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2. More Than 50 Percent Reduction in LDL Cholesterol in Patients With Target LDL <70 mg/dL After a Stroke

Author

Amarenco, Pierre, Lavallée, Philippa C., Kim, Jong S., Labreuche, Julien, Charles, Hugo, Giroud, Maurice, Lee, Byung-Chul, Mahagne, Marie-Hélène, Meseguer, Elena, Nighoghossian, Norbert, Steg, Philippe Gabriel, Vicaut, Éric, Bruckert, Eric, Kim, Jong S, Touboul, Pierre-Jean, Leys, Didier, Béjot, Yannick, Pico, Fernando, Touzé, Emmanuel, Ducrocq, Gregory, Abtan, Jérémy, Varenne, Olivier, Touboul, Pierre-Jean, Kemmel, Agnes, Syana, Fausta, Ledra, Manele, Nagasara, Tharani, Ledjeroud, Mervette, Samia, Bahous, Hadia, Hafirassou, Hazare, Benyoub, Jaghouni, Ikrame El, Yelles, Nessima, Zemouri, Sofia, Ladjeroud, Mervette, Kerai, Salim, In, YunJeong, Hobeanu, Cristina, Guidoux, Celine, Cabrejo, Lucie, Lapergue, Bertrand, Sabben, Candice, Gonzalez-Valcarcel, Jaime, Rigual, Ricardo, Sirimarco, Gaia, Martin-Bechet, Anna, Viedma, Elena, Avram, Ioan, Samson, Yves, Rosso, Charlotte, Crozier, Sophie, Leder, Sara, Léger, Anne, Deltour, Sandrine, Mutlu, Gurkan, Yger, Marion, Zavanone, Chiara, Baronnet, Flore, Pires, Christine, Lapergue, Bertrand, Wang, Adrien, Evrard, Serge, Tchikviladze, Maya, Bourdain, Frédéric, Lopez, Delphine, Pico, Fernando, de la Tour, Laetitia Bayon, Chadenat, Marie-Laure, Duong, Duc Long, Genty, Solène, Hirel, Catherine, Mutlu, Gurkan, Nifle, Chantal, Servan, Jérôme, Stanciu, Daniela, Sudacevschi, Veronica, Tir, Mélissa, Troussière, Anne-Cécile, Yeung, Jennifer, Zeghoudi, Anne-Céline, Tidafi-Bayou, Ikram, Lachaud, Sylvain, Cho, Tae-Hee, Mechtouff, Laura, Ritzenthaller, Thomas, Derex, Laurent, Albanesi, Carlo, Ong, Elodie, Benoit, Amandine, Berhoune, Nadia, Felix, Sandra, Esteban-Mader, Maud, Sibon, Igor, Kazadi, Annabelle, Rouanet, François, Renou, Pauline, Debruxelles, Sabrina, Poli, Mathilde, Sagnier, Sharmila, Mas, Jean-Louis, Domigo, Valérie, Lamy, Catherine, Bodiguel, Eric, Grimaud, Jérôme, Bohotin, Valentin, Obadia, Michael, Sabben, Candice, Morvan, Erwan, Rodier, Gilles, Vadot, Wilfried, Hénon, Hilde, Cordonnier, Charlotte, Dumont, Frédéric, Bodenant, Marie, Lucas, Christian, Moulin, Solène, Dequatre, Nelly, Alamowitch, Sonia, Muresan, Jean-Paul, Drouet, Thomas, Gallea, Magalie, Dalloz, Marie-Amélie, Delorme, Stephen, Yger, Marion, Béjot, Yannick, Loisel, Philippe, Bonnin, Carine, Bernigal, Virginie, Osseby, Guy Victor, Hervieu-BègueMarsac, Marie, Garnier, Pierre, Accassat, Sandrine, Epinat, Magali, Varvat, Jérôme, Marinescu, Doïna, Triquenot-Bagan, Aude, Ozkul- Wermester, Ozlem, Philippeau, Frédéric, Olaru, Angel, Vieillart, Anne, Lannuzel, Annie, Demoly, Alice, Wolff, Valérie, Diaconu, Mihaela, Bataillard, Marc, Montoro, Francisco Macian, Faugeras, Frédéric, Gimenez, Laeticia, Abdallah-Lebeau, Françoise, Timsit, Serge, Viakhireva-Dovganyuk, Irina, Tirel-Badets, Anne, Merrien, François-Mathias, Goas, Philippe, Rouhart, François, Jourdain, Aurore, Guillon, Benoit, Hérissson, Fanny, Sevin-Allouet, Mathieu, Nasr, Nathalie, Olivot, Jean-Marc, Lecluse, Alderic, Marc, Guillaume, Touzé, Emmanuel, de la Sayette, Vincent, Apoil, Marion, Lin, Li, Cogez, Julien, Guettier, Sophie, Godefroy, Olivier, Lamy, Chantal, Bugnicourt, Jean-Marc, Taurin, Grégory, Mérienne, Marc, Gere, Julien, Chessak, Anne-Marie, Habet, Tarik, Ferrier, Anna, Bourgois, Nathalie, Minier, Dominique, Caillier-Minier, Marie, Contégal- Callier, Fabienne, Vion, Philippe, Vaschalde, Yvan, Amrani, Mohammed El, Emilie, Zuber, Mathieu, Bruandet, Marie, Join- Lambert, Claire, Garcia, Pierre-Yves, Serre, Isabelle, Faucheux, Jean-Marc, Radji, Fatia, Leca-Radu, Elena, Debroucker, Thomas, Cumurcuc, Rodica, Cakmak, Serkan, Peysson, Stéphane, Ellie, Emmanuel, Bernady, Patricia, Moulin, Thierry, Montiel, Paola, Revenco, Eugeniu, Decavel, Pierre, Medeiros, Elisabeth, Bouveret, Myriam, Louchart, Pierre, Vaduva, Claudia, Couvreur, Grégory, Sartori, Eric, Carpentier, Alnajar, Levasseur, Michèle, Louchart, Pierre, Faucheux, Jean-Marc, Neau, Philippe, Vandamme, Xavier, Meresse, Isabelle, Stantescu, Bataillard, Marc, Ozsancak, Canan, Beauvais, Katell, Auzou, Pascal, Amevigbe, Joséphine, Vuillemet, Francis, Dugay-Arentz, Marie-Hélène, Carelli, Gabriela, Martinez, Mikel, Maillet-Vioud, Marcel, Escaillas, Jean-Pierre, Chapuis, Stéphane, Tardy, Jean, Manchon, Eric, Varnet, Olivier, Kim, Yong-Jae, Chang, Yoonkyung, Song, Tae-Jin, Kim, Jong Sung, Han, Jung-Hoon, Noh, Kyung Chul, Lee, Eun-Jae, Kang, Dong-Wha, Kwon, Sun Uck, Kwon, Boseoung, Park, Seongho, Lee, Dongwhane, Kwon, Hyuk Sung, Jeong, Daeun, Lee, MinHwan, Kim, Joonggoo, Lee, Hanbin, Nam, Hyo Jung, Lee, Sang Hun, Kim, Bum Joon, Cha, Jae-kwan, Kim, DaeHyun, Kim, Rae Young, Sohn, Sang Wuk, Shim, Dong-Hyun, Lee, Hyungjin, Nah, Hyun-Wook, Sung, Sang Min, Lee, Kyung Bok, Yoon Lee, Jeong, Yoon, Jee Eun, Kim, Eung-Gyu, Seo, Jung Hwa, Kim, Yong-Won, Hwang, Yangha, Park, Man Seok, Kim, Joon-Tae, Choi, Kang-Ho, Nam, Hyo Suk, Heo, Ji Hoe, Kim, Young Dae, Hwang, In Gun, Park, Hyung Jong, Kim, Kyoung Sub, Baek, Jang Hyun, Song, Dong Beom, Yoo, Joon Sang, Park, Jong-Moo, Kwon, Ohyun, Lee, Woong-Woo, Lee, Jung-Ju, Kang, Kyusik, Kim, Byung Kun, Lim, Jae-Sung, Oh, Mi Sun, Yu, Kyung-Ho, Hong, Bora, Jang, Mihoon, Jang, Seyoung, Jin, Jung Eun, Kim, Jei, Jeong, Hye Seon, Hong, Keun Sik, Park, Hong Kyun, Cho, Yong Jin, Bang, Oh Young, Seo, Woo-Keun, and Chung, Jongwon

Published
2023
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3. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Kahles, Timo, Nedeltchev, Krassen, Altersberger, Valerian, Bonati, Leo H, Brehm, Alex, Bruni, Nicole, De Marchis, Gian Marco, Engelter, Stefan T, Fabbro, Thomas, Fisch, Urs, Fladt, Joachim, Gensicke, Henrik, Hert, Lisa, Lyrer, Philippe A, Maurer, Marina, Peters, Nils, Polymeris, Alexandros, Psychogios, Marios-Nikos, Schaedelin, Sabine, Stippich, Christoph, Thilemann, Sebastian, Traenka, Christopher, Wagner, Benjamin, Arnold, Marcel, Fischer, Urs, Goeggel Simonetti, Barbara, Gralla, Jan, Heldner, Mirjam, Jung, Simon, Leib, Stephen L, Seiffge, David J, Mueller, Hubertus, Sveikata, Lukas, Sztajzel, Roman, Correia, Pamela, Eskandari, Ashraf, Meyer, Ivo, Michel, Patrik, Nannoni, Stefania, Remillard, Suzette, Sirimarco, Gaia, Zachariadis, Alexandros, Kaegi, Georg, Mueller, Anna, Vehoff, Jochen, Hamann, Janne, Luft, Andreas R, Steiner, Levke, Wegener, Susanne, Erdur, Hebun J, Nolte, Christian H, von Rennenberg, Regina, Scheitz, Jan F, Feil, Katharina, Kellert, Lars, Christensen, Hanne, Rosenbaum, Sverre, Schaedelin, Sabine A, Simonetti, Barbara Goeggel, Kägi, Georg, Seiffge, David, Polymeris, Alexandros A, and Lyrer, Philippe

Published
2021
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5. Diagnostic accuracy of carotid plaque instability by noninvasive imaging: a systematic review and meta-analysis.

Author

Pakizer, David, Kozel, Jiří, Taffé, Patrick, Elmers, Jolanda, Feber, Janusz, Michel, Patrik, Školoudík, David, and Sirimarco, Gaia

Subjects
ARTERIOSCLEROSIS diagnosis, CAROTID artery, RISK assessment, MEDICAL information storage & retrieval systems, RESEARCH funding, COMPUTED tomography, META-analysis, MAGNETIC resonance imaging, DESCRIPTIVE statistics, SYSTEMATIC reviews, MEDLINE, MEDICAL databases, STROKE, QUALITY assurance, CONFIDENCE intervals, SENSITIVITY & specificity (Statistics), DISEASE risk factors
Abstract

Aims There is increasing evidence that plaque instability in the extracranial carotid artery may lead to an increased stroke risk independently of the degree of stenosis. We aimed to determine diagnostic accuracy of vulnerable and stable plaque using noninvasive imaging modalities when compared to histology in patients with symptomatic and asymptomatic carotid atherosclerosis. Methods and results Medline Ovid, Embase, Cochrane Library, and Web of Science were searched for diagnostic accuracy of noninvasive imaging modalities (CT, MRI, US) in the detection of 1) vulnerable/stable plaque, and 2) vulnerable/stable plaque characteristics, compared to histology. The quality of included studies was assessed by QUADAS-2 and univariate and bivariate random-effect meta-analyses were performed. We included 36 vulnerable and 5 stable plaque studies in the meta-analysis, and out of 211 plaque characteristics from remaining studies, we classified 169 as vulnerable and 42 as stable characteristics (28 CT, 120 MRI, 104 US characteristics). We found that MRI had high accuracy [90% (95% CI: 82–95%)] in the detection of vulnerable plaque, similar to CT [86% (95% CI: 76–92%); P > 0.05], whereas US showed less accuracy [80% (95% CI: 75–84%); P = 0.013]. CT showed high diagnostic accuracy in visualizing characteristics of vulnerable or stable plaques (89% and 90%) similar to MRI (86% and 89%; P > 0.05); however, US had lower accuracy (77%, P < 0.001 and 82%, P > 0.05). Conclusion CT and MRI have a similar, high performance in detecting vulnerable carotid plaques, whereas US showed significantly less diagnostic accuracy. Moreover, MRI visualized all vulnerable plaque characteristics allowing for a better stroke risk assessment. Registration PROSPERO ID CRD42022329690 [ABSTRACT FROM AUTHOR]

Published
2024
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15. Benefit of Targeting a LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke

Author

Amarenco, Pierre, Kim, Jong S., Labreuche, Julien, Charles, Hugo, Giroud, Maurice, Lee, Byung-Chul, Mahagne, Marie-Hélène, Nighoghossian, Norbert, Gabriel Steg, Philippe, Vicaut, Éric, Bruckert, Eric, Touboul, Pierre-Jean, Leys, Didier, Béjot, Yannick, Lavallée, Philippa, Pico, Fernando, Touzé, Emmanuel, Ducrocq, Gregory, Abtan, Jérémy, Varenne, Olivier, Touboul, Pierre-Jean, Kemmel, Agnes, Syana, Fausta, Ledra, Manele, Nagasara, Tharani, Ledjeroud, Mervette, Samia, Bahous, Hadia, Hafirassou, Hazare, Benyoub, El Jaghouni, Ikrame, Yelles, Nessima, Zemouri, Sofia, Ladjeroud, Mervette, Kerai, Salim, In, Yun Jeong, Meseguer, Elena, Lavallée, Philippa C, Hobeanu, Cristina, Guidoux, Celine, Cabrejo, Lucie, Lapergue, Bertrand, Sabben, Candice, Gonzalez-Valcarcel, Jaime, Rigual, Ricardo, Sirimarco, Gaia, Martin-Bechet, Anna, Viedma, Elena, Avram, Ioan, Samson, Yves, Rosso, Charlotte, Crozier, Sophie, Leder, Sara, Léger, Anne, Deltour, Sandrine, Mutlu, Gurkan, Yger, Marion, Zavanone, Chiara, Baronnet, Flore, Pires, Christine, Lapergue, Bertrand, Wang, Adrien, Evrard, Serge, Tchikviladze, Maya, Bourdain, Frédéric, Lopez, Delphine, Pico, Fernando, de la Tour, Laetitia Bayon, Chadenat, Marie-Laure, Duong, Duc Long, Genty, Solène, Hirel, Catherine, Mutlu, Gurkan, Nifle, Chantal, Servan, Jérôme, Stanciu, Daniela, Sudacevschi, Veronica, Tir, Mélissa, Troussière, Anne-Cécile, Yeung, Jennifer, Zeghoudi, Anne-Céline, Tidafi-Bayou, Ikram, Lachaud, Sylvain, Cho, Tae-Hee, Mechtouff, Laura, Ritzenthaller, Thomas, Derex, Laurent, Albanesi, Carlo, Ong, Elodie, Benoit, Amandine, Berhoune, Nadia, Felix, Sandra, Esteban-Mader, Maud, Sibon, Igor, Kazadi, Annabelle, Rouanet, François, Renou, Pauline, Debruxelles, Sabrina, Poli, Mathilde, Sagnier, Sharmila, Mas, Jean-Louis, Domigo, Valérie, Lamy, Catherine, Bodiguel, Eric, Grimaud, Jérôme, Bohotin, Valentin, Obadia, Michael, Sabben, Candice, Morvan, Erwan, Rodier, Gilles, Vadot, Wilfried, Hénon, Hilde, Cordonnier, Charlotte, Dumont, Frédéric, Bodenant, Marie, Lucas, Christian, Moulin, Solène, Dequatre, Nelly, Alamowitch, Sonia, Muresan, Jean-Paul, Drouet, Thomas, Gallea, Magalie, Dalloz, Marie-Amélie, Delorme, Stephen, Yger, Marion, Béjot, Yannick, Loisel, Philippe, Bonnin, Carine, Bernigal, Virginie, Osseby, Guy Victor, Marsac, Marie Hervieu-Bègue, Garnier, Pierre, Accassat, Sandrine, Epinat, Magali, Varvat, Jérôme, Marinescu, Doïna, Triquenot-Bagan, Aude, Ozkul-Wermester, Ozlem, Philippeau, Frédéric, Olaru, Angel, Vieillart, Anne, Lannuzel, Annie, Demoly, Alice, Wolff, Valérie, Diaconu, Mihaela, Bataillard, Marc, Montoro, Francisco Macian, Faugeras, Frédéric, Gimenez, Laeticia, Abdallah-Lebeau, Françoise, Timsit, Serge, Viakhireva-Dovganyuk, Irina, Tirel-Badets, Anne, Merrien, François-Mathias, Goas, Philippe, Rouhart, François, Jourdain, Aurore, Guillon, Benoit, Hérissson, Fanny, Sevin-Allouet, Mathieu, Nasr, Nathalie, Olivot, Jean-Marc, Lecluse, Alderic, Marc, Guillaume, Touzé, Emmanuel, de la Sayette, Vincent, Apoil, Marion, Lin, Li, Cogez, Julien, Guettier, Sophie, Godefroy, Olivier, Lamy, Chantal, Bugnicourt, Jean-Marc, Taurin, Grégory, Mérienne, Marc, Gere, Julien, Chessak, Anne-Marie, Habet, Tarik, Ferrier, Anna, Bourgois, Nathalie, Minier, Dominique, Caillier-Minier, Marie, Contégal-Callier, Fabienne, Vion, Philippe, Vaschalde, Yvan, El Amrani, Emilie, Mohammed, Zuber, Mathieu, Bruandet, Marie, Join-Lambert, Claire, Garcia, Pierre-Yves, Serre, Isabelle, Faucheux, Jean-Marc, Radji, Fatia, Leca-Radu, Elena, Debroucker, Thomas, Cumurcuc, Rodica, Cakmak, Serkan, Peysson, Stéphane, Ellie, Emmanuel, Bernady, Patricia, Moulin, Thierry, Montiel, Paola, Revenco, Eugeniu, Decavel, Pierre, Medeiros, Elisabeth, Bouveret, Myriam, Louchart, Pierre, Vaduva, Claudia, Couvreur, Grégory, Sartori, Eric, Alnajar-Carpentier, Eric, Levasseur, Michèle, Louchart, Pierre, Neau, Jean-Philippe, Vandamme, Xavier, Meresse, Isabelle, Stantescu, Bataillard, Marc, Ozsancak, Canan, Beauvais, Katell, Auzou, Pascal, Amevigbe, Joséphine, Vuillemet, Francis, Dugay-Arentz, Marie-Hélène, Carelli, Gabriela, Martinez, Mikel, Maillet-Vioud, Marcel, Escaillas, Jean-Pierre, Chapuis, Stéphane, Tardy, Jean, Manchon, Eric, Varnet, Olivier, Kim, Yong-Jae, Chang, Yoonkyung, Song, Tae-Jin, Han, Jung-Hoon, Noh, Kyung Chul, Lee, Eun-Jae, Kang, Dong-Wha, Kwon, Sun Uck, Kwon, Boseoung, Park, Seongho, Lee, Dongwhane, Kwon, Hyuk Sung, Jeong, Daeun, Lee, MinHwan, Kim, Joonggoo, Lee, Hanbin, Nam, Hyo Jung, Lee, Sang Hun, Kim, Bum Joon, Cha, Jae-kwan, Kim, DaeHyun, Young Kim, Rae, Sohn, Sang Wuk, Shim, Dong-Hyun, Lee, Hyungjin, Nah, Hyun-Wook, Sung, Sang Min, Lee, Kyung Bok, Lee, Jeong Yoon, Yoon, Jee Eun, Kim, Eung-Gyu, Seo, Jung Hwa, Kim, Yong-Won, Hwang, Yangha, Park, Man Seok, Kim, Joon-Tae, Choi, Kang-Ho, Nam, Hyo Suk, Heo, Ji Hoe, Kim, Young Dae, Hwang, In Gun, Park, Hyung Jong, Kim, Kyoung Sub, Baek, Jang Hyun, Song, Dong Beom, Yoo, Joon Sang, Park, Jong-Moo, Kwon, Ohyun, Lee, Woong-Woo, Lee, Jung-Ju, Kang, Kyusik, Kim, Byung Kun, Lim, Jae-Sung, Oh, Mi Sun, Yu, Kyung-Ho, Hong, Bora, Jang, Mihoon, Jang, Seyoung, Jin, Jung Eun, Kim, Jei, Jeong, Hye Seon, Hong, Keun Sik, Park, Hong Kyun, Cho, Yong Jin, Bang, Oh Young, Seo, Woo-Keun, and Chung, Jongwon

Published
2020
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19. A tool to identify patients with embolic stroke of undetermined source at high recurrence risk

Author

Ntaios, George, Georgiopoulos, Georgios, Perlepe, Kalliopi, Sirimarco, Gaia, Strambo, Davide, Eskandari, Ashraf, Nannoni, Stefania, Vemmou, Anastasia, Koroboki, Eleni, Manios, Efstathios, Rodríguez-Campello, Ana, Cuadrado-Godia, Elisa, Roquer, Jaume, Arnao, Valentina, Caso, Valeria, Paciaroni, Maurizio, Diez-Tejedor, Exuperio, Fuentes, Blanca, Rodríguez Pardo, Jorge, Sánchez-Velasco, Sara, Arauz, Antonio, Ameriso, Sebastian F., Pertierra, Lucía, Gómez-Schneider, Maia, Hawkes, Maximiliano A., Barboza, Miguel A., Chavarria Cano, Beatriz, Iglesias Mohedano, Ana Maria, García Pastor, Andrés, Gil-Núñez, Antonio, Putaala, Jukka, Tatlisumak, Turgut, Karagkiozi, Efstathia, Papavasileiou, Vasileios, Makaritsis, Konstantinos, Bandini, Fabio, Vemmos, Konstantinos, and Michel, Patrik

Published
2019
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22. Renal Function and Risk Stratification of Patients With Embolic Stroke of Undetermined Source

Author

Ntaios, George, Lip, Gregory Y.H., Lambrou, Dimitris, Michel, Patrik, Perlepe, Kalliopi, Eskandari, Ashraf, Nannoni, Stefania, Sirimarco, Gaia, Strambo, Davide, Vemmos, Konstantinos, Koroboki, Eleni, Manios, Efstathios, Vemmou, Anastasia, Rodríguez-Campello, Ana, Cuadrado-Godia, Elisa, Roquer, Jaume, Arnao, Valentina, Caso, Valeria, Paciaroni, Maurizio, Diez-Tejedor, Exuperio, Fuentes, Blanca, Rodríguez Pardo, Jorge, Arauz, Antonio, Ameriso, Sebastian F., Pertierra, Lucía, Gómez-Schneider, Maia, Hawkes, Maximiliano A., Bandini, Fabio, Chavarria Cano, Beatriz, Mohedano, Ana Maria Iglesias, García Pastor, Andrés, Gil-Núñez, Antonio, Putaala, Jukka, Tatlisumak, Turgut, Barboza, Miguel A., Karagkiozi, Efstathia, Makaritsis, Konstantinos, and Papavasileiou, Vasileios

Published
2018
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24. Predicting Penumbra Salvage and Infarct Growth in Acute Ischemic Stroke: A Multifactor Survival Game.

Author

Sirimarco, Gaia, Strambo, Davide, Nannoni, Stefania, Labreuche, Julien, Cereda, Carlo, Dunet, Vincent, Puccinelli, Francesco, Saliou, Guillaume, Meuli, Reto, Eskandari, Ashraf, Wintermark, Max, and Michel, Patrik

Subjects
*ISCHEMIC stroke, *STROKE, *CEREBRAL arteries, *BRAIN damage, *STROKE patients, *HYPERGLYCEMIA
Abstract

Background. Effective treatment of acute ischemic stroke requires reperfusion of salvageable tissue. We investigated the predictors of penumbra salvage (PS) and infarct growth (IG) in a large cohort of stroke patients. Methods. In the ASTRAL registry from 2003 to 2016, we selected middle cerebral artery strokes <24 h with a high-quality CT angiography and CT perfusion. PS and IG were correlated in multivariate analyses with clinical, biochemical and radiological variables, and with clinical outcomes. Results. Among 4090 patients, 551 were included in the study, 50.8% male, mean age (±SD) 66.3 ± 14.7 years, mean admission NIHSS (±SD 13.3 ± 7.1) and median onset-to-imaging-time (IQR) 170 (102 to 385) minutes. Increased PS was associated with the following: higher BMI and lower WBC; neglect; larger penumbra; absence of early ischemic changes, leukoaraiosis and other territory involvement; and higher clot burden score. Reduced IG was associated with the following: non-smokers; lower glycemia; larger infarct core; absence of early ischemic changes, chronic vascular brain lesions, other territory involvement, extracranial arterial pathology and hyperdense middle cerebral artery sign; and higher clot burden score. When adding subacute variables, recanalization was associated with increased PS and reduced IG, and the absence of haemorrhage with reduced IG. Collateral status was not significantly associated with IG nor with PS. Increased PS and reduced IG correlated with better 3- and 12-month outcomes. Conclusion. In our comprehensive analysis, multiple factors were found to be responsible for PS or IG, the strongest being radiological features. These findings may help to better select patients, particularly for more aggressive or late acute stroke treatment. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Atherogenic Dyslipidemia and Residual Cardiovascular Risk in Statin-Treated Patients

Author

Sirimarco, Gaia, Labreuche, Julien, Bruckert, Eric, Goldstein, Larry B., Fox, Kim M., Rothwell, Peter M., Amarenco, Pierre, Bousser, Marie-Germaine, Chamorro, Angel, Ford, Ian, Fox, Kim, Fisher, Marc, Hennerici, Michael G., Mattle, Heinrich, Rothwell, Peter M., Callahan, Fred, III, Goldstein, Larry B., Sillesen, Henrik, Welch, K. Michael A., and Zivin, Justin A.

Published
2014
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30. Atrial Cardiopathy and Likely Pathogenic Patent Foramen Ovale in Embolic Stroke of Undetermined Source

Author

Leventis, Ioannis A. Sagris, Dimitrios Strambo, Davide and Perlepe, Kalliopi Sirimarco, Gaia Nannoni, Stefania and Korompoki, Eleni Manios, Efstathios Makaritsis, Konstantinos and Vemmos, Konstantinos Michel, Patrik Ntaios, George

Subjects
cardiovascular diseases
Abstract

Background Atrial cardiopathy and likely pathogenic patent foramen ovale (PFO) are two potential embolic sources in patients with embolic stroke of undetermined source (ESUS). The relationship between these two mechanisms among ESUS patients remains unclear. Methods Atrial cardiopathy was defined as increased left atrial diameter index (> 23 mm/m(2)) or left atrial volume index (> 34 mL/m(2)), or PR prolongation (>= 200 ms), or presence of supraventricular extrasystoles in the electrocardiograms performed during hospitalization for the index stoke. The presence of PFO was assessed by transthoracic echocardiography with microbubble test or by transesophageal echocardiography. The presence of PFO was considered as likely pathogenic if the Risk of Paradoxical Embolism score was 7 to 10. Results Among 367 ESUS patients with available information about the presence of PFO and the presence of atrial cardiopathy (median age: 61 years, 40.6% women), likely pathogenic PFO was diagnosed in 62 (16.9%) and atrial cardiopathy in 122 (33.2%). Only 4 patients (1.1%) had both likely pathogenic PFO and atrial cardiopathy. The prevalence of atrial cardiopathy was lower in patients with likely pathogenic PFO (6.5%) compared with patients with likely incidental PFO (31.2%) or without PFO (40.6%) (Pearson’s chi-square test: 26.08,p < 0.001; adjusted odds ratio [OR]: 0.28, 95% confidence interval [CI]: 0.09-0.86). The prevalence of likely pathogenic PFO was lower in patients with atrial cardiopathy compared with patients without atrial cardiopathy (3.3% vs. 23.7%, respectively [Pearson’s chi-square test: 24.13,p < 0.001; adjusted OR: 0.2, 95% CI: 0.02-0.6]). Conclusion The presence of atrial cardiopathy is inversely related to the presence of likely pathogenic PFO in patients with ESUS.

Published
2021

31. Data?driven machine?learning analysis of potential embolic sources in embolic stroke of undetermined source

Author

Ntaios, George, Weng, Stephen F., Perlepe, Kalliopi, Akyea, Ralph, Condon, Laura, Lambrou, Dimitrios, Sirimarco, Gaia, Strambo, Davide, Eskandari, Ashraf, Karagkiozi, Efstathia, Vemmou, Anastasia, Korompoki, Eleni, Manios, Efstathios, Makaritsis, Konstantinos, Vemmos, Konstantinos, and Michel, Patrik

Subjects
machine learning, potential embolic source, embolic stroke of undetermined source, stroke, hierarchical clustering
Abstract

Background: Hierarchical clustering, a common “unsupervised” machine‐learning algorithm, is advantageous for exploring potential underlying aetiology in particularly heterogeneous diseases. We investigated potential embolic sources in ESUS using a data‐driven, machine‐learning method, and explored variation in stroke recurrence between clusters.Methods: We used hierarchical k‐means clustering algorithm on patients’ baseline data, which assigned each individual into a unique clustering group, using a minimum‐variance method to calculate the similarity between ESUS patients based on all baseline features. Potential embolic sources were categorised into atrial cardiopathy, atrial fibrillation, arterial disease, left ventricular disease, cardiac valvulopathy, patent foramen ovale (PFO) and cancer.Results: Among 800 consecutive ESUS patients (43.3% women, median age 67years), the optimal number of clusters was 4. Left ventricular disease was most prevalent in cluster 1 (present in all patients) and perfectly associated with cluster 1. PFO was most prevalent in cluster 2 (38.9% of patients) and associated significantly with increased likelihood of cluster 2 (adjusted odds‐ratio:2.69, 95%CI:1.64‐4.41). Arterial disease was most prevalent in cluster 3 (57.7%) and associated with increased likelihood of cluster 3 (adjusted odds‐ratio:2.21, 95%CI:1.43‐3.13). Atrial cardiopathy was most prevalent in cluster 4 (100%) and perfectly associated with cluster 4. Cluster 3 was the largest cluster involving 53.7% of patients. Atrial fibrillation was not significantly associated with any cluster.Conclusions: This data‐driven machine‐learning analysis identified 4 clusters of ESUS which were strongly associated with arterial disease, atrial cardiopathy, PFO and left ventricular disease respectively. More than half of patients were assigned to the cluster associated with arterial disease.

Published
2021

32. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Engelter, Stefan T, Traenka, Christopher, Gensicke, Henrik, Schaedelin, Sabine A, Luft, Andreas R, Goeggel Simonetti, Barbara, Fischer, Urs, Michel, Patrik, Sirimarco, Gaia, Kägi, Georg, Vehoff, Jochen, Nedeltchev, Krassen, Kahles, Timo, Kellert, Lars, Rosenbaum, Sverre, von Rennenberg, Regina, Sztajzel, Roman, Leib, Stephen L, Jung, Simon, Gralla, Jan, Bruni, Nicole, Seiffge, David, Feil, Katharina, Polymeris, Alexandros A, Steiner, Levke, Hamann, Janne, Bonati, Leo H, Brehm, Alex, De Marchis, Gian Marco, Peters, Nils, Stippich, Christoph, Nolte, Christian H, Christensen, Hanne, Wegener, Susanne, Psychogios, Marios-Nikos, Arnold, Marcel, and Lyrer, Philippe

Subjects
570 Life sciences, biology, 610 Medicine & health
Abstract

BACKGROUND Cervical artery dissection is a major cause of stroke in young people (aged

Published
2021
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33. Embolic Stroke of Undetermined Source and Patent Foramen Ovale Risk of Paradoxical Embolism Score Validation and Atrial Fibrillation Prediction

Author

Strambo, Davide Sirimarco, Gaia Nannoni, Stefania Perlepe, Kalliopi Ntaios, George Vemmos, Kostantinos Michel, Patrik

Abstract

Background and Purpose: The Risk of Paradoxical Embolism (RoPE) score stratifies patients with stroke according to the probability of having a patent foramen ovale (PFO), which (through Bayes theorem and simple assumptions) can be used to estimate the probability that a PFO is pathogenic in a given subgroup of patients with specific features (ie, a given RoPE score value): a higher PFO prevalence corresponds to a higher probability that a PFO is pathogenic. Among alternative mechanisms in embolic stroke of undetermined source (ESUS), the actual stroke cause may be covert atrial fibrillation. We aimed to validate the RoPE score in a large ESUS population and investigate the rate of stroke recurrence and new incident atrial fibrillation during follow-up according to PFO status and RoPE score. Methods: We pooled data of consecutive patients with ESUS from 3 prospective stroke registries. We assessed RoPE score’s calibration and discrimination for the presence of PFO (and consequently for the probability that it is pathogenic). Multivariate logistic regression analysis was performed to identify factors associated with PFO. Results: Among 455 patients with ESUS (median age 59 years), 184 (40%) had PFO. The RoPE score’s area under the receiver operating characteristic curve was 0.75. In addition to RoPE score variables, absence of left ventricular hypertrophy, absence of atherosclerosis, and infratentorial lesions were independently associated with PFO. In patients with PFO and RoPE 7 to 10, PFO and RoPE 0 to 6, and without PFO, new incident atrial fibrillation rate was 3.1%, 20.5%, and 31.8%, respectively (log-rank test=6.28, P=0.04). Stroke recurrences in patients with likely pathogenic PFO were not statistically different from other patients. Conclusions: This multicenter study validates the RoPE score to predict the presence/absence of PFO in patients with ESUS, which strongly suggests that RoPE score is helpful in identifying patients with ESUS with pathogenic versus incidental PFOs. Left ventricular hypertrophy, atherosclerosis, and infratentorial stroke may further improve the score. Low RoPE scores were associated with more incidental atrial fibrillation during 10-year follow-up.

Published
2021

34. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Engelter, Stefan T, primary, Traenka, Christopher, additional, Gensicke, Henrik, additional, Schaedelin, Sabine A, additional, Luft, Andreas R, additional, Simonetti, Barbara Goeggel, additional, Fischer, Urs, additional, Michel, Patrik, additional, Sirimarco, Gaia, additional, Kägi, Georg, additional, Vehoff, Jochen, additional, Nedeltchev, Krassen, additional, Kahles, Timo, additional, Kellert, Lars, additional, Rosenbaum, Sverre, additional, von Rennenberg, Regina, additional, Sztajzel, Roman, additional, Leib, Stephen L, additional, Jung, Simon, additional, Gralla, Jan, additional, Bruni, Nicole, additional, Seiffge, David, additional, Feil, Katharina, additional, Polymeris, Alexandros A, additional, Steiner, Levke, additional, Hamann, Janne, additional, Bonati, Leo H, additional, Brehm, Alex, additional, De Marchis, Gian Marco, additional, Peters, Nils, additional, Stippich, Christoph, additional, Nolte, Christian H, additional, Christensen, Hanne, additional, Wegener, Susanne, additional, Psychogios, Marios-Nikos, additional, Arnold, Marcel, additional, Lyrer, Philippe, additional, Altersberger, Valerian, additional, Engelter, Stefan T, additional, Fabbro, Thomas, additional, Fisch, Urs, additional, Fladt, Joachim, additional, Hert, Lisa, additional, Lyrer, Philippe A, additional, Maurer, Marina, additional, Polymeris, Alexandros, additional, Schaedelin, Sabine, additional, Thilemann, Sebastian, additional, Wagner, Benjamin, additional, Goeggel Simonetti, Barbara, additional, Heldner, Mirjam, additional, Seiffge, David J, additional, Mueller, Hubertus, additional, Sveikata, Lukas, additional, Correia, Pamela, additional, Eskandari, Ashraf, additional, Meyer, Ivo, additional, Nannoni, Stefania, additional, Remillard, Suzette, additional, Zachariadis, Alexandros, additional, Kaegi, Georg, additional, Mueller, Anna, additional, Erdur, Hebun J, additional, and Scheitz, Jan F, additional

Published
2021
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39. Is Intracerebral Hemorrhage a Time-Dependent Phenomenon After Successful Combined Intravenous and Intra-Arterial Therapy?

Author

Mosimann, Pascal J., Sirimarco, Gaia, Meseguer, Elena, Serfaty, Jean-Michel, Laissy, Jean-Pierre, Labreuche, Julien, Lapergue, Bertrand, Gonzalez-Valcarcel, Jaime, Lavallée, Philippa C., Cabrejo, Lucie, Guidoux, Celine, Klein, Isabelle F., Olivot, Jean-Marc, Schouman-Claeys, Elisabeth, Amarenco, Pierre, and Mazighi, Mikael

Published
2013
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43. Atrial Cardiopathy and Likely Pathogenic Patent Foramen Ovale in Embolic Stroke of Undetermined Source

Author

Leventis, Ioannis A., additional, Sagris, Dimitrios, additional, Strambo, Davide, additional, Perlepe, Kalliopi, additional, Sirimarco, Gaia, additional, Nannoni, Stefania, additional, Korompoki, Eleni, additional, Manios, Efstathios, additional, Makaritsis, Konstantinos, additional, Vemmos, Konstantinos, additional, Michel, Patrik, additional, and Ntaios, George, additional

Published
2020
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45. Identification of patients with embolic stroke of undetermined source and low risk of new incident atrial fibrillation: The AF-ESUS score

Author

Ntaios, George, primary, Perlepe, Kalliopi, additional, Lambrou, Dimitris, additional, Sirimarco, Gaia, additional, Strambo, Davide, additional, Eskandari, Ashraf, additional, Karagkiozi, Efstathia, additional, Vemmou, Anastasia, additional, Korompoki, Eleni, additional, Manios, Efstathios, additional, Makaritsis, Konstantinos, additional, Vemmos, Konstantinos, additional, and Michel, Patrik, additional

Published
2020
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46. Characteristics and outcomes of Embolic Stroke of Undetermined Source according to stroke severity

Author

Leventis, Ioannis, primary, Perlepe, Kalliopi, additional, Sagris, Dimitrios, additional, Sirimarco, Gaia, additional, Strambo, Davide, additional, Georgiopoulos, Georgios, additional, Eskandari, Ashraf, additional, Karagkiozi, Efstathia, additional, Vemmou, Anastasia, additional, Koroboki, Eleni, additional, Manios, Efstathios, additional, Makaritsis, Konstantinos, additional, Vemmos, Konstantinos, additional, Michel, Patrik, additional, and Ntaios, George, additional

Published
2020
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47. sj-pdf-4-wso-10.1177_1747493020932787 - Supplemental material for A score to predict one-year risk of recurrence after acute ischemic stroke

Author

Strambo, Davide, Zachariadis, Alexandros, Lambrou, Dimitris, Ghil Schwarz, Sirimarco, Gaia, Karolinaa Aarnio, Putaala, Jukka, Ntaios, George, Vemmos, Kostantinos, and Michel, Patrik

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-4-wso-10.1177_1747493020932787 for A score to predict one-year risk of recurrence after acute ischemic stroke by Davide Strambo, Alexandros Zachariadis, Dimitris Lambrou, Ghil Schwarz, Gaia Sirimarco, Karolinaa Aarnio, Jukka Putaala, George Ntaios, Kostantinos Vemmos and Patrik Michel in International Journal of Stroke

Published
2020
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48. Supraventricular Extrasystoles on Standard 12-lead Electrocardiogram Predict New Incident Atrial Fibrillation after Embolic Stroke of Undetermined Source: The AF-ESUS Study

Author

Ntaios, George Perlepe, Kalliopi Lambrou, Dimitrios and Sirimarco, Gaia Strambo, Davide Eskandari, Ashraf and Karagkiozi, Efstathia Vemmou, Anastasia Koroboki, Eleni and Manios, Efstathios Makaritsis, Konstantinos Michel, Patrik and Vemmos, Konstantinos

Abstract

Background: The diagnosis of covert atrial fibrillation (AF) remains a major challenge to guide secondary prevention of patients with embolic stroke of undetermined source (ESUS). Aims: We analyzed consecutive ESUS patients from 3 prospective stroke registries to assess whether the presence of supraventricular extrasystoles (SVE) on standard 12-lead electrocardiogram (ECG) is associated with the detection of AF (primary outcome), stroke recurrence and death (secondary outcomes) during follow-up. Methods: We measured the number of SVEs in all available ECGs of patients hospitalized for ESUS. Multivariate stepwise regression with forward selection of covariates assessed the association between SVE (classified in 4 groups according to their number per 10 seconds of ECG: no SVE, >0-1SVEs, >1-2SVEs, and >2SVEs) and outcomes during follow-up. The Kaplan-Meier product limit method estimated the 10-year cumulative probabilities of outcomes in each SVE group. We calculated the negative prognostic value (NPV) of the presence of any SVE to predict new AF, defined as the probability that AF will not be detected during follow-up if there is no SVE. Results: Among 853 ESUS patients followed for 2857 patient-years (median age: 67 years, 43.0% women), 226 (26.5%) patients had at least 1 SVE at the standard 12-lead ECGs performed during hospitalization. AF was detected in 125 (14.7%) of patients in the overall population during follow-up: 8.9%, 22.5%, 28.1%, and 48.3% in patients with no SVE, greater than 0-1SVE, greater than 1-2SVE and greater than 2SVE respectively. In multivariate regression analysis, compared to patients with no SVEs, the corresponding hazard-ratios were 1.80 [95% confidence intervals (95%CI):1.06-3.05], 2.26 (95%CI:1.28-4.01) and 3.19 (95%CI:1.93-5.27). The NPV of the presence of any SVE for the prediction of new AF was 91.4%. There was no statistically significant association of SVE with the risk of ischemic stroke recurrence and death. Conclusions: In ESUS patients without SVEs during hospitalization, the probability that AF will not be detected during a follow-up of 3.4 years is more than 91%.

Published
2020

49. Characteristics and outcomes of Embolic Stroke of Undetermined Source according to stroke severity

Author

Leventis, Ioannis Perlepe, Kalliopi Sagris, Dimitrios and Sirimarco, Gaia Strambo, Davide Georgiopoulos, Georgios and Eskandari, Ashraf Karagkiozi, Efstathia Vemmou, Anastasia and Koroboki, Eleni Manios, Efstathios Makaritsis, Konstantinos and Vemmos, Konstantinos Michel, Patrik Ntaios, George

Subjects
macromolecular substances
Abstract

Background and aims Patients with embolic strokes of undetermined source (ESUS) usually present with mild symptoms. We aimed to compare the baseline characteristics between mild and severe ESUS, identify predictors for severe ESUS, and assess outcomes of patients with severe ESUS. Methods In the AF-ESUS (AF-ESUS) dataset, we stratified ESUS severity using the median National Institutes of Health Stroke Scale (NIHSS) score on admission as cut-off. We performed multivariable stepwise regression analyses to identify independent predictors of severe ESUS and to assess the association between ESUS severity and stroke recurrence, death, and new incident atrial fibrillation (AF) on follow-up. The 10-year cumulative probabilities of outcome incidence were estimated by the Kaplan-Meier product limit method. Results In 772 patients (median NIHSS: 6 (interquartile range: 3-12)), 414 (53.6%) patients had severe ESUS (i.e. NIHSS >= 6). Female sex was the only independent predictor for severe ESUS (odds ratio: 1.72 (1.27-2.33)). The rates of recurrence (3.3%/year vs. 3.4%/year, adjusted-hazard ratio: 1.09 (0.73-1.62)) and new incident AF (13.5% vs. 17.0%, adjusted odds ratio: 0.67 (0.44-1.03)) were similar between severe and mild ESUS, but mortality was higher (5.4%/year vs. 3.7%/year, adjusted-hazard ratio: 1.51 (1.05-2.16)) in severe ESUS. The 10-year cumulative probability for stroke recurrence was similar between severe and mild ESUS (38.1% (29.2-48.6) vs. 36.6% (27.8-47.0), log-rank test: 0.01, p = 0.920). The 10-year cumulative probability of death was higher in patients with severe ESUS compared with mild ESUS (40.5% (32.5-50.0) vs. 34.0% (26.0-43.6) respectively; log-rank test: 4.54, p = 0.033). Conclusions Women have more severe ESUS compared with men. Patients with severe ESUS have similar rates of stroke recurrence and new incident AF, but higher mortality compared with mild ESUS.

Published
2020

50. sj-pdf-1-wso-10.1177_1747493020925281 - Supplemental material for Identification of patients with embolic stroke of undetermined source and low risk of new incident atrial fibrillation: The AF-ESUS score

Author

Ntaios, George, Perlepe, Kalliopi, Lambrou, Dimitris, Sirimarco, Gaia, Strambo, Davide, Eskandari, Ashraf, Karagkiozi, Efstathia, Vemmou, Anastasia, Korompoki, Eleni, Manios, Efstathios, Makaritsis, Konstantinos, Vemmos, Konstantinos, and Michel, Patrik

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-pdf-1-wso-10.1177_1747493020925281 for Identification of patients with embolic stroke of undetermined source and low risk of new incident atrial fibrillation: The AF-ESUS score by George Ntaios Kalliopi Perlepe, Dimitris Lambrou, Gaia Sirimarco, Davide Strambo, Ashraf Eskandari, Efstathia Karagkiozi, Anastasia Vemmou, Eleni Korompoki, Efstathios Manios, Konstantinos Makaritsis, Konstantinos Vemmos and Patrik Michel in International Journal of Stroke

Published
2020
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