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398 results on '"Yoshimura, Sohei"'

2. Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis

Author

Kamogawa, Naruhiko, Miwa, Kaori, Toyoda, Kazunori, Jensen, Märit, Inoue, Manabu, Yoshimura, Sohei, Fukuda-Doi, Mayumi, Kitazono, Takanari, Boutitie, Florent, Ma, Henry, Ringleb, Peter, Wu, Ona, Schwamm, Lee H., Warach, Steven, Hacke, Werner, Davis, Stephen M., Donnan, Geoffrey A., Gerloff, Christian, Thomalla, Götz, Koga, Masatoshi, Cheng, Bastian, Bendszus, Martin, Bladin, Christopher, Churilov, Leonid, Campbell, Brunce, Parsons, Mark, Yassi, Nawaf, Ebinger, Martin, Endres, Matthias, Fiebach, Jochen B., Kleinig, Timothy, Latour, Lawrence, Lemmens, Robin, Levi, Christopher, Leys, Didier, Molina, Carlos, Muir, Keith, Nighoghossian, Norbert, Pedraza, Salvador, Schellinger, Peter D., Schwab, Stefan, Simonsen, Claus Z., Song, Shlee S., Thijs, Vincent, Toni, Danilo, Hsu, Chung Y., and Wahlgren, Nils

Published
2024
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9. Clinical impact of body mass index on outcomes of ischemic and hemorrhagic strokes.

Author

Miwa, Kaori, Nakai, Michikazu, Yoshimura, Sohei, Sasahara, Yusuke, Wada, Shinichi, Koge, Junpei, Ishigami, Akiko, Yagita, Yoshiki, Kamiyama, Kenji, Miyamoto, Yoshihiro, Kobayashi, Shotai, Minematsu, Kazuo, Toyoda, Kazunori, and Koga, Masatoshi

Subjects
HEMORRHAGIC stroke, ISCHEMIC stroke, STROKE, LOGISTIC regression analysis, BODY mass index
Abstract

Background and aim: To investigate the prognostic implication of body mass index (BMI) on clinical outcomes after acute ischemic and hemorrhagic stroke. Methods: The subjects of the study included adult patients with available baseline body weight and height data who had suffered an acute stroke and were registered in the Japan Stroke Data Bank—a hospital-based, multicenter stroke registration database—between January 2006 and December 2020. The outcome measures included unfavorable outcomes defined as a modified Rankin Scale (mRS) score of 5–6 and favorable outcomes (mRS 0–2) at discharge, and in-hospital mortality. Mixed effects logistic regression analysis was conducted to determine the relationship between BMI categories (underweight, normal weight, overweight, class I obesity, class II obesity; <18.5, 18.5–23.0, 23.0–25.0, 25–30, ⩾30 kg/m2) and the outcomes, after adjustment for covariates. Results: A total of 56,230 patients were assigned to one of the following groups: ischemic stroke (IS, n = 43,668), intracerebral hemorrhage (ICH, n = 9741), and subarachnoid hemorrhage (SAH, n = 2821). In the IS group, being underweight was associated with an increased likelihood of unfavorable outcomes (odds ratio, 1.47 (95% confidence interval (CI):1.31−1.65)) and in-hospital mortality (1.55 (1.31−1.83)) compared to outcomes in those with normal weight. Being overweight was associated with an increased likelihood of favorable outcomes (1.09 (1.01−1.18)). Similar associations were observed between underweight and these outcomes in specific IS subtypes (cardioembolic stroke, large artery stroke, and small-vessel occlusion). Patients with a BMI ⩾30.0 kg/m2 was associated with an increased likelihood of unfavorable outcomes (1.44 (1.01−2.17)) and in-hospital mortality (2.42 (1.26−4.65)) in large artery stroke. In patients with ICH, but not those with SAH, being underweight was associated with an increased likelihood of unfavorable outcomes (1.41 (1.01−1.99)). Conclusions: BMI substantially impacts functional outcomes following IS and ICH. Lower BMI consistently affected post-stroke disability and mortality, while higher BMI values similarly affected these outcomes after large artery stroke. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Abstract WP19: Is Direct Oral Anticoagulant More Effective Than Warfarin to Reduce Size of Left Atrial Thrombus in Stroke Patients?

Author

Nishimura, Takuya, primary, Aoki, Junya, additional, Terakado, Mariko, additional, Suzuki, Fumiaki, additional, Sakamoto, Yuki, additional, Terasawa, Yuka, additional, Sakai, Kenichiro, additional, Iguchi, Yasuyuki, additional, Anan, Yuhei, additional, Fujimoto, Shigeru, additional, Yoshimura, Sohei, additional, Ihara, Masafumi, additional, Koga, Masatoshi, additional, and Kimura, Kazumi, additional

Published
2024
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15. Abstract WP167: Clinical Characteristics and Outcomes of Mixed Cerebral Small Vessel Disease According to the CLAS-ICH Classification

Author

Ogawa, Atsushi, primary, Miwa, Kaori, additional, Shiozawa, Masayuki, additional, Inutsuka, Ryoko, additional, Usui, Ryo, additional, Arakaki, Yoshito, additional, Kamogawa, Naruhiko, additional, Yoshimura, Sohei, additional, Toyoda, Kazunori, additional, Ihara, Masafumi, additional, and Koga, Masatoshi, additional

Published
2024
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16. Abstract WP21: Intravenous Alteplase for Unknown Onset Stroke on Prior Antiplatelet Therapy: EOS Individual Participant Data

Author

Shiomi, Yuma, primary, Miwa, Kaori, additional, Toyoda, Kazunori, additional, Jensen, Märit, additional, Inoue, Manabu, additional, yoshimura, sohei, additional, Naruhiko, Kamogawa, additional, fukuda, mayumi, additional, Ma, Henry, additional, Ringleb, Peter, additional, Wu, Ona, additional, Schwamm, Lee H, additional, Davis, Stephen M, additional, Donnan, Geoffrey A, additional, Gerloff, Christian P, additional, Thomalla, Gotz, additional, and Koga, Masatoshi, additional

Published
2024
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18. Cerebral Small Vessel Disease Burden for Bleeding Risk during Antithrombotic Therapy: Bleeding with Antithrombotic Therapy 2 Study.

Author

Tanaka, Kanta, Miwa, Kaori, Koga, Masatoshi, Yoshimura, Sohei, Kamiyama, Kenji, Yagita, Yoshiki, Nagakane, Yoshinari, Hoshino, Haruhiko, Terasaki, Tadashi, Okada, Yasushi, Yakushiji, Yusuke, Takahashi, Shinichi, Ueda, Toshihiro, Hasegawa, Yasuhiro, Shiozawa, Masayuki, Sasaki, Makoto, Kudo, Kohsuke, Tanaka, Jun, Nishihara, Masashi, and Yamaguchi, Yoshitaka

Subjects
CEREBRAL small vessel diseases, FIBRINOLYTIC agents, INTRACRANIAL hemorrhage, GASTROINTESTINAL hemorrhage, CEREBROVASCULAR disease
Abstract

Objective: This study was undertaken to determine the excess risk of antithrombotic‐related bleeding due to cerebral small vessel disease (SVD) burden. Methods: In this observational, prospective cohort study, patients with cerebrovascular or cardiovascular diseases taking oral antithrombotic agents were enrolled from 52 hospitals across Japan between 2016 and 2019. Baseline multimodal magnetic resonance imaging acquired under prespecified conditions was assessed by a central diagnostic radiology committee to calculate total SVD score. The primary outcome was major bleeding. Secondary outcomes included bleeding at each site and ischemic events. Results: Of the analyzed 5,250 patients (1,736 women; median age = 73 years, 9,933 patient‐years of follow‐up), antiplatelets and anticoagulants were administered at baseline in 3,948 and 1,565, respectively. Median SVD score was 2 (interquartile range = 1–3). Incidence rate of major bleeding was 0.39 (per 100 patinet‐years) in score 0, 0.56 in score 1, 0.91 in score 2, 1.35 in score 3, and 2.24 in score 4 (adjusted hazard ratio [aHR] for score 4 vs 0 = 5.47, 95% confidence interval [CI] = 2.26–13.23), that of intracranial hemorrhage was 0.11, 0.33, 0.58, 0.99, and 1.06, respectively (aHR = 9.29, 95% CI = 1.99–43.35), and that of ischemic event was 1.82, 2.27, 3.04, 3.91, and 4.07, respectively (aHR = 1.76, 95% CI = 1.08–2.86). In addition, extracranial major bleeding (aHR = 3.43, 95% CI = 1.13–10.38) and gastrointestinal bleeding (aHR = 2.54, 95% CI = 1.02–6.35) significantly increased in SVD score 4 compared to score 0. Interpretation: Total SVD score was predictive for intracranial hemorrhage and probably for extracranial bleeding, suggesting the broader clinical relevance of cerebral SVD as a marker for safe implementation of antithrombotic therapy. ANN NEUROL 2024;95:774–787 [ABSTRACT FROM AUTHOR]

Published
2024
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21. Magnetic Resonance Imaging–Guided Thrombolysis (0.6 mg/kg) Was Beneficial for Unknown Onset Stroke Above a Certain Core Size: THAWS RCT Substudy

Author

Toyoda, Kazunori, Inoue, Manabu, Yoshimura, Sohei, Yamagami, Hiroshi, Sasaki, Makoto, Fukuda-Doi, Mayumi, Kimura, Kazumi, Asakura, Koko, Miwa, Kaori, Kanzawa, Takao, Ihara, Masafumi, Kondo, Rei, Shiozawa, Masayuki, Ohtaki, Masafumi, Kamiyama, Kenji, Itabashi, Ryo, Iwama, Toru, Aoki, Junya, Minematsu, Kazuo, Yamamoto, Haruko, and Koga, Masatoshi

Published
2021
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22. Association of the Timing of Atrial Fibrillation Detection and Insular Involvement With the Risk of Embolic Events After Acute Ischemic Stroke.

Author

Tokunaga, Keisuke, Toyoda, Kazunori, Kimura, Shunsuke, Minematsu, Kazuo, Yasaka, Masahiro, Okada, Yasushi, Yoshimura, Sohei, and Koga, Masatoshi

Subjects
ISCHEMIC stroke, ATRIAL fibrillation, STROKE patients, TRANSIENT ischemic attack, INSULAR cortex, MAGNETIC resonance imaging
Abstract

Objective: Atrial fibrillation (AF) detected after insular stroke might arise from autonomic and inflammatory mechanisms triggered by insular damage, and be associated with a low embolic risk. We assessed the association of the timing of AF detection and insular involvement with the risk of embolic events after acute ischemic stroke. Methods: Acute ischemic stroke patients with AF who underwent brain magnetic resonance imaging at baseline were enrolled. Patients were classified according to the timing of AF detection (AF detected after stroke [AFDAS] or known AF [KAF]) and insular involvement. The primary outcome was embolic events defined as recurrent ischemic stroke, transient ischemic attack, and systemic embolism within 90 days. Results: Of 1,548 patients, 360 had AFDAS with insular cortex lesions (+I), 409 had AFDAS without insular cortex lesions (−I), 349 had KAF+I, and 430 had KAF−I. Cumulative incidence rates of embolic events at 90 days in patients with AFDAS+I, AFDAS−I, KAF+I, and KAF−I were 0.8%, 3.5%, 4.9%, and 3.3%, respectively. Patients with AFDAS−I (adjusted hazard ratio 5.04, 95% confidence interval 1.43–17.75), KAF+I (6.18, 1.78–21.46), and KAF−I (5.26, 1.48–18.69) had a significantly higher risk of embolic events than those with AFDAS+I. Interpretation: Acute ischemic stroke patients with AFDAS and insular cortex lesions had a lower risk of embolic events than those who had AFDAS without insular cortex lesions or those with KAF, regardless of insular involvement. ANN NEUROL 2024;95:338–346 [ABSTRACT FROM AUTHOR]

Published
2024
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23. Thrombolysis for Acute Wake-Up and Unclear-Onset Strokes with Alteplase at 0.6 mg/kg in Clinical Practice: THAWS2 Study.

Author

Yoshimura, Sohei, Koga, Masatoshi, Okada, Takashi, Inoue, Manabu, Miwa, Kaori, Fukuda-Doi, Mayumi, Kondo, Rei, Inoue, Takeshi, Ichijo, Masahiko, Ohtaki, Masafumi, Nagakane, Yoshinari, Itabashi, Ryo, Sakai, Nobuyuki, Kimura, Kazumi, Kamiyama, Kenji, Shiokawa, Yoshiaki, Yagita, Yoshiki, Iwama, Toru, Yakushiji, Yusuke, and Kusumi, Masayoshi

Subjects
*THROMBOLYTIC therapy, *ISCHEMIC stroke, *STROKE patients, *ALTEPLASE, *INTRACRANIAL hemorrhage
Abstract

Introduction: The aim of this study was to determine the safety and efficacy of intravenous (IV) alteplase at 0.6 mg/kg for patients with acute wake-up or unclear-onset strokes in clinical practice. Methods: This multicenter observational study enrolled acute ischemic stroke patients with last-known-well time >4.5 h who had mismatch between DWI and FLAIR and were treated with IV alteplase. The safety outcomes were symptomatic intracranial hemorrhage (sICH) after thrombolysis, all-cause deaths, and all adverse events. The efficacy outcomes were favorable outcome defined as an mRS score of 0–1 or recovery to the same mRS score as the premorbid score, complete independence defined as an mRS score of 0–1 at 90 days, and change in NIHSS at 24 h from baseline. Results: Sixty-six patients (35 females; mean age, 74 ± 11 years; premorbid complete independence, 54 [82%]; median NIHSS on admission, 11) were enrolled at 15 hospitals. Two patients (3%) had sICH. Median NIHSS changed from 11 (IQR, 6.75–16.25) at baseline to 5 (3–12.25) at 24 h after alteplase initiation (change, −4.8 ± 8.1). At discharge, 31 patients (47%) had favorable outcome and 29 (44%) had complete independence. None died within 90 days. Twenty-three (35%) also underwent mechanical thrombectomy (no sICH, NIHSS change of −8.5 ± 7.3), of whom 11 (48%) were completely independent at discharge. Conclusions: In real-world clinical practice, IV alteplase for unclear-onset stroke patients with DWI-FLAIR mismatch provided safe and efficacious outcomes comparable to those in previous trials. Additional mechanical thrombectomy was performed safely in them. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Thrombolysis With Alteplase at 0.6 mg/kg for Stroke With Unknown Time of Onset: A Randomized Controlled Trial

Author

Koga, Masatoshi, Yamamoto, Haruko, Inoue, Manabu, Asakura, Koko, Aoki, Junya, Hamasaki, Toshimitsu, Kanzawa, Takao, Kondo, Rei, Ohtaki, Masafumi, Itabashi, Ryo, Kamiyama, Kenji, Iwama, Toru, Nakase, Taizen, Yakushiji, Yusuke, Igarashi, Shuichi, Nagakane, Yoshinari, Takizawa, Shunya, Okada, Yasushi, Doijiri, Ryosuke, Tsujino, Akira, Ito, Yasuhiro, Ohnishi, Hideyuki, Inoue, Takeshi, Takagi, Yasushi, Hasegawa, Yasuhiro, Shiokawa, Yoshiaki, Sakai, Nobuyuki, Osaki, Masato, Uesaka, Yoshikazu, Yoshimura, Shinichi, Urabe, Takao, Ueda, Toshihiro, Ihara, Masafumi, Kitazono, Takanari, Sasaki, Makoto, Oita, Akira, Yoshimura, Sohei, Fukuda-Doi, Mayumi, Miwa, Kaori, Kimura, Kazumi, Minematsu, Kazuo, and Toyoda, Kazunori

Published
2020
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27. Early Initiation of Direct Oral Anticoagulants After Onset of Stroke and Short- and Long-Term Outcomes of Patients With Nonvalvular Atrial Fibrillation

Author

Mizoguchi, Tadataka, Tanaka, Kanta, Toyoda, Kazunori, Yoshimura, Sohei, Itabashi, Ryo, Takagi, Masahito, Todo, Kenichi, Shiozawa, Masayuki, Yagita, Yoshiki, Yoshimoto, Takeshi, Terasaki, Tadashi, Yamagami, Hiroshi, Takizawa, Shunya, Inoue, Manabu, Kamiyama, Kenji, Ihara, Masafumi, Okada, Yasushi, Kitazono, Takanari, and Koga, Masatoshi

Published
2020
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30. Atrial Fibrillation Detected before or after Stroke:Role of Anticoagulation

Author

Lyrer, Flurina, Zietz, Annaelle, Seiffge, David J., Koga, Masatoshi, Volbers, Bastian, Wilson, Duncan, Bonetti, Bruno, Schaedelin, Sabine, Gensicke, Henrik, Yoshimura, Sohei, Macha, Kosmas, Ambler, Gareth, Thilemann, Sebastian, Dittrich, Tolga, Inoue, Manabu, Miwa, Kaori, Wang, Ruihao, Siedler, Gabriela, Biburger, Luise, Brown, Martin M., Jäger, Rolf H., Muir, Keith, Traenka, Christopher, Tanaka, Kanta, Shiozawa, Masayuki, Bonati, Leo H., Peters, Nils, Lip, Gregory Y. H., Lyrer, Philippe A., Cappellari, Manuel, Toyoda, Kazunori, Kallmünzer, Bernd, Schwab, Stefan, Werring, David J., Engelter, Stefan T., De Marchis, Gian Marco, and Polymeris, Alexandros A.

Abstract

Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre-existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk.Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF-associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all-cause death) among patients with AFDAS versus KAF and among anticoagulation-naïve versus previously anticoagulated patients using multivariable Cox, Fine-Gray models, and goodness-of-fit statistics to investigate the relative independent prognostic importance of AF-category and pre-existing anticoagulation.Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation-naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient-years of follow-up, we observed 244 recurrent strokes and 661 deaths. Only pre-existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine-Gray models. Models incorporating pre-existing anticoagulation showed better fit than those with AF category; adding AF-category did not result in better model fit. Neither pre-existing anticoagulation nor KAF were independently associated with death.Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023. Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre-existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk.Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF-associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all-cause death) among patients with AFDAS versus KAF and among anticoagulation-naïve versus previously anticoagulated patients using multivariable Cox, Fine-Gray models, and goodness-of-fit statistics to investigate the relative independent prognostic importance of AF-category and pre-existing anticoagulation.Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation-naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient-years of follow-up, we observed 244 recurrent strokes and 661 deaths. Only pre-existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine-Gray models. Models incorporating pre-existing anticoagulation showed better fit than those with AF category; adding AF-category did not result in better model fit. Neither pre-existing anticoagulation nor KAF were independently associated with death.Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023.

Published
2023

33. Abstract 3: Cerebral Small Vessel Disease Burden For Bleeding Risk During Antithrombotic Therapy -BAT2-

Author

Tanaka, Kanta, primary, Miwa, Kaori, additional, Yoshimura, Sohei, additional, Kamiyama, Kenji, additional, Yagita, Yoshiki, additional, Nagakane, Yoshinari, additional, Hoshino, Haruhiko, additional, Terasaki, Tadashi, additional, Okada, Yasushi, additional, Yakushiji, Yusuke, additional, Takahashi, Shinichi, additional, Ueda, Toshihiro, additional, Hasegawa, Yasuhiro, additional, Shiozawa, Masayuki, additional, Sasaki, Makoto, additional, Kudo, Kohsuke, additional, Tanaka, Jun, additional, Nishihara, Masashi, additional, Yamaguchi, Yoshitaka, additional, Fujita, Kyohei, additional, Honda, Yuko, additional, Kawano, Hiroyuki, additional, Ide, Toshihiro, additional, Yoshimoto, Takeshi, additional, Ihara, Masafumi, additional, Koga, Masatoshi, additional, Hirano, Teruyuki, additional, and Toyoda, Kazunori, additional

Published
2023
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35. Abstract WP88: Discrepant Nationwide Trends In Outcomes Of Acute Ischemic Stroke Depending On Severity: The Japan Stroke Data Bank

Author

Koge, Junpei, primary, Yoshimura, Sohei, additional, Koga, Masatoshi, additional, nakai, michikazu, additional, Wada, Shinichi, additional, Sasahara, Yusuke, additional, Shiozawa, Masayuki, additional, Miwa, Kaori, additional, Ishigami, Akiko, additional, Sonoda, Kazutaka, additional, Iihara, Koji, additional, Ikawa, Fusao, additional, Itabashi, Ryo, additional, Iwanaga, Yoshitaka, additional, Miyamoto, Yoshihiro, additional, Kobayashi, Shotai, additional, Minematsu, Kazuo, additional, and Toyoda, Kazunori, additional

Published
2023
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36. Abstract TMP2: Intravenous Thrombolysis For Ischemic Stroke With Unknown Time Of Onset: Differences Between Wake-up Stroke And Non-wake-up Subtypes: EOS

Author

Naruhiko, Kamogawa, primary, Miwa, Kaori, additional, Koga, Masatoshi, additional, Märit, Jensen, additional, Inoue, Manabu, additional, Yoshimura, Sohei, additional, Fukuda-Doi, Mayumi, additional, Ma, Henry, additional, Ringleb, Peter, additional, Wu, Ona, additional, Schwamm, Lee H, additional, Davis, Stephen, additional, Donnan, Geoffrey A, additional, Gerloff, Christian P, additional, Thomalla, Götz, additional, and Toyoda, Kazunori, additional

Published
2023
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38. Sequential Detection Rates of Intramural Hematoma for Diagnosing Spontaneous Intracranial Artery Dissection

Author

Hosoki, Satoshi, primary, Fukuda‐Doi, Mayumi, additional, Miwa, Kaori, additional, Yoshimura, Sohei, additional, Morita, Yoshiaki, additional, Chiba, Tetsuya, additional, Noda, Kotaro, additional, Yamaguchi, Yoshitaka, additional, Ikenouchi, Hajime, additional, Makita, Naoki, additional, Mizoguchi, Tadataka, additional, Nakamura, Yuki, additional, Satow, Tetsu, additional, Kataoka, Hiroharu, additional, Toyoda, Kazunori, additional, Ihara, Masafumi, additional, and Koga, Masatoshi, additional

Published
2023
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39. Severity, Outcomes, and Their Secular Changes in 33,870 Ischemic Stroke Patients with Atrial Fibrillation in a Long-Lasting, Nationwide, Hospital-Based Registry

Author

Toyoda, Kazunori, primary, Yoshimura, Sohei, additional, Nakai, Michikazu, additional, Wada, Shinichi, additional, Miwa, Kaori, additional, Koge, Junpei, additional, Yoshida, Takashi, additional, Kamiyama, Kenji, additional, Mizoue, Tatsuya, additional, Hatano, Taketo, additional, Yoshida, Yasuhisa, additional, Sasahara, Yusuke, additional, Ishigami, Akiko, additional, Iwanaga, Yoshitaka, additional, Miyamoto, Yoshihiro, additional, Minematsu, Kazuo, additional, Kobayashi, Shotai, additional, Koga, Masatoshi, additional, and Investigators, Japan Stroke Data Bank, additional

Published
2023
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43. Intravenous Alteplase at 0.6 mg/kg for Unknown Onset Stroke with Prior Antithrombotic Medication: THAWS Randomized Clinical Trial

Author

Koga, Masatoshi, primary, Inoue, Manabu, additional, Miwa, Kaori, additional, Yoshimura, Sohei, additional, Fukuda-Doi, Mayumi, additional, Aoki, Junya, additional, Asakura, Koko, additional, Kanzawa, Takao, additional, Ohtaki, Masafumi, additional, Kamiyama, Kenji, additional, Yakushiji, Yusuke, additional, Igarashi, Shuichi, additional, Doijiri, Ryosuke, additional, Ito, Yasuhiro, additional, Takagi, Yasushi, additional, Sasaki, Makoto, additional, Kitazono, Takanari, additional, Kimura, Kazumi, additional, Minematsu, Kazuo, additional, Yamamoto, Haruko, additional, and Toyoda, Kazunori, additional

Published
2023
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44. IC methods in acute stroke trials-ascoping review

Author

Ishigami, Akiko, Inoue, Manabu, Yamaguchi, Eriko, Fukuda-Doi, Mayumi, Toyoda, Kazunori, Yoshimura, Sohei, and Koga, Masatoshi

Subjects
Stroke, Informed concent, waivers of concent, EFIC, Medicine and Health Sciences, Clinical Trials
Abstract

In clinical trials for hyperacute stroke treatment, obtaining timely and appropriate consent from participants is a major challenge in order to deliver effective therapeutic interventions within the limited therapeautic time window. This scoping review maps the method and strategy of obtaining consent from participants, including EFIC, in recent acute stroke trials as well as other clinical trials in emergency settings. The purpose of our reserch is to find appropriate procedures for obtaining consent in acute stroke trials, by understand the barriers in obtaining consent and how to address it.

Published
2023
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45. Impact of Cerebral Microbleeds in Stroke Patients with Atrial Fibrillation

Author

Soo, Yannie, Zietz, Annaelle, Yiu, Brian, Mok, Vincent C T, Polymeris, Alexandros A, Seiffge, David, Ambler, Gareth, Wilson, Duncan, Leung, Thomas Wai Hong, Tsang, Suk Fung, Chu, Winnie, Abrigo, Jill, Cheng, Cyrus, Lee, Keon-Joo, Lim, Jae-Sung, Shiozawa, Masayuki, Koga, Masatoshi, Chabriat, Hugues, Hennerici, Michael, Wong, Yuen Kwun, Mak, Henry, Collet, Roger, Inamura, Shigeru, Yoshifuji, Kazuhisa, Arsava, Ethem Murat, Horstmann, Solveig, Purrucker, Jan, Lam, Bonnie Y K, Wong, Adrian, Kim, Young Dae, Song, Tae-Jin, Lemmens, Robin, Eppinger, Sebastian, Gattringer, Thomas, Uysal, Ender, Demirelli, Derya Selçuk, Bornstein, Natan M, Assayag, Einor Ben, Hallevi, Hen, Molad, Jeremy, Nishihara, Masashi, Tanaka, Jun, Coutts, Shelagh B, Kappelle, L Jaap, Salman, Rustam Al-Shahi, Jager, Rolf, Lip, Gregory Y. H., Goeldlin, Martina B, Panos, Leonidas D, Mas, Jean-Louis, Legrand, Laurence, Karayiannis, Chris, Phan, Thanh, Bellut, Maximilian, Chappell, Francesca, Makin, Stephen, Hayden, Derek, Williams, David, van Dam-Nolen, Dianne H K, Nederkoorn, Paul J, Barbato, Carmen, Browning, Simone, Wiegertjes, Kim, Tuladhar, Anil Man, Mendyk, Anne-Marie, Köhler, Sebastian, van Oostenburgge, Robert, Zhou, Ying, Xu, Chao, Hilal, Saima, Gyanwali, Bibek, Chen, Christopher, Lou, Min, Staals, Julie, Bordet, Regis, Kandiah, Nagaendran, de Leeuw, Frank-Erik, Simister, Robert, Hendrikse, Jeroen, Wardlaw, Joanna, Kelly, Peter, Fluri, Felix, Srikanth, Velandai, Calvet, David, Jung, Simon, Kwa, Vincent I H, Smith, Eric E, Hara, Hideo, Yakushiji, Yusuke, Orken, Dilek Necioglu, Fazekas, Franz, Thijs, Vincent, Heo, Ji-Hoe, Veltkamp, Roland, Ay, Hakan, Imaizumi, Toshio, Lau, Kui Kai, Jouvent, Eric, Toyoda, Kazunori, Yoshimura, Sohei, Bae, Hee-Joon, Martí-Fàbregas, Joan, Prats-Sánchez, Luis, Lyrer, Philippe, Best, Jonathan, Werring, David, Engelter, Stefan T, Peters, Nils, Neurology, ACS - Atherosclerosis & ischemic syndromes, and ANS - Neurovascular Disorders

Subjects
All institutes and research themes of the Radboud University Medical Center, Neurology, Neurology (clinical), Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
Abstract

Objectives: Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate the risks of intracranial hemorrhage and ischemic stroke associated with microbleeds in patients with atrial fibrillation treated with vitamin K antagonists, direct oral anticoagulants, antiplatelets, and combination therapy (i.e. concurrent oral anticoagulant and antiplatelet).Methods: We included patients with documented atrial fibrillation from the pooled individual patient data analysis by the Microbleeds International Collaborative Network. Risks of subsequent intracranial hemorrhage and ischemic stroke were compared between patients with and without microbleeds, stratified by antithrombotic use.Results: A total of 7,839 patients were included. The presence of microbleeds was associated with an increased relative risk of intracranial hemorrhage (adjusted hazard ratio [aHR] = 2.74, 95% confidence interval = 1.76-4.26) and ischemic stroke (aHR = 1.29, 95% confidence interval = 1.04-1.59). For the entire cohort, the absolute incidence of ischemic stroke was higher than intracranial hemorrhage regardless of microbleed burden. However, for the subgroup of patients taking combination of anticoagulant and antiplatelet therapy, the absolute risk of intracranial hemorrhage exceeded that of ischemic stroke in those with 2 to 4 microbleeds (25 vs 12 per 1,000 patient-years) and ≥ 11 microbleeds (94 vs 48 per 1,000 patient-years).Interpretation: Patients with atrial fibrillation and high burden of microbleeds receiving combination therapy have a tendency of higher rate of intracranial hemorrhage than ischemic stroke, with potential for net harm. Further studies are needed to help optimize stroke preventive strategies in this high-risk group. ANN NEUROL 2023. Objectives: Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate the risks of intracranial hemorrhage and ischemic stroke associated with microbleeds in patients with atrial fibrillation treated with vitamin K antagonists, direct oral anticoagulants, antiplatelets, and combination therapy (i.e. concurrent oral anticoagulant and antiplatelet).Methods: We included patients with documented atrial fibrillation from the pooled individual patient data analysis by the Microbleeds International Collaborative Network. Risks of subsequent intracranial hemorrhage and ischemic stroke were compared between patients with and without microbleeds, stratified by antithrombotic use.Results: A total of 7,839 patients were included. The presence of microbleeds was associated with an increased relative risk of intracranial hemorrhage (adjusted hazard ratio [aHR] = 2.74, 95% confidence interval = 1.76-4.26) and ischemic stroke (aHR = 1.29, 95% confidence interval = 1.04-1.59). For the entire cohort, the absolute incidence of ischemic stroke was higher than intracranial hemorrhage regardless of microbleed burden. However, for the subgroup of patients taking combination of anticoagulant and antiplatelet therapy, the absolute risk of intracranial hemorrhage exceeded that of ischemic stroke in those with 2 to 4 microbleeds (25 vs 12 per 1,000 patient-years) and ≥ 11 microbleeds (94 vs 48 per 1,000 patient-years).Interpretation: Patients with atrial fibrillation and high burden of microbleeds receiving combination therapy have a tendency of higher rate of intracranial hemorrhage than ischemic stroke, with potential for net harm. Further studies are needed to help optimize stroke preventive strategies in this high-risk group. ANN NEUROL 2023.

Published
2023

46. Alteplase for Stroke With Unknown Onset Time in Chronic Kidney Disease: A Pooled Analysis of Individual Participant Data

Author

Miwa, Kaori, primary, Koga, Masatoshi, additional, Jensen, Märit, additional, Inoue, Manabu, additional, Yoshimura, Sohei, additional, Fukuda-Doi, Mayumi, additional, Boutitie, Florent, additional, Ma, Henry, additional, Ringleb, Peter A., additional, Wu, Ona, additional, Schwamm, Lee H., additional, Warach, Steven, additional, Hacke, Werner, additional, Davis, Stephen M., additional, Donnan, Geoffrey A., additional, Gerloff, Christian, additional, Thomalla, Götz, additional, Toyoda, Kazunori, additional, Cheng, Bastian, additional, Bendszus, Martin, additional, Bladin, Christopher, additional, Churilov, Leonid, additional, Campbell, Brunce, additional, Parsons, Mark, additional, Yassi, Nawaf, additional, Ebinger, Martin, additional, Endres, Matthias, additional, Fiebach, Jochen B., additional, Kleinig, Timothy, additional, Latour, Lawrence, additional, Lemmens, Robin, additional, Levi, Christopher, additional, Leys, Didier, additional, Molina, Carlos, additional, Muir, Keith, additional, Nighoghossian, Norbert, additional, Pedraza, Salvador, additional, Schellinger, Peter D., additional, Schwab, Stefan, additional, Simonsen, Claus Z., additional, Song, Shlee S., additional, Thijs, Vincent, additional, Toni, Danilo, additional, Hsu, Chung Y., additional, and Wahlgren, Nils, additional

Published
2022
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47. Intravenous Thrombolysis With Alteplase at 0.6 mg/kg in Patients With Ischemic Stroke Taking Direct Oral Anticoagulants

Author

Okada, Takashi, primary, Yoshimoto, Takeshi, additional, Wada, Shinichi, additional, Yoshimura, Sohei, additional, Chiba, Tetsuya, additional, Egashira, Shuhei, additional, Kimura, Shunsuke, additional, Shiozawa, Masayuki, additional, Inoue, Manabu, additional, Ihara, Masafumi, additional, Toyoda, Kazunori, additional, Takashima, Hiroshi, additional, and Koga, Masatoshi, additional

Published
2022
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48. Atrial Fibrillation Detected before or after Stroke: Role of Anticoagulation.

Author

Lyrer, Flurina, Zietz, Annaelle, Seiffge, David J., Koga, Masatoshi, Volbers, Bastian, Wilson, Duncan, Bonetti, Bruno, Schaedelin, Sabine, Gensicke, Henrik, Yoshimura, Sohei, Macha, Kosmas, Ambler, Gareth, Thilemann, Sebastian, Dittrich, Tolga, Inoue, Manabu, Miwa, Kaori, Wang, Ruihao, Siedler, Gabriela, Biburger, Luise, and Brown, Martin M.

Subjects
ATRIAL fibrillation, ISCHEMIC stroke, ANTICOAGULANTS, STROKE
Abstract

Background: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre‐existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk. Methods: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF‐associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all‐cause death) among patients with AFDAS versus KAF and among anticoagulation‐naïve versus previously anticoagulated patients using multivariable Cox, Fine‐Gray models, and goodness‐of‐fit statistics to investigate the relative independent prognostic importance of AF‐category and pre‐existing anticoagulation. Results: Of 4,357 patients, 1,889 (43%) had AFDAS and 2,468 (57%) had KAF, while 3,105 (71%) were anticoagulation‐naïve before stroke and 1,252 (29%) were previously anticoagulated. During 6,071 patient‐years of follow‐up, we observed 244 recurrent strokes and 661 deaths. Only pre‐existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine‐Gray models. Models incorporating pre‐existing anticoagulation showed better fit than those with AF category; adding AF‐category did not result in better model fit. Neither pre‐existing anticoagulation nor KAF were independently associated with death. Conclusion: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. ANN NEUROL 2023;94:43–54 [ABSTRACT FROM AUTHOR]

Published
2023
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49. Practical “1-2-3-4-Day” Rule for Starting Direct Oral Anticoagulants After Ischemic Stroke With Atrial Fibrillation: Combined Hospital-Based Cohort Study

Author

Kimura, Shunsuke, primary, Toyoda, Kazunori, additional, Yoshimura, Sohei, additional, Minematsu, Kazuo, additional, Yasaka, Masahiro, additional, Paciaroni, Maurizio, additional, Werring, David J., additional, Yamagami, Hiroshi, additional, Nagao, Takehiko, additional, Yoshimura, Shinichi, additional, Polymeris, Alexandros, additional, Zietz, Annaelle, additional, Engelter, Stefan T., additional, Kallmünzer, Bernd, additional, Cappellari, Manuel, additional, Chiba, Tetsuya, additional, Yoshimoto, Takeshi, additional, Shiozawa, Masayuki, additional, Kitazono, Takanari, additional, Koga, Masatoshi, additional, Todo, Kenichi, additional, Kimura, Kazumi, additional, Yagita, Yoshiki, additional, Furui, Eisuke, additional, Itabashi, Ryo, additional, Terasaki, Tadashi, additional, Shiokawa, Yoshiaki, additional, Hirano, Teruyuki, additional, Kamiyama, Kenji, additional, Nakagawara, Jyoji, additional, Takizawa, Shunya, additional, Homma, Kazunari, additional, Okuda, Satoshi, additional, Okada, Yasushi, additional, Tokunaga, Keisuke, additional, Kameda, Tomoaki, additional, Kario, Kazuomi, additional, Nagakane, Yoshinari, additional, Hasegawa, Yasuhiro, additional, Akiyama, Hisanao, additional, Shibuya, Satoshi, additional, Mochizuki, Hiroshi, additional, Ito, Yasuhiro, additional, Nakashima, Takahiro, additional, Matsuoka, Hideki, additional, Takamatsu, Kazuhiro, additional, Nishiyama, Kazutoshi, additional, Sato, Shoichiro, additional, Arihiro, Shoji, additional, Inoue, Manabu, additional, Takagi, Masahito, additional, Tanaka, Kanta, additional, Nagatsuka, Kazuyuki, additional, Yamaguchi, Takenori, additional, Hashimoto, Yoichiro, additional, Houkin, Kiyohiro, additional, Kitagawa, Kazuo, additional, Matsumoto, Masayasu, additional, Tanahashi, Norio, additional, Terayama, Yasuo, additional, Uchiyama, Shinichiro, additional, Mori, Etsuro, additional, Furukawa, Yutaka, additional, Kimura, Takeshi, additional, Kumon, Yoshiaki, additional, Nagata, Ken, additional, Nogawa, Shigeru, additional, Sakamoto, Tomohiro, additional, Hirai, Toshinori, additional, Kudo, Kohsuke, additional, Sasaki, Makoto, additional, Kobayashi, Shotai, additional, Hamasaki, Toshimitsu, additional, Giustozzi, Michela, additional, Acciarresi, Monica, additional, Agnelli, Giancarlo, additional, Caso, Valeria, additional, Bandini, Fabio, additional, Tsivgoulis, Georgios, additional, Yaghi, Shadi, additional, Furie, Karen L., additional, Tadi, Prasanna, additional, Becattini, Cecilia, additional, Zedde, Marialuisa, additional, Abdul-Rahim, Azmil H, additional, Lees, Kennedy R, additional, Alberti, Andrea, additional, Venti, Michele, additional, D’Amore, Cataldo, additional, Giulia Mosconi, Maria, additional, Anna Cimini, Ludovica, additional, Bovi, Paolo, additional, Carletti, Monica, additional, Rigatelli, Alberto, additional, Putaala, Jukka, additional, Tomppo, Liisa, additional, Tatlisumak, Turgut, additional, Marcheselli, Simona, additional, Pezzini, Alessandro, additional, Poli, Loris, additional, Padovani, Alessandro, additional, Vannucchi, Vieri, additional, Sohn, Sung-Il, additional, Lorenzini, Gianni, additional, Tassi, Rossana, additional, Guideri, Francesca, additional, Acampa, Maurizio, additional, Martini, Giuseppe, additional, Ntaios, George, additional, Athanasakis, George, additional, Makaritsis, Konstantinos, additional, Karagkiozi, Efstathia, additional, Vadikolias, Konstantinos, additional, Liantinioti, Chrissoula, additional, Chondrogianni, Maria, additional, Mumoli, Nicola, additional, Galati, Franco, additional, Sacco, Simona, additional, Tiseo, Cindy, additional, Corea, Francesco, additional, Ageno, Walter, additional, Bellesini, Marta, additional, Colombo, Giovanna, additional, Silvestrelli, Giorgio, additional, Ciccone, Alfonso, additional, Lanari, Alessia, additional, Scoditti, Umberto, additional, Denti, Licia, additional, Mancuso, Michelangelo, additional, Maccarrone, Miriam, additional, Ulivi, Leonardo, additional, Orlandi, Giovanni, additional, Giannini, Nicola, additional, Tassinari, Tiziana, additional, De Lodovici, Maria Luisa, additional, Rueckert, Christina, additional, Baldi, Antonio, additional, Toni, Danilo, additional, Letteri, Federica, additional, Giuntini, Martina, additional, Lotti, Enrico Maria, additional, Flomin, Yuriy, additional, Pieroni, Alessio, additional, Kargiotis, Odysseas, additional, Karapanayiotides, Theodore, additional, Monaco, Serena, additional, Baronello, Mario Maimone, additional, Csiba, Laszló, additional, Szabó, Lilla, additional, Chiti, Alberto, additional, Giorli, Elisa, additional, Del Sette, Massimo, additional, Imberti, Davide, additional, Zabzuni, Dorjan, additional, Doronin, Boris, additional, Volodina, Vera, additional, Michel, Patrik, additional, Vanacker, Peter, additional, Barlinn, Kristian, additional, Pallesen, Lars-Peder, additional, Barlinn, Jessica, additional, Deleu, Dirk, additional, Melikyan, Gayane, additional, Ibrahim, Faisal, additional, Akhtar, Naveed, additional, Gourbali, Vanessa, additional, Masotti, Luca, additional, Parry-Jones, Adrian, additional, Patterson, Chris, additional, Price, Christopher, additional, Elmarimi, Abduelbaset, additional, Parry, Anthea, additional, Nallasivam, Arumug, additional, Mohd Nor, Azlisham, additional, Esis, Bernard, additional, Bruce, David, additional, Roffe, Christine, additional, Holmes, Clare, additional, Cohen, David, additional, Hargroves, David, additional, Mangion, David, additional, Chadha, Dinesh, additional, Vahidassr, Djamil, additional, Manawadu, Dulka, additional, Giallombardo, Elio, additional, Warburton, Elizabeth, additional, Flossman, Enrico, additional, Gunathilagan, Gunaratam, additional, Proschel, Harald, additional, Emsley, Hedley, additional, Anwar, Ijaz, additional, Okwera, James, additional, Putterill, Janet, additional, O’Connell, Janice, additional, Bamford, John, additional, Corrigan, John, additional, Scott, Jon, additional, Birns, Jonathan, additional, Kee, Karen, additional, Saastamoinen, Kari, additional, Pasco, Kath, additional, Dani, Krishna, additional, Sekaran, Lakshmanan, additional, Choy, Lillian, additional, Iveson, Liz, additional, Mamun, Maam, additional, Sajid, Mahmud, additional, Cooper, Martin, additional, Burn, Matthew, additional, Smith, Matthew, additional, Power, Michael, additional, Davis, Michelle, additional, Smyth, Nigel, additional, Veltkamp, Roland, additional, Sharma, Pankaj, additional, Guyler, Paul, additional, O’Mahony, Paul, additional, Wilkinson, Peter, additional, Datta, Prabel, additional, Aghoram, Prasanna, additional, Marsh, Rachel, additional, Luder, Robert, additional, Meenakishundaram, Sanjeevikumar, additional, Subramonian, Santhosh, additional, Leach, Simon, additional, Ispoglou, Sissi, additional, Andole, Sreeman, additional, England, Timothy, additional, Manoj, Aravindakshan, additional, Harrington, Frances, additional, Rehman, Habib, additional, Sword, Jane, additional, Staals, Julie, additional, Mahawish, Karim, additional, Harkness, Kirsty, additional, Shaw, Louise, additional, McCormich, Michael, additional, Sprigg, Nikola, additional, Mansoor, Syed, additional, Krishnamurthy, Vinodh, additional, Lyrer, Philippe A, additional, Bonati, Leo H, additional, Seiffge, David J, additional, Traenka, Christopher, additional, Peters, Nils, additional, De Marchis, Gian Marco, additional, Thilemann, Sebastian, additional, Avramiotis, Nikolaos S, additional, Gensicke, Henrik, additional, Hert, Lisa, additional, Wagner, Benjamin, additional, Schaub, Fabian, additional, Meya, Louisa, additional, Fladt, Joachim, additional, Dittrich, Tolga, additional, Fisch, Urs, additional, Bonetti, Bruno, additional, Tomelleri, Giampaolo, additional, Micheletti, Nicola, additional, Zivelonghi, Cecilia, additional, Emiliani, Andrea, additional, Macha, Kosmas, additional, Siedler, Gabriela, additional, Stoll, Svenja, additional, Wang, Ruihao, additional, Volbers, Bastian, additional, Schwab, Stefan, additional, Haupenthal, David, additional, and Gaßmann, Luise, additional

Published
2022
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50. Increased Cerebral Small Vessel Disease Burden With Renal Dysfunction and Albuminuria in Patients Taking Antithrombotic Agents: The Bleeding With Antithrombotic Therapy 2

Author

Tanaka, Kanta, primary, Miwa, Kaori, additional, Takagi, Masahito, additional, Sasaki, Makoto, additional, Yakushiji, Yusuke, additional, Kudo, Kohsuke, additional, Shiozawa, Masayuki, additional, Tanaka, Jun, additional, Nishihara, Masashi, additional, Yamaguchi, Yoshitaka, additional, Fujita, Kyohei, additional, Honda, Yuko, additional, Kawano, Hiroyuki, additional, Ide, Toshihiro, additional, Yoshimura, Sohei, additional, Koga, Masatoshi, additional, Hirano, Teruyuki, additional, and Toyoda, Kazunori, additional

Published
2022
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