleeding taking factor Xa inhibitors. A proportion of this was traumatic and nontraumatic intracranial bleeding. Different measurements were applied in the trial including volumetrics to assess for intracranial bleeding depending on the compartment involved. We aimed to determine the most reliable way to measure intracranial hemorrhage (ICrH) volume by comparing individual brain compartment and total ICrH volume. Methods Thirty patients were randomly selected from the ANNEXA‐4 database to assess measurement of ICrH volume by compartment and in total. Total and compartmental hemorrhage volumes were measured by five readers using Quantomo software. Each reader measured baseline hemorrhage volumes twice separated by 1 week. Twenty‐eight different ANNEXA‐4 subjects were also randomly selected to assess intra‐rater reliability of total ICrH volume measurement change at baseline and 12‐h follow up, performed by three readers twice to assess hemostatic efficacy categories used in ANNEXA‐4. Results Compartmental minimal detectable change percentages (MDC%) ranged between 9.72 and 224.13, with the greatest measurement error occurring in patients with a subdural hemorrhage. Total ICrH volume measurements had the lowest MDC%, which ranged between 6.57 and 33.52 depending on the reader. Conclusion Measurement of total ICrH volumes is more accurate than volume by compartment with less measurement error. Determination of hemostatic efficacy was consistent across readers, and within the same reader, as well as when compared to consensus read. Volumetric analysis of intracranial hemostatic efficacy is feasible and reliable when using total ICrH volumes.
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- 2024
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9. Blood Pressure Management Following Endovascular Stroke Treatment: A Feasibility Trial and Meta‐Analysis of Outcomes
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Aristeidis H. Katsanos, Luciana Catanese, Demetrios J. Sahlas, Abhilek Srivastava, Areti‐Angeliki Veroniki, Kanjana Perera, Kelvin K. H. Ng, Raed Joundi, Brian Van Adel, Ramiro Larrazabal, Christine Hawkes, Aviraj Deshmukh, Kanchana Ratnayake, Lina Palaiodimou, Georgios Tsivgoulis, Oscar Benavente, Robert Hart, Mukul Sharma, and Ashkan Shoamanesh
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blood pressure ,endovascular thrombectomy ,large‐vessel occlusion ,meta‐analysis ,outcomes ,Neurology. Diseases of the nervous system ,RC346-429 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Although postprocedure blood pressure (BP) correlates with outcome in patients undergoing endovascular thrombectomy (EVT), the optimal target is unknown. Methods We performed a pilot randomized‐controlled clinical trial enrolling participants with persistently elevated BP after successful EVT. Participants were randomized within 1 hour from the end of EVT to either intensive (systolic BP target
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- 2024
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10. Secondary stroke prevention in people with atrial fibrillation: treatments and trials
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Seiffge, David J, Cancelloni, Virginia, Räber, Lorenz, Paciaroni, Maurizio, Metzner, Andreas, Kirchhof, Paulus, Fischer, Urs, Werring, David J, Shoamanesh, Ashkan, and Caso, Valeria
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- 2024
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11. Effect of the Factor XIa Inhibitor Asundexian According to Baseline Infarct Pattern and on MRI Covert Infarct Outcomes
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Smith, Eric E., Shoamanesh, Ashkan, Xu, Lizhen, Heenan, Laura, Saad, Feryal, Colorado, Pablo, Chen, Chih-Hao, Lemmens, Robin, De Marchis, Gian Marco, Caso, Valeria, Masjuan, Jaime, Hirano, Teruyuki, Milanov, Ivan, Campbell, Bruce C.V., Mas, Jean-Louis, Connolly, Stuart J., Mundl, Hardi, Hart, Robert G., Bailey, P., Kleinig, T., Cordato, D., Choi, P., Garcia-Esperon, C., Chew, A., Cloud, G., Stanislaus, V., Krause, M., Priglinger, M., Grimley, R., Ghia, D., Sahathevan, R., Brown, H., Kwan, C., Devlin, M., Greisenegger, S., Bonelli-Nauer, S., Rath, J., Langer, A., Marko, M., Ferrari, J., Bernegger, A., Baumgartinger, M., Vigl, M., Krebs, S., Lang, W., Knoflach, M., Dejakum, B., Kiechl, S., Töll, T., Domig, L., Mutzenbach, J.S., Ganser, B., Hecker, C., Rösler, C., Bubel, N., Pikija, S., Zellner, T., Leitner, U., Berger, O., Surböck, B., Beirer, S., Staykov, D., Schrammel, D., Halilovic, A., Frattner, M., Barmherzigen, D., Lampl, C., Höfer, C., Nagl, S., Bocksrucker, C., Demeestere, J., Desfontaines, P., Ciobanu, C., De Pauw, A., Terwecoren, A., Hasenbroekx, M.C., Clement, F., De Klippel, N., Soors, P., Hermans, S., De Raedt, S., Vandervorst, F., Seynaeve, L., Fockaert, N., Smet, S., Rutgers, M., Del Gaudio, N., Paindeville, P., Staikov, I., Simeonova, A., Stoyanova, I., Cholakova, M., Mihnev, N., Petrova, T., Koralova, A., Dimov, D., Kuzev, Y., Danovska, M., Marinova, D., Marinova-Trifonova, D., Ovcharova, E., Mladenovski, I., Yanakieva, M., Stoev, P., Dimitrova, M., Todorova-Georgieva, S., Haralanov, L., Milkov, B., Solakov, D., Petkova, N., Ignatova-Valkova, V., Karabinov, V., Marinova, V., Miteva, Y., Andonova, V., Kasabova, D., Kostadinova, E., Shopova-Vrabcheva, Y., Gatev, D., Semova, D., Halil, E., Kaprelyan, A., Ivanov, B., Panov, G., Grudkova, M., Syuleyman, N., Kalpachki, R., Alexiev, F., Ivanova, I., Kancheva, K., Sakelarova, T., Maslarov, D., Drenska, D., Georgiev, V., Petrova, K., Petrova, N., Ivanova, I., Semerdjieva, N., Zhelyazkov, P., Spasova-Markova, S., Dong, X., Wang, D., Wang, S., Huang, W., Zhao, H., Wang, C., Jie, L., Xinyang, Y., Ping, Z., Dong, Q., Wang, Y., Fuling, Y., Yue, W., Liu, R., Yang, Y., Stetkarova, I., Mikulenka, P., Vasko, P., Peisker, T., Bar, M., Roubec, M., Mikulik, R., Cabukova, M., Vinklarek, J., Kovar, M., Pansky, M., Mencl, P., Skoda, O., Carek, M., Pernicka, M., Skodova, M., Geier, P., Cepkova, J., Drlik, J., Prax, T., Herzig, R., Krajickova, D., Vitkova, E., Haluskova, S., Vaclavik, D., Martinkova, J., Blejcharova, K., Tkacova, M., Pavlik, O., Nevšímalová, M., Rosol, J., Nevsimalova, M., Hruby, R., Iversen, H., Andersen, A.V., Rahimi, D., Christensen, H., Grundtvig, J., Hjort, N., Andersen, G., Sandal, B., Stilund, M., Modrau, B., Strade, A., Porobic, M., Andersen, S.D., Kruuse, C., Ölmestig, J., Kolmos, M., Parvez, A., Christensen, T., Stokholm, J., Jensen, H.B., Putaala, J., Strbian, D., Sibolt, G., Tiainen, M., Martinez-Majander, N., Curtze, S., Raty, S., Kraemer, Y., Roine, R., Aivo, J., Ruuskanen, J., Ylikotila, P., Roine, S., Hallikainen, M., Jakala, P., Kurl, S., Julkunen, V., Sibon, I., Olindo, S., Richard, S., Larrue, V., Gollion, C., Catala, H., Henon, H., Lucie, D.S., Nelly, D., Calvet, D., Malbranque, A., Mazé, B., Barbieux-Ghitu, C., Rosso, C., Samson, Y., Vannier, S., Moulin, T., Bonnet, L., Reiner, P., Buffon, F., Denier, C., Amri, K., Legris, N., Chassin, O., Selli, N., Mariana, S., Berrouschot, J., Stoll, A., Klunk, D., Keilitz, J., Neustadt, M., Zerrenner, S., Veltkamp, R., Hajjar, K., Heeger, A., Winezki, E., Apel, L., Pompsch, M., Mueller, P., Rappard, P., Auer, R., Ringleb, P.A., Berberich, A., Heyse, M., Mundiyanapurath, S., Reiff, T., Poli, S., Gomez-Exposito, A., Mengel, A., Tünnerhoff, J., Adeyemi, K., Poli, K., Kusch, V., Pelz, J., Michalski, D., Wartenberg, K., Althaus, K., Tavares, F., Mueller, S., Soda, H., Rascher, A., Hiermann, E., Weinhardt, R., Weissenborn, K., Leotescu, A., Grosse, G., Worthmann, H., Ernst, J., Gabriel, M., Schuppner, R., Schäfer, J.H., Charisse, D., Gruber, K., Kurka, N., Reitz, S.C., Pfeilschifter, W., Lee, J.I., Gliem, M., Moll, M., Steiner, T., Segura, L., Szegedi, N., Barandi, D., Uhrinakova, L., Czencz, M., Pasztor, M., Gyuker, N., Bartha, N.E., May, Z., Simony, Z., Szasz, G., Kakuk, I., Pető, N., Panczel, G.F., Olah, A., Racz, O., Balla, T., Horvath, B., Tuba, K., Czinderi, V., Klivenyi, P., Annus, A., Hertelendy, P., Szapary, L., Bosnyak, E., Kalmar, P., Karadi, Z., Cziba, L., Olah, L., Berki, A., Hudak, L., Kozák, M., Babel, S., Nemeth, L., Molnár, B., Simon, Z., Roveri, L., Cerri, F., Giacalone, G., Zini, A., Mauro, G., Asioli, G.M., Forlivesi, S., Arnone, G., Fiaccadori, A., Maria Fontana Francesca, E., Allegra, G., Mosconi, M.G., Longoni, M., Terlizzi, R., Paolucci, M., Tassi, R., Franci, B., Lucani, B., Domenichelli, C., Paoletti, D., Acampa, M., Zedde, M.L., Pezzella, F.R., Mangiardi, M., Galizia, P., Anticoli, S., Scalise, S., Lattanzi, S., Norata, D., Cannuccia, M., Cavallini, A., Federica, F., Denaro, M.F., Tosi, P., Sonoda, K., Kawajiri, M., Kusano, Y., Haraguchi, K., Kawano, H., Terasaki, T., Kaneko, C., Murase, S., Kumagai, M., Murai, N., Miyazaki, Y., Mori, T., Hatano, T., Kawanishi, M., Ochiai, J., Ishihara, S., Uehara, T., Yasaka, M., Nakagawa, H., Makino, M., Yonehara, T., Fukushima, Y., Hirotsune, N., Sakai, N., Yamasaki, M., Coutinho, J., Wouters, A., den Hertog, H., Zwartbol, R., Beumer, D., Kerklaan, J., Hilkens, P., Schreuder, T., Propper, D., Slowik, A., Wlodarczyk, E., Wrona, P., Pulyk, R., Lasek-Bal, A., Kosarz-Lanczek, K., Puz, P., Bilik, M., Magielska, A., Zamiela – Żółciak, A., Ochocinska, L., Bahdasaryan, S., Stępień, A., Dębiec, A., Joanna, K., Pawel, M., Jacek, S., Daniel, P., Marta, S., Rejdak, K., Wojczal, J., Luchowski, P., Fryze, W., Wisniewska, A., Krzyzanowska, M., Skowron, P., Wolosz, A., Galan, A., Grzymala, K., Krajewska, M., Nowak, R., Kłos, M., Cruz, V., Castro, P., Ferro, J., Canhão, P., Gouveia, R., Inácio, N., Rodrigues, M., Rachão, A., Ionel, C., Pereira, L., Viana-Baptista, M., Machado, C., Fernandes, C., Sargento, J., Inácio, N., Timchenko, L., Mironova, J., Zhadan, O., Torgashova, A., Bazhenova, O., Barashenkova, M., Kireeva, M., Romadina, N., Stepanova, I., Lenskaya, L., Lukinykh, L., Vorontsova, T., Agafina, A., Fedorova, A., Yashina, A., Alasheev, A., Smolkin, A., Prazdnichkova, E., Lutskovich, O., Gonysheva, Y., Mordvintseva, E., Nechaev, A., Martynova, E., Fedoraeva, N., Vishnyakova, T., Popov, D., Merzliakova, A., Margarita, K., Rechkalova, L., Ilyina, A., Kurenkova, N., Barbarash, O., Bazdyrev, E., Zvereva, T., Hromova, A., Morkvenas, A., Postnikova, E., Kovalenko, G., Taran, I., Pavlov, L., Ott, M., Chernitsova, N., Vodopyanova, N., Drozdova, E., Korebo, E., Lobanova, M., Lazareva, N., Snegova, N., Nikolaeva, O., Kolesnikov, Y., Kosheleva, Y., Krastev, G., Tomasova, K., Danis, M., Mako, M., Jankovicova, Z., Stevkova, Z., Kovacik, M., Kubikova, T., Jarosova, A., Serdahely, V., Cilingova, I., Pribulova, I., Sedlak, J., Slebodova, K., Paldaufova, M., Risnovsky, R., Berndtova, B., Urbanova, I., Junas, R., Karapetian, S., Gurcik, L., Vantrobova, A., Verbovsky, F., Vanacka, K., Ferenc, M., Galik, P., Bucakova, S., Ferencova, M., Kubalova, P., Boksanska, Z., Zacharova, E., Mahundi, E., Judita, H., Bachnak, M., Turcani, P., Kvasnicova Kamenska, A., Jurik, M., Vestenicka, V., Kycina, M., Sagatova, E., Dvorak, M., Hlubekova, A., Kucera, C., Gernath, L., Ferenc, M., Frimmelova, P., Slebodnikova, J., Aksteinerova, N., Horny, V., Gregova, Z., Segura, T., Romero, C., Ayo, O., Masjuan Vallejo, J., Cruz, A., De felipe, A, Matute, M.C., Garcia, S., Tembl Ferrairo, J., Vielba, I., Morales Caba, L., Molina, C., Garcia-Tornel García-Camba, Á., Requena Ruiz, M., Noelia, R., Rodriguez-Yañez, M., Rodriguez Castro, E., Lopez, I., Santamaria, M., Arias, S., Purroy García, F., Vázquez Justes, D., Mauri Capdevila, G., Vicente Pascual, M., Martí Fabregas, J., Camps Renom, P., Rodríguez Campello, A., Giralt, E., Krupinski, J., Molina, J., Trillo Senin, C. Ramos Martin, S., De La Fuente Sanz, E., Moniche, F., Manuel, M.R., Pardo, B., Martínez, I., Hernández Pérez, M., Arenillas Lara, J.F., De Lera, M., Egido, J.A., Gomez Escalonilla, C., Guillan, M., Martinez, J., Lindgren, A., Andsberg, G., Wictor, L., Leonidou, M., Stenman, M., Dalberg, N., Laska, A.C., Grünfeldt, A., Lundström, A., Nadzjafov, E., Rooth, E., Dalenbring, I., Sandén, P., Johansson, E., Thomas, G., Zietz, A.V., Rudin, S., Dittrich, T.D., Lilian, K., Kägi, G., Vehoff, J., Arnold, M., Scutelnic, A., Clénin, L., Beyeler, M., Madlaine, M., Maamari, B., Siepen, B., Vynckier, J., Tarnutzer, A., Bertschi, D., Luciani, M., Cereda, C., Maulucci, F., Bianco, G., Shairin, S., Pihan, H.A., Salmen, S., Quinn, T., McAlpine, C., Wright, F., Kalladka, D., Taylor, E., Sohaa, J., Brown, Z., Dawson, J., Cameron, A., Muir, S., Dima, S., Khan, U., Zhang, L., Warburton, E., Chatterjee, K., Nallasivan, A., Curran, D., Haider, S., Ghani, U., Kenton, A., Dallol, B., Mirza, M., Menezes, B., Davies, R., Robinson, T.G., Manning, L., Sztriha, L., Phinney, T., Sethi, P., Altafullah, I., Sharaf, A., Ostrander, M., Renati, S., Burgin, W.S., Olds, K., Delio, P., Malek, A., Dissin, J., Khatri, P., Flaherty, M., Demel, S., and Dofitas, S.
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- 2024
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12. Cortical superficial siderosis in the general population: The Framingham Heart and Rotterdam studies
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Shoamanesh, Ashkan, Akoudad, Saloua, Himali, Jayandra J, Beiser, Alexa S, DeCarli, Charles, Seshadri, Sudha, Ikram, M Arfan, Romero, Jose R, and Vernooij, Meike W
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Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Neurosciences ,Dementia ,Clinical Research ,Acquired Cognitive Impairment ,Aging ,Stroke ,Brain Disorders ,Neurological ,Aged ,Cerebral Amyloid Angiopathy ,Cerebral Hemorrhage ,Humans ,Longitudinal Studies ,Magnetic Resonance Imaging ,Siderosis ,Brain microbleeds ,cerebral amyloid angiopathy ,cerebral hemorrhage ,community ,cortical superficial siderosis ,stroke facilities ,Neurology & Neurosurgery ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectiveWe aimed to characterize cortical superficial siderosis, its determinants and sequel, in community-dwelling older adults.MethodsThe sample consisted of Framingham (n = 1724; 2000-2009) and Rotterdam (n = 4325; 2005-2013) study participants who underwent brain MRI. In pooled individual-level analysis, we compared baseline characteristics in patients with cortical superficial siderosis to two reference groups: (i) persons without hemorrhagic MRI markers of cerebral amyloid angiopathy (no cortical superficial siderosis and no microbleeds) and (ii) those with presumed cerebral amyloid angiopathy based on the presence of strictly lobar microbleeds but without cortical superficial siderosis.ResultsAmong a total of 6049 participants, 4846 did not have any microbleeds or cortical superficial siderosis (80%), 401 had deep/mixed microbleeds (6.6%), 776 had strictly lobar microbleeds without cortical superficial siderosis (12.8%) and 26 had cortical superficial siderosis with/without microbleeds (0.43%). In comparison to participants without microbleeds or cortical superficial siderosis and to those with strictly lobar microbleeds but without cortical superficial siderosis, participants with cortical superficial siderosis were older (OR 1.09 per year, 95% CI 1.05, 1.14; p 999.99; p = 0.006). During a mean follow-up of 5.6 years, 42.4% participants with cortical superficial siderosis had a stroke (five intracerebral hemorrhage, two ischemic strokes and four undetermined strokes), 19.2% had transient neurological deficits and 3.8% developed incident dementia.ConclusionOur study adds supporting evidence to the association between cortical superficial siderosis and cerebral amyloid angiopathy within the general population. Community-dwelling persons with cortical superficial siderosis may be at high risk for intracerebral hemorrhage and future neurological events.
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- 2021
13. Corrigendum: Bleeding Risk Prediction in Patients Treated with Antithrombotic Drugs According to the Anatomic Site of Bleeding, Indication for Treatment, and Time Since Treatment Initiation
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Vinai Bhagirath, Tanya Kovalova, Jia Wang, Lizhen Xu, Shrikant I. Bangdiwala, Martin O'Donnell, Ashkan Shoamanesh, Jackie Bosch, Rosa Coppolecchia, Tatsiana Vaitsiakhovich, Frank Kleinjung, Hardi Mundl, and John Eikelboom
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2024
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14. Bleeding Risk Prediction in Patients Treated with Antithrombotic Drugs According to the Anatomic Site of Bleeding, Indication for Treatment, and Time Since Treatment Initiation
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Vinai Bhagirath, Tanya Kovalova, Jia Wang, Lizhen Xu, Shrikant I. Bangdiwala, Martin O'Donnell, Ashkan Shoamanesh, Jackie Bosch, Rosa Coppolecchia, Tatsiana Vaitsiakhovich, Frank Kleinjung, Hardi Mundl, and John Eikelboom
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bleeding ,risk prediction ,antithrombotic ,atrial fibrillation ,ESUS, CAD, PAD ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Reasons for the relatively poor performance of bleeding prediction models are not well understood but may relate to differences in predictors for various anatomical sites of bleeding.
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- 2024
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15. Predictors of Intracranial Hemorrhage Volume Expansion in Patients Receiving Factor Xa Inhibitors in ANNEXA‐4: Time and Severity Matter Most
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Mauricio Concha, Lizhen Xu, MacKenzie Horn, Tomoyuki Ohara, Juliet Nakamya, Jan Beyer‐Westendorf, Ashkan Shoamanesh, Alexander Cohen, Per Ladenvall, Stuart J. Connolly, and Andrew M. Demchuk
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andexanet alfa ,anti‐factor Xa activity ,direct factor Xa inhibitor reversal ,hematoma expansion ,intracranial hemorrhage ,Neurology. Diseases of the nervous system ,RC346-429 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Andexanet alfa, a specific reversal agent for factor Xa inhibitors, resulted in effective hemostasis in 79% of patients with intracranial bleeding in the ANNEXA‐4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of Factor Xa Inhibitors) trial (NCT02329327). However, little is known about predictors associated with hematoma expansion in patients with factor Xa inhibitor–associated intracranial hemorrhage (ICrH) receiving andexanet alfa. Methods The ANNEXA‐4 trial was a prospective, single‐arm, open‐label study of andexanet alfa in patients with acute major bleeding within 18 hours after taking a factor Xa inhibitor. Hematoma volumes at baseline and 12 hours after andexanet alfa treatment were measured using a computerized‐assisted volumetric method. Univariable and multivariable logistic regression analyses of clinical and nonclinical parameters were performed to identify factors predictive of different volumes of hematoma expansion. To this end, an ICrH Expansion Scale was developed. Results Overall, 305 ANNEXA‐4 study patients with baseline and follow‐up imaging were included, 15.7% of whom showed evidence of any ICrH expansion ≥6‐mL. Patients with ≥6‐mL ICrH expansion had a significantly (P
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- 2024
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16. Relationship between prior statin therapy and radiological features and clinical outcomes of intracerebral hemorrhage
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Lee, Kun He, Carvalho, Filipa, Lioutas, Vasileios-Arsenios, Heistand, Elizabeth, Das, Alvin S., Marchina, Sarah, Shoamanesh, Ashkan, Katsanos, Aristeidis H., Shehadah, Amjad, Incontri, Diego, and Selim, Magdy
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- 2023
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17. Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials
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Klug, Didier, Casolla, Barbara, Puy, Laurent, Coffee, Morgane, Kuchcinski, Grégory, Labreuche, Julien, van Nieuwenhuizen, Koen M., Algra, Ale, van Gelder, Isabelle C., Kappelle, L. Jaap, Rinkel, Gabriel J.E., Schutgens, Roger E.G., Khatri, Pooja, Conwit, Robin, Falcone, Guido, Elm, Jordan, Anderson, Craig S., Song, Lili, Pandian, Jeyaraj, Hart, Robert G., Sharma, Mukul, Aref, Hany, Tarhuni, Wadea, Fabregas, Joan Marti, Diener, Hans-Christoph, Endres, Matthias, Lemmens, Robin, Kwon, Sun U., Lee, Byung-Chul, Ameriso, Sebastian, Milling, Truman J., Kasner, Scott E., Mikulik, Robert, Xavier, Denis, Beer, Ronny, Toni, Danilo, Eckstein, Jens, Seiffge, David, Ferro, Jose M., Tsivgoulis, Georgios, Sharma, Sanjib K., Wei-Liou, Chia, Hohnloser, Stefan H., Katsanos, Aristeidis, Bosch, Jackie, Healey, Jeff, Eikelboom, John, Khaw, Alexander, Gladstone, David, Pikula, Aleksandra, Coutts, Shelagh, Smith, Eric E., Butcher, Ken, Field, Thalia, Gioia, Laura, Stapf, Christian, Halse, Omid, Ringleb, Peter, Enzinger, Christian, Sibon, Igor, Montaner, Joan, Caso, Valeria, Heuschmann, Peter, Lip, Gregory Y.H., Haefeli, Walter, Debette, Stefanie, Dennis, Martin S., Wyller, Torgeir Bruun, Rønning, Ole M., Eilertsen, Helle, Ihle-Hansen, Hege, Sandset, Else Charlotte, Pennlert, Johanna, Glader, Eva-Lotta, Kruuse, Christina, Wester, Per, Carlsson, Maria, Forfang, Elisabeth, Al-Shahi Salman, Rustam, Stephen, Jacqueline, Tierney, Jayne F, Lewis, Steff C, Newby, David E, Parry-Jones, Adrian R, White, Philip M, Connolly, Stuart J, Benavente, Oscar R, Dowlatshahi, Dar, Cordonnier, Charlotte, Viscoli, Catherine M, Sheth, Kevin N, Kamel, Hooman, Veltkamp, Roland, Larsen, Kristin T, Hofmeijer, Jeannette, Kerkhoff, Henk, Schreuder, Floris H B M, Shoamanesh, Ashkan, Klijn, Catharina J M, and van der Worp, H Bart
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- 2023
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18. Abstract 230: Endovascular therapy for large core ischemic strokes: Meta‐analysis of randomized clinical trials
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Mohammad Hossein Abbasi, Ashkan Shoamanesh, David S. Liebeskind, Steven Warach, and Hamidreza Saber
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Neurology. Diseases of the nervous system ,RC346-429 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction Background: Patients with acute strokes with large infarct size are traditionally excluded from endovascular therapies, as like as clinical care. However, questions remain with respect to the safety and efficacy of EVT in these patients. Methods We conducted a meta‐analysis based on pooled data from SELECT 2 trial [1], ANGEL‐ASPECT trial [2], RESCUE Japan [3], and HERMES study [4]. We explored the efficacy of EVT for large infarcts to achieve a favorable 90‐day modified Rankin Scale. Also, we compared favorable outcomes following EVT in those with a core infarct at baseline of more than 70 ml, delayed thrombectomy of more than 6 hours, older than 75 years, and those who received concomitant IV thrombolysis. We also examined the pooled rate of hemorrhagic transformation following EVT in large core strokes. Results This meta‐analysis showed a statistically significant higher rate of favorable outcome in subjects with extremely large infarct size who undergone EVT compared to those who were managed by medical therapy alone (RR: 1.41, 95% CI: [1.05‐1.98], p: 0.03). In the subgroups of patients with core size > 70ml (RR: 1.51, 95% CI: [1.23‐1.87]), late window presentation (LKN to randomization ≥ 6 hours), (RR: 1.53, 95% CI: [1.27‐1.84]), or those 75 or older than 75 years old (RR: 1.43, 95% CI: [1.12‐1.84]), EVT was associated with higher rates of favorable 90‐day mRS score of 0‐3 compared to medical therapy alone. However, EVT was not associated with better outcomes in those who received IV thrombolysis (RR: 1.37, 95% CI: [0.93‐2.01]. Based on pooled data from SELECT‐2, ANGEL‐ASPECT, and RESCUE Japan trials, the overall rate of early symptomatic hemorrhagic transformation among cases with ASPECT 0‐5 in the thrombectomy group was not significantly higher compared to patients who were managed non‐surgically (OR 1.75, 95% CI: [0.89‐3.47]). Conclusion Endovascular therapy is a reasonable option for the management of large infarcts. EVT results in favorable outcome by a delayed thrombectomy for a large core infarct and in older patients.
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- 2023
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19. Key design elements of successful acute ischemic stroke treatment trials
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L. Yperzeele, A. Shoamanesh, Y. V. Venugopalan, S. Chapman, M. V. Mazya, M. Charalambous, V. Caso, W. Hacke, P. M. Bath, and I. Koltsov
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Acute stroke care ,Randomized controlled trials ,Trial design ,Stroke ,Acute stroke therapy ,Stroke research ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Purpose We review key design elements of positive randomized controlled trials (RCTs) in acute ischemic stroke (AIS) treatment and summarize their main characteristics. Method We searched Medline, Pubmed and Cochrane databases for positive RCTs in AIS treatment. Trials were included if (1) they had a randomized controlled design, with (at least partial) blinding for endpoints, (2) they tested against placebo (or on top of standard therapy in a superiority design) or against approved therapy; (3) the protocol was registered and/or published before trial termination and unblinding (if required at study commencement); (4) the primary endpoint was positive in the intention to treat analysis; and (5) the study findings led to approval of the investigational product and/or high ranked recommendations. A topical approach was used, therefore the findings were summarized as a narrative review. Findings Seventeen positive RCTs met the inclusion criteria. The majority of trials included less than 1000 patients (n = 15), had highly selective inclusion criteria (n = 16), used the modified Rankin score as a primary endpoint (n = 15) and had a frequentist design (n = 16). Trials tended to be national (n = 12), investigator-initiated and performed with public funding (n = 11). Discussion Smaller but selective trials are useful to identify efficacy in a particular subgroup of stroke patients. It may also be of advantage to limit the number of participating countries and centers to avoid heterogeneity in stroke management and bureaucratic burden. Conclusion The key characteristics of positive RCTs in AIS treatment described here may assist in the design of further trials investigating a single intervention with a potentially high effect size.
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- 2023
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20. Is There Still a Role for Dual Antiplatelet Therapy in the Secondary Prevention of Lacunar Stroke?
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Shoamanesh, Ashkan
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- 2023
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21. World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials
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Katsanos, Aristeidis H., Lee, Shun Fu, Cukierman-Yaffe, Tali, Sherlock, Laura, Muniz-Terrera, Graciela, Canavan, Michele, Joundi, Raed, Sharma, Mukul, Shoamanesh, Ashkan, Derix, Andrea, Gerstein, Hertzel C., Yusuf, Salim, O'Donnell, Martin J., Bosch, Jackie, and Whiteley, William N.
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- 2023
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22. Factor XIa inhibition with asundexian after acute non-cardioembolic ischaemic stroke (PACIFIC-Stroke): an international, randomised, double-blind, placebo-controlled, phase 2b trial
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Shoamanesh, Ashkan, Mundl, Hardi, Smith, Eric E, Masjuan, Jaime, Milanov, Ivan, Hirano, Teruyuki, Agafina, Alina, Campbell, Bruce, Caso, Valeria, Mas, Jean-Louis, Dong, Qiang, Turcani, Peter, Christensen, Hanne, Ferro, Jose M, Veltkamp, Roland, Mikulik, Robert, De Marchis, Gian Marco, Robinson, Thompson, Lemmens, Robin, Stepien, Adam, Greisenegger, Stefan, Roine, Risto, Csiba, Laszlo, Khatri, Pooja, Coutinho, Jonathan, Lindgren, Arne G, Demchuk, Andrew M, Colorado, Pablo, Kirsch, Bodo, Neumann, Christoph, Heenan, Laura, Xu, Lizhen, Connolly, Stuart J, and Hart, Robert G
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- 2022
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23. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial
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Srivastava, Abhilekh, Aljammaz, Ahmed M, Akindotun, Akintomide Femi, Jin, Albert Y, Fraser, Alexander, Khaw, Alexander V, Lemnaru, Alexandru, Southwell, Alisia, Ramji, Alnar, Alvarado-Bolaños, Alonso, Mouminah, Amr, Lahlouh, Amro B, Yu, Amy Y, Alrohimi, Anas, Lavoie, Andre, Rogge, Andrea, Micieli, Andrew, Nguyen, Andrew Linh, Callaghan-Brown, Angelique, Florendo-Cumbermack, Anita, Wadhwa, Ankur, Beaudoin, Ann-Marie, Cayley, Anne, Liddy, Anne Marie, Trivedi, Anurag, Katsanos, Aristeidis H, Shuaib, Ashfaq, Butt, Asif Javed, Bereznyakova, Olena, Beauchamp, Beth, Mahlitz, Breane, Graham, Brett R, Dewar, Brian, Buck, Brian H, Durafourt, Bryce A, Holtby, Caitlin, Jackson-Tarlton, Caitlin S, Bockus, Caitlyn, Stephenson, Caroline, Galloway, Camille, Odier, Céline, Deacon, Charles, Zerna, Charlotte, Vekhande, Chetan C, Bocti, Christian, Stapf, Christian, Hawkes, Christine, Stables, Christine Anne, Bogiatzi, Chrysi, Rodriguez, Claudia, Candale-Radu, Claudia, Murphy, Colleen, Casserly, Courtney Sarah, Fok, Daniel, Boasquevisque, Danielle de Sa, Wile, Daryl, Volders, David, Sahlas, Demetrios J, Shand, Elaine, Cora, Elena Adela, Battista, Eliane Di, Stewart, Eileen, Junk, Emily, Harrison, Emma L, Frenette, Eric, Teleg, Ericka, Abdellah, Eslam, Ghrooda, Esseddeeg, Akthar, Farhana, Evoy, François, Klein, Gary M, Maclean, Genoveva, Jickling, Glen C, Hawthorne, Glenda, Boyd, Gordon, Walker, Gregory, Saposnik, Gustavo, Lau, H Lee, Badr, Hanan E, Toma, Hassanain, Kalashyan, Hayrapet, Marion-Moffet, Hugo, Grant, Ian, Fatakdawala, Idris, Beaulieu-Boire, Isabelle, Williams, Janice, Brar, Jaskiran, Rivest, Jean, Wang, Jeffrey Z, Dawe, Jessica, Stang, Jillian, Day, Joanne, Miller, Jodi, Gorman, Johnathon, Hopyan, Julia Jasmine, Lee, Julian, Kromm, Julie, Foster, Kaitlyn, Ratnayake, Kanchana, Perera, Kanjana S, Murray, Karina Villaluna, Ryckborst, Karla, Lin, Katie, Sage, Kayla, Sivakuma, Keithan, MacDonald, Kelly A, Ng, Kelvin Kuan, Merchant, Ketki, Khan, Khurshid, Ghavami, Kimia, Johnston, Kyra, Mai, Lauren M, White, Leah, Barratt, Lee, Longpre, Linda, Crellin, Lisa, Peeling, Lissa, Piquette, Lori, Lomax, Lysa Boissé, Sadeghi, Mahsa, Kamra, Maneesha, Lavoie-April, Manuel, Moores, Margaret, Bullrich, Maria Bres, McClelland, Marie, Salluzzi, Marina, Wilcox, Mark, Boulos, Mark I, Marko, Martha, Boyko, Matthew, Lantagne-Hurtubise, Maude, AlHamid, May Adel, Shawawrah, Mays, Kelly, Michael E, Thorne, Michael W D, Shamy, Michel, Bussiere, Miguel, Dominc Tse, Ming Yin, Benguzzi, Mowad, Sharma, Mukul, Horton, Myles, Newcommon, Nancy, Simon, Nandy-Shelwine, Parks, Natalie E, Sultan, Nazeem, Markovic, Nevena, Daneault, Nicole, Ishaque, Noman, Fairall, Paige, Kostyrko, Pawel B, Stys, Peter K, Teal, Philip, Couillard, Philippe, King-Azote, Princess, Collier, Quentin, Epp, Rachel, Nair, Radhika, Joundi, Raed A, Jassal, Rajive, Schneider, Raphael, Hosseini, Reza, Bouchard, Rosalie, Whelan, Ruth, Cooley, S Regan, Sujanthan, Sajeevan, Mansoor, Salman, Yip, Samuel, Wasyliw, Sanchea, Taylor, Sean W., Friedman, Sebastian, Mann, Sharan, Maley, Sharleen Weese, Chiasson, Sherry, Hu, Sherry Xueying, Althubait, Shorog, Himed, Shuhira, Chen, Shuo, Bal, Simerpreet S, Page, Stacey A, Beck, Stacey D, Woodroffe, Stephanie, Reiter, Stephanie D, Gaal, Stephen van, Peters, Steven Ray, Darvesh, Sultan, Save, Supriya, Alcock, Susan, Piercey, Susannah, Adam, Suzie, Gosselin, Sylvie, Fitzpatrick, Tess, Perron, Thomas-Louis, Stewart, Tim, Benstead, Timothy J, Naidoo, Vishaya, Wahab, Wasan Abd, Oczkowski, Wiesław, Kingston, William, Leduc, William, To, William T H, Yu, Yeyao Joe, Liu, Zhongyu A, Aljundi, Ziad Ezzat, Menon, Bijoy K, Singh, Nishita, Deschaintre, Yan, Almekhlafi, Mohammed A, Coutts, Shelagh B, Thirunavukkarasu, Sibi, Khosravani, Houman, Appireddy, Ramana, Moreau, Francois, Gubitz, Gord, Tkach, Aleksander, Catanese, Luciana, Dowlatshahi, Dar, Medvedev, George, Mandzia, Jennifer, Pikula, Aleksandra, Shankar, Jai, Williams, Heather, Field, Thalia S, Manosalva, Alejandro, Siddiqui, Muzaffar, Zafar, Atif, Imoukhuede, Oje, Hunter, Gary, Demchuk, Andrew M, Mishra, Sachin, Gioia, Laura C, Jalini, Shirin, Cayer, Caroline, Phillips, Stephen, Elamin, Elsadig, Shoamanesh, Ashkan, Subramaniam, Suresh, Kate, Mahesh, Jacquin, Gregory, Camden, Marie-Christine, Benali, Faysal, Alhabli, Ibrahim, Bala, Fouzi, Horn, MacKenzie, Stotts, Grant, Hill, Michael D, Gladstone, David J, Poppe, Alexandre, Sehgal, Arshia, Zhang, Qiao, Lethebe, Brendan Cord, Doram, Craig, Ademola, Ayoola, Kenney, Carol, Sajobi, Tolulope T, and Swartz, Richard H
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- 2022
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24. Final Study Report of Andexanet Alfa for Major Bleeding With Factor Xa Inhibitors
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Milling, Truman J., Jr, Middeldorp, Saskia, Xu, Lizhen, Koch, Bruce, Demchuk, Andrew, Eikelboom, John W., Verhamme, Peter, Cohen, Alexander T., Beyer-Westendorf, Jan, Michael Gibson, C., Lopez-Sendon, Jose, Crowther, Mark, Shoamanesh, Ashkan, Coppens, Michiel, Schmidt, Jeannot, Albaladejo, Pierre, Connolly, Stuart J., Anand, R., Bastani, A., Clark, C., Concha, M., Cornell, J., Dombrowski, K., Fermann, G., Fulmer, J., Goldstein, J., Kereiakes, D., Milling, T., Pallin, D., Patel, N., Refaai, M., Rehman, M., Schmaier, A., Schwarz, E., Shillinglaw, W., Spohn, M., Takata, T., Venkat, A., Welker, J., Welsby, I., Wilson, J., Van Keer, L., Verschuren, F., Blostein, M., Eikelboom, J., Althaus, K., Berrouschot, J., Braun, G., Doeppner, T., Dziewas, R., Genth-Zotz, S., Greinacher, P., Hamann, F., Hanses, F., Heide, W., Kallmuenzer, B., Kermer, P., Poli, S., Royl, G., Schellong, S., Schnupp, S., Schwarze, J., Spies, C., Thomalla, G., von Mering, M., Weissenborn, K., Wollenweber, F., Gumbinger, C., Jaschinski, U., Maschke, M., Mochmann, H-C., Pfeilschifter, W., Pohlmann, C., Zahn, R., Bouzat, P., Schmidt, J., Vallejo, C., Floccard, B., Coppens, M., van Wissen, S., Arellano-Rodrigo, E., Valles, E., Alikhan, R., Breen, K., Hall, R., Crowther, M., Albaladejo, P., Cohen, A., Demchuk, A.M., Schmidt, J., Wyse, D.G., Garcia, D.A., Prins, M., Nakamya, J., Büller, H.R., Mahaffey, K. W., Alexander, J. H., Cairns, J.A., Hart, R.G., Joyner, C.D., Raskob, G.E., Schulman, S., Veltkamp, R., Meeks, B., Zotova, E., Ahmad, S., Pinto, T., Baker, K., Dykstra, A., Holadyk-Gris, I., Malvaso, A., and Demchuk, A.M.
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- 2023
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25. Emergency physician gender and head computed tomography orders for older adults who have fallen.
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Kraft, Rhys, Mercuri, Mathew, Clayton, Natasha, Worster, Andrew, Mercier, Eric, Emond, Marcel, Varner, Catherine, McLeod, Shelley L., Eagles, Debra, Stiell, Ian, Barbic, David, Morris, Judy, Jeanmonod, Rebecca, Kagoma, Yoan K., Shoamanesh, Ashkan, Engels, Paul T., Sharma, Sunjay, Papaioannou, Alexandra, Parpia, Sameer, and Buchanan, Ian
- Subjects
CRANIAL radiography ,ACCIDENTAL falls in old age ,PATIENTS ,SECONDARY analysis ,RESEARCH funding ,SEX distribution ,COMPUTED tomography ,LOGISTIC regression analysis ,EMERGENCY medical services ,DECISION making in clinical medicine ,DESCRIPTIVE statistics ,ODDS ratio ,PHYSICIANS ,DATA analysis software ,CONFIDENCE intervals - Abstract
Objective: Physicians vary in their computed tomography (CT) scan usage. It remains unclear how physician gender relates to clinical practice or patient outcomes. The aim of this study was to assess the association between physician gender and decision to order head CT scans for older emergency patients who had fallen. Methods: This was a secondary analysis of a prospective observational cohort study conducted in 11 hospital emergency departments (EDs) in Canada and the United States. The primary study enrolled patients who were 65 years and older who presented to the ED after a fall. The analysis evaluated treating physician gender adjusted for multiple clinical variables. Primary analysis used a hierarchical logistic regression model to evaluate the association between treating physician gender and the patient receiving a head CT scan. Secondary analysis reported the adjusted odds ratio (OR) for diagnosing intracranial bleeding by physician gender. Results: There were 3663 patients and 256 physicians included in the primary analysis. In the adjusted analysis, women physicians were no more likely to order a head CT than men (OR 1.26, 95% confidence interval 0.98–1.61). In the secondary analysis of 2294 patients who received a head CT, physician gender was not associated with finding a clinically important intracranial bleed. Conclusions: There was no significant association between physician gender and ordering head CT scans for older emergency patients who had fallen. For patients where CT scans were ordered, there was no significant relationship between physician gender and the diagnosis of clinically important intracranial bleeding. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From COMBINE AF.
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Johnson, Linda S., Benz, Alexander P., Shoamanesh, Ashkan, Eikelboom, John W., Ezekowitz, Michael, Giugliano, Robert P., Wallentin, Lars, Ruff, Christian T., Lopes, Renato D., Jolly, Sanjit, Whitlock, Richard, Granger, Christopher B., Connolly, Stuart, and Healey, Jeffrey S.
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- 2024
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27. Predictors of severe intracerebral hemorrhage expansion.
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Morotti, Andrea, Li, Qi, Nawabi, Jawed, Busto, Giorgio, Mazzacane, Federico, Cavallini, Anna, Shoamanesh, Ashkan, Morassi, Mauro, Schlunk, Frieder, Piccolo, Laura, Urbinati, Giacomo, Pezzini, Debora, Paciaroni, Maurizio, Fainardi, Enrico, Casetta, Ilaria, Padovani, Alessandro, and Zini, Andrea
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- 2024
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28. Intensive Blood Pressure Lowering and DWI Lesions in Intracerebral Hemorrhage: Exploratory Analysis of the ATACH-2 Randomized Trial
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Shoamanesh, Ashkan, Cassarly, Christy, Morotti, Andrea, Romero, Javier M., Oliveira-Filho, Jamary, Schlunk, Frieder, Jessel, Michael, Butcher, Kenneth, Gioia, Laura, Ayres, Alison, Vashkevich, Anastasia, Schwab, Kristin, Afzal, Mohammad Rauf, Martin, Renee H., Qureshi, Adnan I., Greenberg, Steven M., Rosand, Jonathan, and Goldstein, Joshua N.
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- 2022
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29. World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials
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Aristeidis H. Katsanos, Shun Fu Lee, Tali Cukierman-Yaffe, Laura Sherlock, Graciela Muniz-Terrera, Michele Canavan, Raed Joundi, Mukul Sharma, Ashkan Shoamanesh, Andrea Derix, Hertzel C. Gerstein, Salim Yusuf, Martin J. O'Donnell, Jackie Bosch, and William N. Whiteley
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Cognition ,Dementia ,Function ,Country ,Cardiovascular ,Specialties of internal medicine ,RC581-951 ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: Better understanding of worldwide variation in simple tests of cognition and global function in older adults would aid the delivery and interpretation of multi-national studies of the prevention of dementia and functional decline. Method: In six RCTs that measured cognition with the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and activities of daily living (ADL) with the Standardised Assessment of Everyday Global Activities (SAGEA), we estimated average scores by global region with multilevel mixed-effects models. We estimated the proportion of participants with cognitive or functional impairment with previously defined thresholds (MMSE≤24 or MoCA≤25, SAGEA≥7), and with a country-standardised z-score threshold of cognitive or functional score of ≤-1. Results: In 91,396 participants (mean age 66.6 years [SD 7.8], 31% females) from seven world regions, all global regions differed significantly in estimated cognitive function (z-score differences 0.11–0.45, p
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- 2023
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30. Efficacy and Safety of Statins for Secondary Stroke Prevention in Patients With Cerebral Microbleeds
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Nadareishvili, Zurab, primary, Katsanos, Aristeidis H., additional, and Shoamanesh, Ashkan, additional
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- 2024
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31. Blood Pressure Trajectories and Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke
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Katsanos, Aristeidis H., primary, Joundi, Raed A., additional, Palaiodimou, Lina, additional, Ahmed, Niaz, additional, Kim, Joon-Tae, additional, Goyal, Nitin, additional, Maier, Ilko L., additional, de Havenon, Adam, additional, Anadani, Mohammad, additional, Matusevicius, Marius, additional, Mistry, Eva A., additional, Khatri, Pooja, additional, Arthur, Adam S., additional, Sarraj, Amrou, additional, Yaghi, Shadi, additional, Shoamanesh, Ashkan, additional, Catanese, Luciana, additional, Psychogios, Marios-Nikos, additional, Tsioufis, Konstantinos, additional, Malhotra, Konark, additional, Spiotta, Alejandro M., additional, Sandset, Else Charlotte, additional, Alexandrov, Andrei V., additional, Petersen, Nils H., additional, and Tsivgoulis, Georgios, additional
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- 2024
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32. Quality of Life After Intravenous Thrombolysis for Acute Ischemic Stroke: Results From the AcT Randomized Controlled Trial
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Sajobi, Tolulope T., primary, Arimoro, Olayinka I., additional, Ademola, Ayoola, additional, Singh, Nishita, additional, Bala, Fouzi, additional, Almekhlafi, Mohammed A., additional, Deschaintre, Yan, additional, Coutts, Shelagh B., additional, Thirunavukkarasu, Sibi, additional, Khosravani, Houman, additional, Appireddy, Ramana, additional, Moreau, François, additional, Gubitz, Gordon J., additional, Tkach, Aleksander, additional, Catanese, Luciana, additional, Dowlatshahi, Dar, additional, Medvedev, George, additional, Mandzia, Jennifer, additional, Pikula, Aleksandra, additional, Shankar, Jai Shiva, additional, Williams, Heather, additional, Field, Thalia S., additional, Manosalva, Alejandro, additional, Siddiqui, Muzaffar, additional, Zafar, Atif, additional, Imoukhuede, Oje, additional, Hunter, Gary, additional, Demchuk, Andrew M., additional, Mishra, Sachin M., additional, Gioia, Laura C., additional, Jalini, Shirin, additional, Cayer, Caroline, additional, Phillips, Stephen J., additional, Elamin, Elsadig, additional, Shoamanesh, Ashkan, additional, Subramaniam, Suresh, additional, Kate, Mahesh P., additional, Jacquin, Gregory, additional, Camden, Marie-Christine, additional, Benali, Faysal, additional, Alhabli, Ibrahim, additional, Horn, MacKenzie, additional, Stotts, Grant, additional, Hill, Michael D., additional, Gladstone, David J., additional, Poppe, Alexandre Y., additional, Sehgal, Arshia, additional, Zhang, Qiao, additional, Lethebe, Brendan, additional, Doram, Craig, additional, Shamy, Michel, additional, Kenney, Carol, additional, Buck, Brian H., additional, Swartz, Richard H., additional, and Menon, Bijoy K., additional
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- 2024
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33. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial
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Abdelhamid, N, Abdul Rahman, D, Abdul-Saheb, M, Abreu, P, Abroskina, M, Abu Ahmad, F, Accassat, S, Acciaresi, M, Adami, A, Ahmad, N, Ahmed, F, Alberto Hawkes, M, Alemseged, F, Ali, A, Altavilla, R, Alwis, L, Amarenco, P, Amaro, S, Amaya Sanchez, LE, Amelia Pinto, A, Ameriso, SF, Amin, H, Amino, T, Amjad, AK, Anagnostou, E, Andersen, G, Anderson, C, Anderson, DC, Andrea Falco, M, Andres Mackinnon, F, Andreu, D, Androulakis, M, Angel Gamero, M, Angel Saredo, G, Angeles Diaz, R, Angels Font, M, Anticoli, S, Arauz, A, Arauz Gongora, AA, Araya, P, Arenillas Lara, JF, Arias Rivas, S, Arnold, M, Augustin, S, Avelar, W, Azevedo, E, Babikian, V, Bacellar, A, Badalyan, K, Bae, HJ, Baez Martinez, EM, Bagelmann, H, Bailey, P, Bak, Z, Baker, M, Balazs, A, Baldaranov, D, Balogun, I, Balueva, T, Bankuti, Z, Bar, M, Baranowska, A, Bardutzky, J, Barker Trejo, S, Barlinn, J, Baronnet, F, Barroso, C, Barteys, M, Bartolottiova, T, Barulin, A, Bas, M, Bashir, S, Basile, V, Bathe-Peters, R, Bathula, R, Batista, C, Batur Caglayan, H, Baumgartner, P, Bazan, R, Bazhenova, O, Beaudry, M, Beer, J, Behnam, Y, Beilei, C, Beinlich, A, Bejot, Y, Belkin, A, Benavente, OR, Benjamin, A, Berardi, V, Bereczki, D, Berkowitz, SD, Berlingieri, J, Berrios, W, Berrouschot, J, Bhandari, M, Bhargavah, M, Bicker, H, Bicsak, T, Bilik, M, Bindila, D, Birchenall, J, Birnbaum, L, Black, T, Blacker, D, Blacquiere, D, Blanc-Labarre, C, Blank, C, Blazejewska-Hyzorek, B, Bloch, S, Bodiguel, E, Bogdanov, E, Boos, L, Borcsik, L, Bornstein, N, Bouly, S, Braga, G, Bragado, I, Bravi, MC, Brokalaki, C, Brola, W, Brouns, R, Bruce, D, Brzoska-Mizgalska, J, Buck, B, Buksinska-Lisik, M, Burke, J, Burn, M, Bustamante, G, Cabrejo, L, Cai, K, Cajaraville, S, Calejo, M, Calvet, D, Campillo, J, Campos Costa, E, Camps, P, Can Alaydin, H, Candeloro, E, Canepa, C, Cantu Brito, CG, Cappellari, M, Carcel, C, Cardona Portela, P, Cardoso, F, Carek, M, Carletti, M, Carlos Portilla, J, Caruso, P, Casado-Naranjo, I, Castellini, P, Castro, D, Castro Meira, F, Cavallini, A, Cayuela Caudevilla, N, Cenciarelli, S, Cereda, C, Cerrone, P, Chakrabarti, A, Chaloulos-Iakovidis, P, Chamorro, A, Chandrasena, D, Chang, DI, Che, C, Chembala, J, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, G, Chen, L, Chen, S, Cheripelli, B, Chin, M, Chiquete Anaya, E, Chorazy, M, Christensen, H, Christensen, T, Christian, L, Chu, F, Chung, CS, Clark, W, Clarke, R, Claverie, S, Clemente Agostoni, E, Clissold, B, Coelho, J, Cohen, D, Colakoglu, S, Collas, D, Condurso, R, Connolly, SJ, Consoli, D, Constantin, C, Constantino Silva, AB, Contardo, L, Corlobe, A, Correia, M, Correia, C, Cortijo Garcia, E, Coull, B, Coutts, S, Coveney, S, Cras, P, Crols, R, Crozier, S, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Cui, L, Cunha, L, Curtze, S, Czerska, M, Czlonkowska, A, Czurko, M, Czuryszkiewicz, M, Dagnino, M, Dai, C, Daineko, A, Dalek, G, Damgaard, D, Danese, A, Dani, K, Danku, V, Dario Toledo, W, Dávalos, A, De Havenon, A, De Keyser, J, De Klippel, N, De La Torre, J, De Pauw, A, De Smedt, A, De Torres, R, De Vries Basson, MM, Dearborn, J, Deganutto, R, Degeorgia, M, Deguchi, I, Del Giudice, A, Delcourt, C, Delgado-Mederos, R, Della Marca, G, Delpont, B, Deltour, S, Demets, DL, Dennis, M, Desai, J, Devine, J, Dhollander, I, Di Mascio, MT, Diaconu, M, Diaz Otero, F, Dietzel, J, Diez-Tejedor, E, Ding, N, Ding, J, Diomedi, M, Dioszeghy, P, Distefano, M, Domigo, V, Dorodnicov, E, Dossi, D, Doubal, F, Druzenko, I, Du, P, Du, J, Duman, T, Duodu, Y, Dutta, D, Dylewicz, L, Eckstein, J, Ehrensperger, E, Ehrlich, S, Einer Allende, G, Elena Halac, B, Elyas, S, Endres, M, Engelbrecht, JM, Engelter, S, Epinat, M, Eren, F, Esbjornsson, M, Escribano, B, Escudero, I, Esisi, B, Essa, B, Esterbauer, M, Evans, N, Eveson, D, Fabio, S, Fang, L, Fanta, S, Fares, M, Fatar, M, Faust, K, Favate, A, Fazekas, F, Federica Denaro, M, Fedin, A, Felipe Amaya, P, Feng, J, Ferencova, K, Fernanda Gilli, M, Fernandez, MD, Fernandez Pirrone, PN, Fernandez Vera, J, Ferrari, J, Ferreira, A, Ferreira Junior, G, Fidler, M, Field, D, Field, T, Figueroa, C, Fiksa, J, Filipov, A, Firstenfeld, A, Fisch, L, Fischer, U, Fisselier, M, Fiszer, U, Fluri, F, Fortea, G, Fotherby, K, Fraczek, A, France, E, Freitas, G, Frey, S, Frick, M, Friedman, A, Friedrich, M, Frisullo, G, Fryze, W, Fuentes Gimeno, B, Fujigasaki, H, Fukuyama, K, Furlan, A, Furlanis, G, Furnace, J, Gabriel, M, Gabriel Reich, E, Gagliardi, RJ, Galati, F, Galli Giqueauk, E, Gallina, A, Gallinella, E, Gallo, J, Gangadharan, S, Gao, Y, Garcia Lopez, R, Garcia Pastor, A, Garcia Sanchez, SM, Garnauf, M, Garnier, P, Gasecki, D, Gasic, K, Gasiorek, K, Gasser, S, Gaugg, M, Gebreyohanns, M, Gebura, K, Geng, J, Geniz Clavijo, M, Georg Haeusler, K, Geran, R, Geremek, M, Gerocs, Z, Ghia, D, Giannandrea, D, Giatsidis, F, Gien Lopez, JA, Gil Nunez, A, Gimenez, L, Giralt, E, Glabinski, A, Gladstone, D, Gliem, M, Gluszkiewicz, M, Goddeau, R, Gogoleva, E, Gokce, M, Goldemund, D, Golikov, K, Gomes Neto, A, Gomez Schneider, M, Gomez-Choco, M, Gomis, M, Gongora-Rivera, JF, Gonysheva, Y, Gonzalez, L, Gonzalez Toledo, ME, Gottschal, M, Gozdzik, I, Grabowski, S, Graf, S, Green, D, Greer, D, Gregorio, T, Greisenegger, S, Greshnova, I, Griebe, M, Grzesik, M, Guan, J, Guarda, S, Gueguen, A, Guidoux, C, Guillermo Povedano, P, Guillon, B, Guiraudg, V, Gunathilagan, G, Guryanova, N, Gusev, V, Gustavo Persi, G, Gutiérrez, R, Guyler, P, Gyuker, N, Hachinski, V, Hajas, A, Hallevi, H, Hankey, G, Hankey, GJ, Hanouskova, L, Hao, L, Haraguchi, K, Haralur Sreekantaiah, Y, Haratz, S, Hargroves, D, Harkness, K, Harmel, P, Harrasser, M, Hart, RG, Harvey, M, Hasan, R, Hasegawa, Y, Hassan, A, Hattori, M, Hatzitolios, A, Hauk, M, Hayashi, T, Hayhoe, H, Hedna, VS, Heine, M, Held, V, Hellwig, S, Henkner, J, Henninger, N, Hermans, S, Hernandez, J, Herrero, D, Hervieu-Begue, M, Herzig, R, Hicken, L, Hieber, M, Hill, M, Hirose, M, Hobeanu, MC, Hobson, B, Hochstetter, M, Hoe Heo, J, Hoffmann, M, Holmstedt, C, Hon, P, Hong, KS, Honma, Y, Horev, A, Horgan, G, Horvath, L, Horvath, M, Hoyer, C, Huang, D, Huang, H, Huber, B, Huhtakangas, J, Hussain, M, Igarashi, S, Iglesias Mohedano, AM, Ignacio Tembl, J, Impellizzeri, M, Inanc, Y, Ioli, P, Irina Aniculaesei, A, Ishida, K, Itabashi, R, Iversen, H, Jagolino, A, Jakab, K, Jander, S, Janka, H, Jankovych, J, Jansen, J, Jasek, L, Javier Alet, M, Javor, L, Jin, X, Jing, P, Joachim, B, Joan Macleod, M, Johnson, M, Jose Martin, J, Joyner, C, Judit Szabo, K, Jun-Oconnell, A, Jura, R, Kaczorowska, B, Kadlcikova, J, Kahles, T, Kakaletsis, N, Kakuk, I, Kalinowska, K, Kaminska, K, Kaneko, C, Kanellos, I, Kapeller, P, Kapica-Topczewska, K, Karasz, O, Karlinski, M, Karlsson, JE, Kasa, K, Kashaeva, E, Kasner, SE, Kaste, M, Kasza, J, Katalin Iljicsov, A, Katsurayama, M, Kaur, S, Kawanishi, M, Kaygorodtseva, S, Ke, K, Kei, A, Keilitz, J, Kellner, J, Kelly, P, Kelly, S, Kemlink, D, Kerekgyarto, M, Keskinarkaus, I, Khairutdinova, D, Khanna, A, Khaw, A, Kholopov, M, 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Papadopoulou, E, Papagiannis, A, Papavasileiou, V, Papina, M, Pardo De Donlebun, JR, Parisi, V, Park, JM, Pasten, J, Patel, N, Pavlik, O, Pawelczyk, M, Peacock, WF, Pei, H, Peisker, T, Pena Sedna, LF, Penn, A, Pentek, S, Pepper, E, Pereira, L, Perera, K, Perez, Y, Perez, S, Perez Leguizamon, P, Pernicka, M, Perry, R, Persico, A, Pesant, Y, Peska, S, Peters, D, Peters, G, Pettigrew, L, Phan, T, Philippi, S, Phinney, T, Pico, F, Pidal, A, Piechowski-Jozwiak, B, Pieroni, A, Pineiro, S, Piras, V, Pizova, N, Polanco, J, Polin, M, Polyakov, A, Polychronopoulou, E, Polymeris, A, Popov, D, Poppe, A, Postorino, P, Pozzerese, C, Pradhan, M, Prats, L, Prazdnichkova, E, Prendl, B, Pretorius, M, Profice, P, Prokopenko, S, Pudov, E, Pujol Lereis, V, Punzo Bravo, G, Purroy, F, Qiu, J, Qu, X, Quenardelle, V, Quesada Garcia, H, Radrizzani, L, Radtke, A, Raffelsberger, T, Ramirez Moreno, JM, Ramos-Estebanez, C, Rani, A, Rapantova, P, Rashed, K, Rasheed Nihara, A, Rasmussen, J, Redondo Robles, L, Reif, M, Reiner, P, Rekova, P, Renu, A, Repetto, M, Reyes, P, Reyes Morales, S, Rha, JH, Ribeiro, J, Ricci, S, Richard, C, Rigual, R, Rinaldi, C, Riveira Rodriguez, C, Rizzato, B, Robinson, TG, Rocco, A, Rodrigues, M, Rodriguez, G, Rodriguez Campello, A, Rodriguez Lucci, F, Rodriguez Yanez, M, Roesler, C, Roffe, C, Roine, R, Roine, S, Roldan, A, Romana Pezzella, F, Romano, M, Roos, JS, Rosso, C, Rostrup Kruuse, C, Roth, Y, Roukens, R, Roveri, L, Rozanski, D, Rozniecki, J, Rozsa, C, Rudilosso, S, Ruiz Ares, G, Ruiz Franco, A, Rum, G, Ruuskanen, J, Rybinnik, I, Ryota, K, Saarinen, J, Saavedra, V, Sabben, C, Sabet, A, Sagris, D, Sahlas, J, Sakai, N, Salamanca, P, Salgado, P, Salig, S, Salletmayr, T, Salnikov, M, Samoshkina, O, Samson, Y, Sanak, D, Sànchez Cerón, M, Santalucia, P, Santamaria Cadavid, M, Santiago, P, Santo, G, Sanz Cuesta, B, Sargento, J, Sarraj, A, Sas, K, Sas, A, Satoshi, O, Satsoglou, S, Sattar, N, Savitz, S, Savopoulos, C, Saw, J, Sawicka, M, Sawyer, R, Scandura, T, Schillinger, N, Schindler, J, Schlachetzki, F, Schneider, I, Schuppner, R, Schurig, J, Schwarzbach, CJ, Sebejova, M, Seidel, G, Sekaran, L, Selcuk, D, Selvarajah, J, Semerano, A, Semjen, J, Semushina, D, Sen, S, Seok Park, M, Serena, J, Serhat Tokgoz, O, Serles, W, Serrano, F, Sevin, M, Seynaeve, L, Shah, S, Shamalov, N, Shang, T, Sharma, M, Sharrief, A, Shazam Hussain, M, Shchukin, I, Shen, W, Shepeleva, E, Shinsuke, I, Shmonin, A, Shoamanesh, A, Shuaib, A, Shulga, A, Sibolt, G, Sibon, I, Sicilia, I, Siebert, M, Sieczkowska, E, Sila, C, Silva, AA, Silva, D, Silva, P, Silva, Y, Silvestrini, M, Simony, Z, Simpkins, A, Singh, B, Sinha, D, Sipos, I, Skoda, O, Skowron, P, Skowronska, M, Sliwinska, B, Slonkova, J, Smolkin, A, Smyth, A, Sobolewski, P, Sobota, A, Sohn, SI, Soldatov, M, Solganov, I, Soloveva, L, Solovyeva, E, Sonntag, N, Soors, P, Sorgun, M, Soriano, C, Spence, D, Spengos, K, Sposato, L, Staaf, G, Stadler, K, Stakhovskaya, L, Stamatelopoulos, K, Steinert, S, Stetkarova, I, Stiehm, M, Stocker, R, Stoinski, J, Stoll, A, Stotts, G, Stumpp, A, Sucapane, P, Suenaga, T, Sun, X, Sundararajan, S, Sung Kim, J, Suzuki, H, Svaneborg, N, Szasz, G, Szczuchniak, W, Szczyrba, S, Szegedi, N, Szekely, A, Szewczyk, Z, Szilagyi, G, Szlufik, S, Szoboszlai, K, Szpisjak, L, Sztajzel, R, Sztriha, L, Ta Wil, SE, Taggeselle, J, Takamatsu, K, Takao, M, Taki, W, Takizawa, S, Talahma, M, Tamayo, A, Tan, J, Tanne, D, Tapanainen, A, Tapiola, T, Tarasiuk, J, Tatlisumak, T, Tayal, A, Tcvetkova, S, Teal, P, Tejada Garcia, J, Tejada Meza, H, Tenora, D, Terceno, M, Terentiou, A, Tezcan, S, Thaler, D, Thomson, A, Thouvenot, E, Tiainen, M, Timberg, I, Timsit, S, Tinchon, A, Tirschwell, D, Togay Isikay, C, Tokunaga, K, Tolino, M, Toloza, C, Tomelleri, G, Tomoyuki, K, Tomppo, LM, Tong, Z, Tong, L, Toni, D, Torres, J, Tossavainen, C, Toth, G, Tountopoulou, A, Touze, E, Tovar, M, Toyoda, K, Trillo, S, Trommer, A, Tropepi, D, Tryambake, D, Tu, H, Tuetuencue, S, Tumova, R, Tumpula, O, Turc, G, Tutaj, A, Tynkkynen, J, Uchiyama, S, Uchwat, U, Uhrinyakova, L, Ulku Acar, R, Uluduz Ugurlu, D, Urra, X, Urui, S, Usero Ruiz, M, Vaclavik, D, Vahedi, K, Valikovics, A, Valpas, J, Van Acker, P, Van Daele, W, Vanderschueren, G, Vanina Jure, L, Varela, R, Varga, Z, Varvat, J, Varvyanskaya, N, Vasco Salgado, A, Vasko, P, Vass, L, Vassilopoulou, S, Vastagh, I, Vazquez, P, Vecsei, L, Veltkamp, R, Venti, M, Verdugo, M, Verocai, V, Veronica Marroquin, M, Veronica Simonsini, C, Veverka, T, Vigl, M, Vila, A, Vilar, C, Villanueva Osorio, JA, Virta, J, Vitkova, E, Voglsperger, B, Volna, J, Von Weitzel-Mudersbach, PA, Vora, N, Voznyuk, I, Wach-Klink, A, Wacongne, A, Walters, D, Wang, Y, Wang, J, Wang, L, Wang, X, Wang, W, Wang, N, Wang, D, Wang, H, Warnack, W, Wartenberg, K, Waters, R, Waters, M, Webb, T, Weber, J, Weiss, G, Weissenborn, K, Weitz, JI, Weller, B, Wen, G, Weng, G, Werner, P, Werring, D, Wester, P, Whiteley, W, Whiting, R, Wijeratne, T, Willems, C, Wilson, L, Wilson, C, Winder, T, Windt, J, Winkler, A, Winska-Tereszkiewicz, A, Wisniewska, A, Wittayer, M, Wlodek, A, Wojnarowska-Arendt, A, Wolf, M, Wolff, V, Wolter, C, Wong, A, Wook Nah, H, Worthmann, H, Wu, W, Wu, S, Wunderlich, S, Wurzinger, H, Wyse, DG, Xiao, B, Xiaopeng, W, Ximenez-Carrillo, A, Xiong, L, Xiong, Y, Xiong, W, Xu, Y, Xu, J, Xu, Z, Yalo, B, Yamada, T, Yamasaki, M, Yang, L, Yang, Y, Yang, X, Yang, Q, Yang, B, Yang, J, Yasuhiro, I, Yee Lam, M, Yegappan, C, Yip, S, Ylikallio, E, Ylikotila, P, Yongwon Jin, A, Yoon, BW, Yoshida, Y, Yperzeele, L, Yuan, H, Yuasa, H, Zalewska, J, Zanferrari, C, Zapata, E, Zboznovits, D, Zelenka, I, Zhang, C, Zhang, B, Zhang, S, Zhang, M, Zhang, X, Zhang, J, Zhao, L, Zhirnova, O, Zhou, L, Zielinska-Turek, J, Zinchenko, I, Ziomek, M, Zitzmann, A, Zweifler, R, Zwiernik, J, Kasner, Scott E, Swaminathan, Balakumar, Lavados, Pablo, Sharma, Mukul, Muir, Keith, Veltkamp, Roland, Ameriso, Sebastian F, Endres, Matthias, Lutsep, Helmi, Messé, Steven R, Spence, J David, Nedeltechev, Krassen, Perera, Kanjana, Santo, Gustavo, Olavarria, Veronica, Lindgren, Arne, Bangdiwala, Shrikant, Shoamanesh, Ashkan, Berkowitz, Scott D, Mundl, Hardi, Connolly, Stuart J, and Hart, Robert G
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- 2018
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34. Cerebral microbleeds and risk of incident dementia: the Framingham Heart Study
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Romero, José R, Beiser, Alexa, Himali, Jayandra J, Shoamanesh, Ashkan, DeCarli, Charles, and Seshadri, Sudha
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Biological Psychology ,Biomedical and Clinical Sciences ,Neurosciences ,Psychology ,Alzheimer's Disease ,Stroke ,Prevention ,Brain Disorders ,Acquired Cognitive Impairment ,Dementia ,Cardiovascular ,Rehabilitation ,Neurodegenerative ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Aging ,Clinical Research ,Aetiology ,2.1 Biological and endogenous factors ,Neurological ,Aged ,Aged ,80 and over ,Brain ,Cerebral Amyloid Angiopathy ,Cerebral Hemorrhage ,Female ,Follow-Up Studies ,Humans ,Hypertension ,Incidence ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Models ,Statistical ,Proportional Hazards Models ,Risk ,Cerebral microbleeds ,Cerebral small vessel disease ,Brain MRI ,Clinical Sciences ,Neurology & Neurosurgery ,Biological psychology - Abstract
Cerebral microbleeds (CMBs) are MRI markers attributed to the most common cerebral angiopathies in the elderly and in patients with dementia: hypertensive and cerebral amyloid angiopathy. CMB detection in asymptomatic persons may help identify those at risk for dementia and may influence preventive strategies and design of clinical trials testing treatments for dementia. We studied the association of CMB with risk of incident dementia in community dwelling individuals. A total of 1296 dementia-free Framingham Heart Study participants (mean age 72 years; 54% women) with available brain MRI and incident dementia data during a mean follow-up period of 6.7 years were included. Using Cox proportional hazards models, we related CMB presence to incident dementia. Multivariable models were adjusted for age, sex, APOE status, and education, with additional models adjusting for vascular risk factors and MRI markers of ischemic brain injury. CMBs were observed in 10.8% and incident dementia in 85 participants (6.6% over study period). Participants with any CMB had 1.74 times higher risk of dementia (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.00-3.01), whereas those with deep and mixed CMB had a three-fold increased risk (HR 2.99, 95% CI 1.52-5.90). The associations were independent of vascular risk factors, and for deep and mixed CMB also independent of MRI markers of ischemia (HR 2.44, 95% CI 1.22-4.88). Purely lobar CMBs were not associated with incident dementia. Our findings support a role for hypertensive vasculopathy and the interplay of hypertensive and cerebral amyloid angiopathy in risk of dementia and suggest that CMB presence can identify individuals at risk of dementia.
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- 2017
35. Cerebral Microbleeds as Predictors of Mortality
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Romero, José R, Preis, Sarah R, Beiser, Alexa, Himali, Jayandra J, Shoamanesh, Ashkan, Wolf, Philip A, Kase, Carlos S, Vasan, Ramachandran S, DeCarli, Charles, and Seshadri, Sudha
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Epidemiology ,Health Sciences ,Acquired Cognitive Impairment ,Neurosciences ,Stroke ,Clinical Research ,Aging ,Cardiovascular ,Dementia ,Prevention ,Brain Disorders ,Neurological ,Good Health and Well Being ,Adult ,Aged ,Aged ,80 and over ,Cerebral Hemorrhage ,Cerebral Small Vessel Diseases ,Female ,Humans ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Prevalence ,Risk Factors ,cerebral microbleed ,cerebral small vessel disease ,community ,epidemiology ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Neurology & Neurosurgery ,Clinical sciences ,Allied health and rehabilitation science - Abstract
Background and purposeCerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia.MethodsWe evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54% women) with available brain magnetic resonance imaging and mortality data. Using Cox proportional hazards models, we related CMB to all-cause, cardiovascular, and stroke-related mortality.ResultsParticipants with CMB (8.9%) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow-up of 7.2±2.6 years, we observed 296 deaths. In age- and sex-adjusted analysis, CMB were associated with increased all-cause mortality (hazards ratio, 1.39; 95% confidence interval 1.03-1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (hazards ratio, 1.15; 95% confidence interval, 0.82-1.63).ConclusionsCMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. Although their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.
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- 2017
36. Statin treatment and cerebral microbleeds: A systematic review and meta-analysis
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Katsanos, Aristeidis H., Lioutas, Vasileios-Arsenios, Charidimou, Andreas, Catanese, Luciana, Ng, Kelvin Kuan Huei, Perera, Kanjana, de Sa Boasquevisque, Danielle, Falcone, Guido J., Sheth, Kevin N., Romero, Jose Rafael, Tsivgoulis, Georgios, Smith, Eric E., Sharma, Mukul, Selim, Magdy H., and Shoamanesh, Ashkan
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- 2021
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37. Stroke and Thromboprophylaxis in the Era of COVID-19
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Ma, Alice, Kase, Carlos S., Shoamanesh, Ashkan, Abdalkader, Mohamad, Pikula, Aleksandra, Sathya, Anvitha, Catanese, Luciana, Ellis, Alun T., and Nguyen, Thanh N.
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- 2021
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38. Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage.
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Connolly, S.J., Sharma, Mukul, Cohen, A.T., Demchuk, A.M., Członkowska, A., Lindgren, A.G., Molina, C.A., Bereczki, D., Toni, D., Seiffge, D.J., Tanne, D., Sandset, E.C., Tsivgoulis, G., Christensen, H., Beyer-Westendorf, J., Coutinho, J.M., Crowther, M., Verhamme, P., Amarenco, P., Roine, R.O., Mikulik, R., Lemmens, R., Veltkamp, R., Middeldorp, S., Robinson, T.G., Milling TJ, J.r., Tedim-Cruz, V., Lang, W., Himmelmann, A., Ladenvall, P., Knutsson, M., Ekholm, E., Law, A., Taylor, A., Karyakina, T., Xu, L., Tsiplova, K., Poli, S., Kallmünzer, B., Gumbinger, C., Shoamanesh, A., Connolly, S.J., Sharma, Mukul, Cohen, A.T., Demchuk, A.M., Członkowska, A., Lindgren, A.G., Molina, C.A., Bereczki, D., Toni, D., Seiffge, D.J., Tanne, D., Sandset, E.C., Tsivgoulis, G., Christensen, H., Beyer-Westendorf, J., Coutinho, J.M., Crowther, M., Verhamme, P., Amarenco, P., Roine, R.O., Mikulik, R., Lemmens, R., Veltkamp, R., Middeldorp, S., Robinson, T.G., Milling TJ, J.r., Tedim-Cruz, V., Lang, W., Himmelmann, A., Ladenvall, P., Knutsson, M., Ekholm, E., Law, A., Taylor, A., Karyakina, T., Xu, L., Tsiplova, K., Poli, S., Kallmünzer, B., Gumbinger, C., and Shoamanesh, A.
- Abstract
Contains fulltext : 306378.pdf (Publisher’s version ) (Closed access), BACKGROUND: Patients with acute intracerebral hemorrhage who are receiving factor Xa inhibitors have a risk of hematoma expansion. The effect of andexanet alfa, an agent that reverses the effects of factor Xa inhibitors, on hematoma volume expansion has not been well studied. METHODS: We randomly assigned, in a 1:1 ratio, patients who had taken factor Xa inhibitors within 15 hours before having an acute intracerebral hemorrhage to receive andexanet or usual care. The primary end point was hemostatic efficacy, defined by expansion of the hematoma volume by 35% or less at 12 hours after baseline, an increase in the score on the National Institutes of Health Stroke Scale of less than 7 points (scores range from 0 to 42, with higher scores indicating worse neurologic deficit) at 12 hours, and no receipt of rescue therapy between 3 hours and 12 hours. Safety end points were thrombotic events and death. RESULTS: A total of 263 patients were assigned to receive andexanet, and 267 to receive usual care. Efficacy was assessed in an interim analysis that included 452 patients, and safety was analyzed in all 530 enrolled patients. Atrial fibrillation was the most common indication for factor Xa inhibitors. Of the patients receiving usual care, 85.5% received prothrombin complex concentrate. Hemostatic efficacy was achieved in 150 of 224 patients (67.0%) receiving andexanet and in 121 of 228 (53.1%) receiving usual care (adjusted difference, 13.4 percentage points; 95% confidence interval [CI], 4.6 to 22.2; P = 0.003). The median reduction from baseline to the 1-to-2-hour nadir in anti-factor Xa activity was 94.5% with andexanet and 26.9% with usual care (P<0.001). Thrombotic events occurred in 27 of 263 patients (10.3%) receiving andexanet and in 15 of 267 (5.6%) receiving usual care (difference, 4.6 percentage points; 95% CI, 0.1 to 9.2; P = 0.048); ischemic stroke occurred in 17 patients (6.5%) and 4 patients (1.5%), respectively. There were no appreciable differences betwee
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- 2024
39. Hemorrhagic Transformation in Noncardioembolic Acute Ischemic Stroke: MRI Analysis From PACIFIC-STROKE.
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Chih-Hao Chen, Shoamanesh, Ashkan, Colorado, Pablo, Saad, Feryal, Lemmens, Robin, De Marchis, Gian Marco, Caso, Valeria, Lizhen Xu, Heenan, Laura, Masjuan, Jaime, Christensen, Hanne, Connolly, Stuart J., Khatri, Pooja, Mundl, Hardi, Hart, Robert G., and Smith, Eric E.
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- 2024
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40. Cerebral microbleeds and asundexian in non-cardioembolic ischemic stroke: Secondary analyses of the PACIFIC-STROKE randomized trial.
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Balali, Pargol, Hart, Robert G, Smith, Eric E, Saad, Feryal, Colorado, Pablo, Lemmens, Robin, De Marchis, Gian Marco, Caso, Valeria, Xu, Lizhen, Heenan, Laura, Connolly, Stuart J, Mundl, Hardi, and Shoamanesh, Ashkan
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ISCHEMIC stroke ,CEREBRAL small vessel diseases ,TRANSIENT ischemic attack ,INTRACRANIAL hemorrhage ,STROKE - Abstract
Background and aims: Cerebral microbleeds are magnetic imaging resonance (MRI) markers of hemorrhage-prone cerebral small vessel disease that predict future risk of ischemic stroke and intracranial hemorrhage (ICrH). There exist concerns about the net benefit of antithrombotic therapy in patients with microbleeds. We aimed to investigate the effects of an oral factor-XIa inhibitor (asundexian), that is hypothesized to inhibit thrombosis without compromising hemostasis, on the development of new microbleeds over time and interactions between microbleeds and asundexian treatment on clinical outcomes. We additionally assessed associations between baseline microbleeds and the risks of clinical and neuroimaging outcomes in patients with non-cardioembolic ischemic stroke. Methods: This is a secondary analysis of the PACIFIC-STROKE, international, multi-center Phase 2b double-blind, randomized clinical trial. PACIFIC-STROKE enrolled patients aged ⩾ 45 years with mild-to-moderate non-cardioembolic ischemic stroke who presented within 48 h of symptom onset for whom antiplatelet therapy was intended. Microbleeds were centrally adjudicated, and participants with an interpretable T2*-weighted sequence at their baseline MRI were included in this analysis. Patients were randomized to asundexian (10/20/50 mg daily) versus placebo plus standard antiplatelet treatment. Regression models were used to estimate the effects of (1) all pooled asundexian doses and (2) asundexian 50 mg daily on new microbleed formation on 26-week MRIs. Cox proportional hazards or regression models were additionally used to estimate interactions between treatment assignment and microbleeds for ischemic stroke/transient ischemic attack (TIA) (primary outcome), and ICrH, all-cause mortality, hemorrhagic transformation (HT), and new microbleeds (secondary outcomes). Results: Of 1746 participants (mean age, 67.0 ± 10.0; 34% female) with baseline MRIs, 604 (35%) had microbleeds. During a median follow-up of 10.6 months, 7.0% (n = 122) had ischemic stroke/TIA, 0.5% (n = 8) ICrH, and 2.1% (n = 37) died. New microbleeds developed in 10.3% (n = 155) of participants with adequate follow-up MRIs and HT in 31.4% (n = 345). In the total sample of patients with adequate baseline and 26-week follow-up MRIs (n = 1507), new microbleeds occurred in 10.2% of patients assigned to any asundexian dose and 10.5% of patients assigned to placebo (OR, 0.96; 95% CI, 0.66–1.41). There were no interactions between microbleeds and treatment assignment for any of the outcomes (p for interaction > 0.05). The rates of new microbleeds, HT, and ICrH were numerically less in patients with microbleeds assigned to asundexian relative to placebo. The presence of microbleeds was associated with a higher risk of HT (aOR, 1.6; 95% CI, 1.2–2.1) and new microbleeds (aOR, 4.4; 95% CI, 3.0–6.3). Conclusion: Factor XIa inhibition with asundexian appears safe in patients with non-cardioembolic ischemic stroke and hemorrhage-prone cerebral small vessel disease marked by microbleeds on MRI. These preliminary findings will be confirmed in the ongoing OCEANIC-STROKE randomized trial. Trial Registration: ClinicalTrials.gov Identifier: NCT04304508. [ABSTRACT FROM AUTHOR]
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- 2024
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41. Andexanet alfa versus non-specific treatments for intracerebral hemorrhage in patients taking factor Xa inhibitors — Individual patient data analysis of ANNEXA-4 and TICH-NOAC.
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Siepen, Bernhard M, Polymeris, Alexandros, Shoamanesh, Ashkan, Connolly, Stuart, Steiner, Thorsten, Poli, Sven, Lemmens, Robin, Goeldlin, Martina B, Müller, Madlaine, Branca, Mattia, Rauch, Janis, Meinel, Thomas, Kaesmacher, Johannes, Z'Graggen, Werner, Arnold, Marcel, Fischer, Urs, Peters, Nils, Engelter, Stefan T, Lyrer, Philippe, and Seiffge, David
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CEREBRAL hemorrhage ,VENOUS thrombosis ,DATA analysis ,MYOCARDIAL infarction ,ISCHEMIC stroke - Abstract
Background: Data comparing the specific reversal agent andexanet alfa with non-specific treatments in patients with non-traumatic intracerebral hemorrhage (ICH) associated with factor-Xa inhibitor (FXaI) use are scarce. Aim: The study aimed to determine the association between the use of andexanet alfa compared with non-specific treatments with the rate of hematoma expansion and thromboembolic complications in patients with FXaI-associated ICH. Methods: We performed an individual patient data analysis combining two independent, prospective studies: ANNEXA-4 (180 patients receiving andexanet alfa, NCT02329327) and TICH-NOAC (63 patients receiving tranexamic acid or placebo ± prothrombin complex concentrate, NCT02866838). The primary efficacy outcome was hematoma expansion on follow-up imaging. The primary safety outcome was any thromboembolic complication (ischemic stroke, myocardial infarction, pulmonary embolism, or deep vein thrombosis) at 30 days. We used binary logistic regression models adjusted for baseline hematoma volume, age, calibrated anti-Xa activity, times from last intake of FXaI, and symptom onset to treatment, respectively. Results: Among 243 participants included, the median age was 80 (IQR 75–84) years, baseline hematoma volume was 9.1 (IQR 3.4–21) mL and anti-Xa activity 118 (IQR 78–222) ng/mL. Times from last FXaI intake and symptom onset to treatment were 11 (IQR 7–16) and 4.7 (IQR 3.0–7.6) h, respectively. Overall, 50 patients (22%) experienced hematoma expansion (ANNEXA-4: n=24 (14%); TICH-NOAC: n=26 (41%)). After adjusting for pre-specified confounders (baseline hematoma volume, age, calibrated anti-Xa activity, times from last intake of FXaI, and symptom onset to treatment, respectively), treatment with andexanet alfa was independently associated with decreased odds for hematoma expansion (aOR 0.33, 95% CI 0.13–0.80, p = 0.015). Overall, 26 patients (11%) had any thromboembolic complication within 30 days (ANNEXA-4: n=20 (11%); TICH-NOAC: n=6 (10%)). There was no association between any thromboembolic complication and treatment with andexanet alfa (aOR 0.70, 95% CI 0.16–3.12, p = 0.641). Conclusion: The use of andexanet alfa compared to any other non-specific treatment strategy was associated with decreased odds for hematoma expansion, without increased odds for thromboembolic complications. [ABSTRACT FROM AUTHOR]
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- 2024
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42. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children
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Rabi, Doreen M., McBrien, Kerry A., Sapir-Pichhadze, Ruth, Nakhla, Meranda, Ahmed, Sofia B., Dumanski, Sandra M., Butalia, Sonia, Leung, Alexander A., Harris, Kevin C., Cloutier, Lyne, Zarnke, Kelly B., Ruzicka, Marcel, Hiremath, Swapnil, Feldman, Ross D., Tobe, Sheldon W., Campbell, Tavis S., Bacon, Simon L., Nerenberg, Kara A., Dresser, George K., Fournier, Anne, Burgess, Ellen, Lindsay, Patrice, Rabkin, Simon W., Prebtani, Ally P.H., Grover, Steven, Honos, George, Alfonsi, Jeffrey E., Arcand, JoAnne, Audibert, François, Benoit, Geneviève, Bittman, Jesse, Bolli, Peter, Côté, Anne-Marie, Dionne, Janis, Don-Wauchope, Andrew, Edwards, Cedric, Firoz, Tabassum, Gabor, Jonathan Y., Gilbert, Richard E., Grégoire, Jean C., Gryn, Steven E., Gupta, Milan, Hannah-Shmouni, Fady, Hegele, Robert A., Herman, Robert J., Hill, Michael D., Howlett, Jonathan G., Hundemer, Gregory L., Jones, Charlotte, Kaczorowski, Janusz, Khan, Nadia A., Kuyper, Laura M., Lamarre-Cliche, Maxime, Lavoie, Kim L., Leiter, Lawrence A., Lewanczuk, Richard, Logan, Alexander G., Magee, Laura A., Mangat, Birinder K., McFarlane, Philip A., McLean, Donna, Michaud, Andre, Milot, Alain, Moe, Gordon W., Penner, S. Brian, Pipe, Andrew, Poppe, Alexandre Y., Rey, Evelyne, Roerecke, Michael, Schiffrin, Ernesto L., Selby, Peter, Sharma, Mike, Shoamanesh, Ashkan, Sivapalan, Praveena, Townsend, Raymond R., Tran, Karen, Trudeau, Luc, Tsuyuki, Ross T., Vallée, Michel, Woo, Vincent, Bell, Alan D., and Daskalopoulou, Stella S.
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- 2020
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43. Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials
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Magid-Bernstein, Jessica R, Li, Yunke, Cho, Sung-Min, Piran, Pirouz J., Roh, David J., Gupta, Ajay, Shoamanesh, Ashkan, Merkler, Alexander, Zhang, Cenai, Avadhani, Radhika, Montano, Nataly, Iadecola, Constantino, Falcone, Guido, Sheth, Kevin, Qureshi, Adnan, Rosand, Jonathan, Goldstein, Joshua, Awad, Issam, Hanley, Daniel, Kamel, Hooman, Ziai, Wendy C., and Murthy, Santosh B.
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- 2021
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44. Prevalence of Clinical and Neuroimaging Markers in Cerebral Amyloid Angiopathy: A Systematic Review and Meta-Analysis
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Malhotra, Konark, Theodorou, Aikaterini, Katsanos, Aristeidis H., Zompola, Christina, Shoamanesh, Ashkan, Boviatsis, Efstathios, Paraskevas, George P., Spilioti, Martha, Cordonnier, Charlotte, Werring, David J., Alexandrov, Andrei V., and Tsivgoulis, Georgios
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- 2022
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45. Abstract WP172: A Novel Score to Predict Early Time From Symptom Onset to Hospital Arrival in Patients With Intracerebral Hemorrhage
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Balali, Pargol, primary, Morotti, Andrea, additional, Joundi, Raed A, additional, Katsanos, Aristeidis, additional, Catanese, Luciana, additional, Lioutas, Vasileios, additional, Carvalho, Filipa, additional, Heistand, Elizabeth, additional, Sharma, Mukul A, additional, Selim, Magdy H, additional, and Shoamanesh, Ashkan, additional
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- 2024
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46. Bleeding risk prediction in patients treated with antithrombotics according to site of bleeding, indication for treatment and time since initiation
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Bhagirath, Vinai, additional, Kovalova, Tanya, additional, Wang, Jia Steven, additional, Xu, Lizhen, additional, Bangdiwala, Shrikant, additional, O'Donnell, Martin, additional, Shoamanesh, Ashkan, additional, Bosch, Jackie, additional, Coppolecchia, Rosa, additional, Vaitsiakhovich, Tatsiana, additional, Kleinjung, Frank, additional, Mundl, Hardi, additional, and Eikelboom, John W, additional
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- 2024
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47. Bleeding Outcomes in Patients Treated With Asundexian in Phase II Trials
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Eikelboom, John W., primary, Mundl, Hardi, additional, Alexander, John H., additional, Caso, Valeria, additional, Connolly, Stuart J., additional, Coppolecchia, Rosa, additional, Gebel, Martin, additional, Hart, Robert G., additional, Holberg, Gerlind, additional, Keller, Lars, additional, Patel, Manesh R., additional, Piccini, Jonathan P., additional, Rao, Sunil V., additional, Shoamanesh, Ashkan, additional, Tamm, Miriam, additional, Viethen, Thomas, additional, Yassen, Ashraf, additional, and Bonaca, Marc P., additional
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- 2024
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48. Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH): prospective, individual participant data meta-analysis of randomised trials
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Al-Shahi Salman, Rustam, primary, Stephen, Jacqueline, additional, Tierney, Jayne F, additional, Lewis, Steff C, additional, Newby, David E, additional, Parry-Jones, Adrian R, additional, White, Philip M, additional, Connolly, Stuart J, additional, Benavente, Oscar R, additional, Dowlatshahi, Dar, additional, Cordonnier, Charlotte, additional, Viscoli, Catherine M, additional, Sheth, Kevin N, additional, Kamel, Hooman, additional, Veltkamp, Roland, additional, Larsen, Kristin T, additional, Hofmeijer, Jeannette, additional, Kerkhoff, Henk, additional, Schreuder, Floris H B M, additional, Shoamanesh, Ashkan, additional, Klijn, Catharina J M, additional, van der Worp, H Bart, additional, Klug, Didier, additional, Casolla, Barbara, additional, Puy, Laurent, additional, Coffee, Morgane, additional, Kuchcinski, Grégory, additional, Labreuche, Julien, additional, van Nieuwenhuizen, Koen M., additional, Algra, Ale, additional, van Gelder, Isabelle C., additional, Kappelle, L. Jaap, additional, Rinkel, Gabriel J.E., additional, Schutgens, Roger E.G., additional, Khatri, Pooja, additional, Conwit, Robin, additional, Falcone, Guido, additional, Elm, Jordan, additional, Anderson, Craig S., additional, Song, Lili, additional, Pandian, Jeyaraj, additional, Hart, Robert G., additional, Sharma, Mukul, additional, Aref, Hany, additional, Tarhuni, Wadea, additional, Fabregas, Joan Marti, additional, Diener, Hans-Christoph, additional, Endres, Matthias, additional, Lemmens, Robin, additional, Kwon, Sun U., additional, Lee, Byung-Chul, additional, Ameriso, Sebastian, additional, Milling, Truman J., additional, Kasner, Scott E., additional, Mikulik, Robert, additional, Xavier, Denis, additional, Beer, Ronny, additional, Toni, Danilo, additional, Eckstein, Jens, additional, Seiffge, David, additional, Ferro, Jose M., additional, Tsivgoulis, Georgios, additional, Sharma, Sanjib K., additional, Wei-Liou, Chia, additional, Hohnloser, Stefan H., additional, Katsanos, Aristeidis, additional, Bosch, Jackie, additional, Healey, Jeff, additional, Eikelboom, John, additional, Khaw, Alexander, additional, Gladstone, David, additional, Pikula, Aleksandra, additional, Coutts, Shelagh, additional, Smith, Eric E., additional, Butcher, Ken, additional, Field, Thalia, additional, Gioia, Laura, additional, Stapf, Christian, additional, Halse, Omid, additional, Ringleb, Peter, additional, Enzinger, Christian, additional, Sibon, Igor, additional, Montaner, Joan, additional, Caso, Valeria, additional, Heuschmann, Peter, additional, Lip, Gregory Y.H., additional, Haefeli, Walter, additional, Debette, Stefanie, additional, Dennis, Martin S., additional, Wyller, Torgeir Bruun, additional, Rønning, Ole M., additional, Eilertsen, Helle, additional, Ihle-Hansen, Hege, additional, Sandset, Else Charlotte, additional, Pennlert, Johanna, additional, Glader, Eva-Lotta, additional, Kruuse, Christina, additional, Wester, Per, additional, Carlsson, Maria, additional, and Forfang, Elisabeth, additional
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- 2023
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49. Cognitive performance following stroke, transient ischaemic attack, myocardial infarction, and hospitalisation: an individual participant data meta-analysis of six randomised controlled trials
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Sherlock, Laura, primary, Lee, Shun Fu, additional, Katsanos, Aristeidis H, additional, Cukierman-Yaffe, Tali, additional, Canavan, Michelle, additional, Joundi, Raed, additional, Sharma, Mukul, additional, Shoamanesh, Ashkan, additional, Brayne, Carol, additional, Gerstein, Hertzel C, additional, O’Donnell, Martin J, additional, Muniz-Terrera, Graciela, additional, Yusuf, Salim, additional, Bosch, Jackie, additional, and Whiteley, William N, additional
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- 2023
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50. Diagnostic value of lobar microbleeds in individuals without intracerebral hemorrhage
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Martinez‐Ramirez, Sergi, Romero, Jose‐Rafael, Shoamanesh, Ashkan, McKee, Ann C, Van Etten, Ellis, Pontes‐Neto, Octavio, Macklin, Eric A, Ayres, Alison, Auriel, Eitan, Himali, Jayandra J, Beiser, Alexa S, DeCarli, Charles, Stein, Thor D, Alvarez, Victor E, Frosch, Matthew P, Rosand, Jonathan, Greenberg, Steven M, Gurol, M Edip, Seshadri, Sudha, and Viswanathan, Anand
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Neurosciences ,Clinical Research ,Brain Disorders ,Biomedical Imaging ,Rare Diseases ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Aged ,Aged ,80 and over ,Brain ,Cerebral Amyloid Angiopathy ,Cerebral Hemorrhage ,Female ,Humans ,Magnetic Resonance Imaging ,Male ,Predictive Value of Tests ,Cerebral amyloid angiopathy ,Microbleed ,Intracerebral hemorrhage ,Boston criteria ,Sensitivity ,Specificity ,Predictive value ,Likelihood ratio ,Clinical Sciences ,Geriatrics - Abstract
IntroductionThe Boston criteria are the basis for a noninvasive diagnosis of cerebral amyloid angiopathy (CAA) in the setting of lobar intracerebral hemorrhage (ICH). We assessed the accuracy of these criteria in individuals with lobar microbleeds (MBs) without ICH.MethodsWe identified individuals aged >55 years having brain magnetic resonance imaging (MRI) and pathological assessment of CAA in a single academic hospital and a community-based population (Framingham Heart Study [FHS]). We determined the positive predictive value (PPV) of the Boston criteria for CAA in both cohorts, using lobar MBs as the only hemorrhagic lesion to fulfill the criteria.ResultsWe included 102 individuals: 55 from the hospital-based cohort and 47 from FHS (mean age at MRI 74.7 ± 8.5 and 83.4 ± 10.9 years; CAA prevalence 60% and 46.8%; cases with any lobar MB 49% and 21.3%; and cases with ≥2 strictly lobar MBs 29.1% and 8.5%, respectively). PPV of "probable CAA" (≥2 strictly lobar MBs) was 87.5% (95% confidence interval [CI], 60.4-97.8) and 25% (95% CI, 13.2-78) in hospital and general populations, respectively.DiscussionStrictly lobar MBs strongly predict CAA in non-ICH individuals when found in a hospital context. However, their diagnostic accuracy in the general population appears limited.
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- 2015
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