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3. Covert Cerebrovascular Changes in People With Heart Disease

Author

Zhou, Zien, primary, You, Shoujiang, additional, Sakamoto, Yuki, additional, Xu, Ying, additional, Ding, Song, additional, Xu, Wenyi, additional, Li, Wenjie, additional, Yu, Jie, additional, Wang, Yanan, additional, Harris, Katie, additional, Delcourt, Candice, additional, Reeves, Mathew J., additional, Lindley, Richard I., additional, Parsons, Mark W., additional, Woodward, Mark, additional, Anderson, Craig, additional, Du, Xin, additional, Pu, Jun, additional, Wardlaw, Joanna M., additional, and Carcel, Cheryl, additional

Published
2024
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8. Local Structure Matching Driven by Joint-Saliency-Structure Adaptive Kernel Regression

Author

Qin, Binjie, Shen, Zhuangming, Zhou, Zien, Zhou, Jiawei, Sun, Jiuai, Zhang, Hui, Hu, Mingxing, and Lv, Yisong

Subjects
Computer Science - Computer Vision and Pattern Recognition
Abstract

For nonrigid image registration, matching the particular structures (or the outliers) that have missing correspondence and/or local large deformations, can be more difficult than matching the common structures with small deformations in the two images. Most existing works depend heavily on the outlier segmentation to remove the outlier effect in the registration. Moreover, these works do not handle simultaneously the missing correspondences and local large deformations. In this paper, we defined the nonrigid image registration as a local adaptive kernel regression which locally reconstruct the moving image's dense deformation vectors from the sparse deformation vectors in the multi-resolution block matching. The kernel function of the kernel regression adapts its shape and orientation to the reference image's structure to gather more deformation vector samples of the same structure for the iterative regression computation, whereby the moving image's local deformations could be compliant with the reference image's local structures. To estimate the local deformations around the outliers, we use joint saliency map that highlights the corresponding saliency structures (called Joint Saliency Structures, JSSs) in the two images to guide the dense deformation reconstruction by emphasizing those JSSs' sparse deformation vectors in the kernel regression. The experimental results demonstrate that by using local JSS adaptive kernel regression, the proposed method achieves almost the best performance in alignment of all challenging image pairs with outlier structures compared with other five state-of-the-art nonrigid registration algorithms., Comment: 12 pages

Published
2013

9. Smoking as a risk factor for lower extremity peripheral artery disease in women compared to men: A systematic review and meta-analysis.

Author

Xu, Ying, Pouncey, Anna Louise, Zhou, Zien, Woodward, Mark, and Harris, Katie

Subjects
SMOKING statistics, PERIPHERAL vascular diseases, ODDS ratio, CROSS-sectional method, SMOKING, CINAHL database
Abstract

Background: To investigate whether the relationship between smoking and peripheral artery disease (PAD) differs by sex (PROSPERO CRD42022352318). Methods: PubMed, EMBASE, and CINAHL were searched (3 March 2024) for studies reporting associations between smoking and PAD in both sexes, at least adjusted for age. Data were pooled using random effects. Between-study heterogeneity was examined using I2 statistic and Cochran's Q test. Newcastle-Ottowa Scale was adopted for quality assessment. Results: Four cohort studies (n = 2,117,860, 54.4% women) and thirteen cross-sectional studies (n = 230,436, 59.9% women) were included. In cohort studies, former and current smokers had higher risk of PAD than never smokers. Compared to those who never or previously smoked, women current smokers (relative risk (RR) 5.30 (95% confidence interval 3.17, 8.87)) had higher excess risk of PAD than men (RR 3.30 (2.46, 4.42)), women-to-men ratio of RR 1.45 (1.30, 1.62)(I2 = 0%, p = 0.328). In cross-sectional studies, risk of PAD was higher among former and current compared to never smokers, more so in men, women-to-men ratios of odds ratio: 0.64 (0.46, 0.90)(I2 = 30%, p = 0.192), 0.63 (0.50, 0.79)(I2 = 0%, p = 0.594), respectively. For both sexes, risk of PAD was higher among current smokers compared to those who were not currently smoking. Cohort studies and five cross-sectional studies were of good quality, scoring 6 to 8 of a possible maximum 9 points. Eight cross-sectional studies scored 2 to 5. Discussions: Further research is required to elucidate sex differences in the relationships between smoking and PAD, as the current evidence is limited and mixed. Tobacco-control programs should consider both sexes. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Angioplasty Guidewire-Assisted Versus Conventional Transseptal Puncture for Left Atrial Appendage Occlusion (ADVANCE-LAAO): A Multicenter Randomized Controlled Trial

Author

Hu, Feng, primary, Xu, Bin, additional, Qiao, Zhiqing, additional, Cheng, Fuyu, additional, Zhou, Zien, additional, Zou, Zhiguo, additional, Zang, Minhua, additional, Ding, Song, additional, Hong, Jun, additional, Xie, Yuquan, additional, Zhou, Yong, additional, Huang, JianFeng, additional, and Pu, Jun, additional

Published
2023
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14. Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion: a multicentre randomized controlled trial.

Author

Hu, Feng, Xu, Bin, Qiao, Zhiqing, Cheng, Fuyu, Zhou, Zien, Zou, Zhiguo, Zang, Minhua, Ding, Song, Hong, Jun, Xie, Yuquan, Zhou, Yong, Huang, JianFeng, and Pu, Jun

Abstract

Aims This study was performed to compare the usability, efficiency, and safety of a modified angioplasty guidewire-assisted transseptal puncture (TSP) technique vs. the conventional approach in facilitating access into the left atrium during left atrial appendage occlusion (LAAO) procedures for the treatment of atrial fibrillation. Methods and results The ADVANCE-LAAO trial (Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion) was an investigator-initiated, prospective, multicentre, randomized controlled trial (NCT05125159). Patients with atrial fibrillation who underwent LAAO were prospectively enrolled from four centres and randomly assigned to an angioplasty guidewire-assisted TSP group (n = 131) or to a conventional Brockenbrough needle TSP group (n = 132). The primary endpoint was the one-time success rate of TSP. We also analysed the TSP procedure time, failure rate of the assigned TSP type, radiation dose, contrast dose, and procedural complications in both groups. All patients in the guidewire-assisted group underwent successful TSP, whereas five in the standard conventional group switched to the guidewire-assisted approach. The guidewire-assisted puncture improved the one-time success rate (92.4 vs. 77.3%, P = 0.001), shortened the TSP procedure time (109.2 ± 48.2 vs. 120.5 ± 57.6 s, P = 0.023), and tended to have a higher rate of good coaxial orientation of the sheath with the left atrial appendage during the LAAO procedure (66.4 vs. 54.5%, P = 0.059). No TSP-related complications occurred in the guidewire-assisted TSP group, whereas two complications occurred in the conventional TSP group. There was no significant difference in the failure rate of the assigned TSP type, the total procedure time, the total radiation dose, the rate of successful LAAO implantation, or the procedural complication rate between the two groups (all P > 0.05). Conclusion This study confirmed that angioplasty guidewire-assisted puncture can effectively improve the success rate of TSP during LAAO procedures. This novel technique has high potential for application in interventional therapies requiring TSP. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Effects of low-dose alteplase and intensive blood pressure control on brain (micro-) circulation: imaging analyses from the ENCHANTED trial

Author

Zhou, Zien

Subjects
42 HEALTH SCIENCES, Acute ischaemic stroke, Alteplase, Thrombolysis, ENCHANTED trial, CT, MRI
Abstract

Background and aims: Worldwide, the burden of acute ischaemic stroke (AIS) is high in terms of disability-adjusted life-years lost. Prior research shows that imaging features of brain frailty (atrophy and severe leucoaraiosis) and acute ischaemia (visible ischaemic lesions, hypoattenuation, large ischaemic lesion, swelling, and hyper-attenuated arteries) on non-contrast computerised tomography (CT) scans are associated with symptomatic intracerebral haemorrhage (sICH) and mortality in thrombolysis-treated AIS patients. This thesis aimed to elucidate other CT and magnetic resonance imaging (MRI) factors related to abnormalities in the brain (micro-) circulation (including fluid-attenuated inversion recovery hyperintense arteries [FLAIR-HAs], a single penetrating artery occlusion presented as a lacunar infarct, and vascular obstruction at different sites) that determine prognosis in thrombolysis-treated AIS patients, and that may modify the effects of treatment with either intravenous alteplase by dose or in the control of blood pressure (BP) according to intensity. Methods: Secondary analyses of datasets from the international randomised trial - Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) - were conducted after central classification of brain scan images. Results: FLAIR-HAs on MRI are frequently present in AIS due to presumed cardioembolism. They indicate a favourable prognosis in such thrombolysis-treated AIS patients, despite also being associated with an increased risk of intracerebral haemorrhage within the region of infarction. A meta-analysis of the ENCHANTED data with similar studies shows that FLAIR-HAs are not associated with the functional outcome overall but are associated with recovery, specifically in patients with endovascular therapy for AIS. FLAIR-HAs are also associated with early recanalisation or haemorrhagic complications, and early neurologic deterioration. My studies on lacunar AIS show no differences in the treatment effect of low- versus standard-dose alteplase, and early intensive versus guideline-recommended BP lowering, on functional recovery and sICH across lacunar and non-lacunar cases of AIS. Furthermore, functional recovery by alteplase dose or BP lowering intensity is not modified by the degree or site of vascular obstruction in cerebral vessels noted on CT or MRI angiography. Conclusions: My thesis has established that several CT/MRI brain imaging features of brain (micro-) circulation are important prognostic markers of functional recovery and sICH in thrombolysis-treated AIS patients. However, these imaging markers do not appear to modify the treatment effects of randomised alteplase dose and degree of BP-lowering among participants of the ENCHANTED trial.

Published
2022
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22. Thrombolysis outcomes according to arterial characteristics of acute ischemic stroke by alteplase dose and blood pressure target

Author

Zhou, Zien, primary, Xia, Chao, additional, Mair, Grant, additional, Delcourt, Candice, additional, Yoshimura, Sohei, additional, Liu, Xiaosheng, additional, Chen, Zengai, additional, Malavera, Alejandra, additional, Carcel, Cheryl, additional, Chen, Xiaoying, additional, Wang, Xia, additional, Al-Shahi Salman, Rustam, additional, Robinson, Thompson G, additional, Lindley, Richard I, additional, Chalmers, John, additional, Wardlaw, Joanna M, additional, Parsons, Mark W, additional, Demchuk, Andrew M, additional, and Anderson, Craig S, additional

Published
2021
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23. sj-pdf-1-wso-10.1177_17474930211025436 - Supplemental material for Thrombolysis outcomes according to arterial characteristics of acute ischemic stroke by alteplase dose and blood pressure target

Author

Zhou, Zien, Xia, Chao, Mair, Grant, Delcourt, Candice, Yoshimura, Sohei, Liu, Xiaosheng, Chen, Zengai, Malavera, Alejandra, Carcel, Cheryl, Chen, Xiaoying, Wang, Xia, Al-Shahi Salman, Rustam, Robinson, Thompson G, Lindley, Richard I, Chalmers, John, Wardlaw, Joanna M, Parsons, Mark W, Demchuk, Andrew M, and Anderson, Craig S

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

Supplemental material, sj-pdf-1-wso-10.1177_17474930211025436 for Thrombolysis outcomes according to arterial characteristics of acute ischemic stroke by alteplase dose and blood pressure target by Zien Zhou, Chao Xia, Grant Mair, Candice Delcourt, Sohei Yoshimura, Xiaosheng Liu, Zengai Chen, Alejandra Malavera, Cheryl Carcel, Xiaoying Chen, Xia Wang, Rustam Al-Shahi Salman, Thompson G Robinson, Richard I Lindley, John Chalmers, Joanna M Wardlaw, Mark W Parsons, Andrew M Demchuk and Craig S Anderson in International Journal of Stroke

Published
2021
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24. Low-Dose vs Standard-Dose Alteplase in Acute Lacunar Ischemic Stroke

Author

Zhou, Zien, Delcourt, Candice, Xia, Chao, Yoshimura, Sohei, Carcel, Cheryl, Torii-Yoshimura, Takako, You, Shoujiang, Malavera, Alejandra, Chen, Xiaoying, Hackett, Maree, Woodward, Mark, Chalmers, John, Xu, Jianrong, Robinson, Thompson G., Parsons, Mark W., Demchuk, Andrew M., Lindley, Richard I., Mair, Grant, Wardlaw, Joanna M., Anderson, Craig S., Zhou, Zien, Delcourt, Candice, Xia, Chao, Yoshimura, Sohei, Carcel, Cheryl, Torii-Yoshimura, Takako, You, Shoujiang, Malavera, Alejandra, Chen, Xiaoying, Hackett, Maree, Woodward, Mark, Chalmers, John, Xu, Jianrong, Robinson, Thompson G., Parsons, Mark W., Demchuk, Andrew M., Lindley, Richard I., Mair, Grant, Wardlaw, Joanna M., and Anderson, Craig S.

Abstract

ObjectiveTo determine any differential efficacy and safety of low- vs standard-dose IV alteplase for lacunar vs nonlacunar acute ischemic stroke (AIS), we performed post hoc analyzes from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) alteplase dose arm.MethodsIn a cohort of 3,297 ENCHANTED participants, we identified those with lacunar or nonlacunar AIS with different levels of confidence (definite/according to prespecified definitions based on clinical and adjudicated imaging findings. Logistic regression models were used to determine associations of lacunar AIS with 90-day outcomes (primary, modified Rankin Scale [mRS] scores 2–6; secondary, other mRS scores, intracerebral hemorrhage [ICH], and early neurologic deterioration or death) and treatment effects of low- vs standard-dose alteplase across lacunar and nonlacunar AIS with adjustment for baseline covariables.ResultsOf 2,588 participants with available imaging and clinical data, we classified cases as definite/probable lacunar (n = 490) or nonlacunar AIS (n = 2,098) for primary analyses. Regardless of alteplase dose received, lacunar AIS participants had favorable functional (mRS 2–6, adjusted odds ratio [95% confidence interval] 0.60 [0.47–0.77]) and other clinical or safety outcomes compared to participants with nonlacunar AIS. Low-dose alteplase (versus standard) had no differential effect on functional outcomes (mRS 2–6, 1.04 [0.87–1.24]) but reduced the risk of symptomatic ICH in all included participants. There were no differential treatment effects of low- vs standard-dose alteplase on all outcomes across lacunar and nonlacunar AIS (all pinteraction ≥0.07).ConclusionsWe found no evidence from the ENCHANTED trial that low-dose alteplase had any advantages over standard dose for definite/probable lacunar AIS.Classification of EvidenceThis study provides Class II evidence that for patients with lacunar AIS, low-dose alteplase had no additional benefit or safety over standa

Published
2021

25. Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease

Author

Zhou, Zien, primary, Jardine, Meg J., additional, Li, Qiang, additional, Neuen, Brendon L., additional, Cannon, Christopher P., additional, de Zeeuw, Dick, additional, Edwards, Robert, additional, Levin, Adeera, additional, Mahaffey, Kenneth W., additional, Perkovic, Vlado, additional, Neal, Bruce, additional, Lindley, Richard I., additional, Ahuad Guerrero, Rodolfo Andres, additional, Aizenberg, Diego, additional, Albisu, Juan Pablo, additional, Alvarisqueta, Andres, additional, Bartolacci, Ines, additional, Berli, Mario Alberto, additional, Bordonava, Anselmo, additional, Calella, Pedro, additional, Cantero, Maria Cecilia, additional, Cartasegna, Luis Rodolfo, additional, Cercos, Esteban, additional, Coloma, Gabriela Cecilia, additional, Colombo, Hugo, additional, Commendatore, Victor, additional, Cuadrado, Jesus, additional, Cuneo, Carlos Alberto, additional, Cusumano, Ana Maria, additional, Douthat, Walter Guillermo, additional, Dran, Ricardo Dario, additional, Farias, Eduardo, additional, Fernandez, Maria Florencia, additional, Finkelstein, Hernan, additional, Fragale, Guillermo, additional, Fretes, Jose Osvaldo, additional, Garcia, Nestor Horacio, additional, Gastaldi, Anibal, additional, Gelersztein, Elizabeth, additional, Glenny, Jorge Archibaldo, additional, Gonzalez, Joaquin Pablo, additional, del Carmen Gonzalez Colaso, Patricia, additional, Goycoa, Claudia, additional, Greloni, Gustavo Cristian, additional, Guinsburg, Adrian, additional, Hermida, Sonia, additional, Juncos, Luis Isaias, additional, Klyver, Maria Isabel, additional, Kraft, Florencia, additional, Krynski, Fernando, additional, Lanchiotti, Paulina Virginia, additional, Leon de la Fuente, Ricardo Alfonso, additional, Marchetta, Nora, additional, Mele, Pablo, additional, Nicolai, Silvia, additional, Novoa, Pablo Antonio, additional, Orio, Silvia Ines, additional, Otreras, Fabian, additional, Oviedo, Alejandra, additional, Raffaele, Pablo, additional, Resk, Jorge Hector, additional, Rista, Lucas, additional, Rodriguez Papini, Nelson, additional, Sala, Jorgelina, additional, Santos, Juan Carlos, additional, Schiavi, Lilia Beatriz, additional, Sessa, Horacio, additional, Smith Casabella, Tomas, additional, Ulla, Maria Rosa, additional, Valdez, Maria, additional, Vallejos, Augusto, additional, Villarino, Adriana, additional, Visco, Virginia Esther, additional, Wassermann, Alfredo, additional, Zaidman, Cesar Javier, additional, Cheung, Ngai Wah, additional, Droste, Carolyn, additional, Fraser, Ian, additional, Johnson, David, additional, Mah, Peak Mann, additional, Nicholls, Kathy, additional, Packham, David, additional, Proietto, Joseph, additional, Roberts, Anthony, additional, Roger, Simon, additional, Tsang, Venessa, additional, Abrão Raduan, Roberto, additional, Alves da Costa, Fernando Augusto, additional, Amodeo, Celso, additional, Andreotti Turatti, Luiz Alberto, additional, Bregman, Rachel, additional, Camelo Sanches, Fernanda Cristina, additional, Canani, Luis Henrique, additional, Chacra, Antônio Roberto, additional, Cunha Borges, João Lindolfo, additional, Cunha Vêncio, Sérgio Alberto, additional, da Silva Franco, Roberto Jorge, additional, d’Avila, Domingos, additional, de Souza Portes, Evandro, additional, de Souza, Pedro, additional, Deboni, Luciane Mônica, additional, Fraige Filho, Fadlo, additional, Geloneze Neto, Bruno, additional, Gomes, Marcus, additional, Keiko Kohara, Suely, additional, Keitel, Elizete, additional, Kerr Saraiva, Jose Francisco, additional, Kurtz Lisboa, Hugo Roberto, additional, Loss de Carvalho Contieri, Fabiana, additional, Milagres, Rosângela, additional, Montenegro Junior, Renan, additional, Moreira de Brito, Claudia, additional, Nasser Hissa, Miguel, additional, Nazario Sabbag, Ângela Regina, additional, Noronha, Irene, additional, Panarotto, Daniel, additional, Pecoits Filho, Roberto, additional, Pereira, Márcio Antônio, additional, Saporito, Wladmir, additional, Scafuto Scotton, Antonio, additional, Schuch, Tiago, additional, Simões de Almeida, Roberto, additional, Slompo Ramos, Cássio, additional, Soares Felício, João, additional, Thomé, Fernando, additional, Tibes Hachmann, Jean Carlo, additional, Yamada, Sérgio, additional, Yoiti Hayashida, Cesar, additional, Zanata Petry, Tarissa Beatrice, additional, Zanella, Maria Teresa, additional, Andreeva, Viktoria, additional, Angelova, Angelina, additional, Dimitrov, Stefan, additional, Genadieva, Veselka, additional, Genova-Hristova, Gabriela, additional, Hristozov, Kiril, additional, Kamenov, Zdravko, additional, Koundurdjiev, Atanas, additional, Lozanov, Lachezar, additional, Margaritov, Viktor, additional, Nonchev, Boyan, additional, Rangelov, Rangel, additional, Shinkov, Alexander, additional, Temelkova, Margarita, additional, Velichkova, Ekaterina, additional, Yakov, Andrian, additional, Aggarwal, Naresh, additional, Aronson, Ronnie, additional, Bajaj, Harpreet, additional, Cherney, David, additional, Chouinard, Guy, additional, Conway, James, additional, Cournoyer, Serge, additional, DaRoza, Gerald, additional, De Serres, Sacha, additional, Dubé, François, additional, Goldenberg, Ronald, additional, Gupta, Anil, additional, Gupta, Milan, additional, Henein, Sam, additional, Khandwala, Hasnain, additional, Leiter, Lawrence, additional, Madore, François, additional, McMahon, Alan, additional, Muirhead, Norman, additional, Pichette, Vincent, additional, Rabasa-Lhoret, Remi, additional, Steele, Andrew, additional, Tangri, Navdeep, additional, Torshizi, Ali, additional, Woo, Vincent, additional, Zalunardo, Nadia, additional, Fernández Montenegro, María Alicia, additional, Godoy Jorquera, Juan Gonzalo, additional, Medina Fariña, Marcelo, additional, Saavedra Gajardo, Victor, additional, Vejar, Margarita, additional, Chen, Nan, additional, Chen, Qinkai, additional, Gan, Shenglian, additional, Kong, Yaozhong, additional, Li, Detian, additional, Li, Wenge, additional, Li, Xuemei, additional, Lin, Hongli, additional, Liu, Jian, additional, Lu, Weiping, additional, Mao, Hong, additional, Ren, Yan, additional, Song, Weihong, additional, Sun, Jiao, additional, Sun, Lin, additional, Tu, Ping, additional, Wang, Guixia, additional, Yang, Jinkui, additional, Yin, Aiping, additional, Yu, Xueqing, additional, Zhao, Minghui, additional, Zheng, Hongguang, additional, Accini Mendoza, Jose Luis, additional, Arcos, Edgar, additional, Avendano, Jorge, additional, Diaz Ruiz, Jorge Ernesto Andres, additional, Garcia Ortiz, Luis Hernando, additional, Gonzalez, Alexander, additional, Hernandez Triana, Eric, additional, Higuera, Juan Diego, additional, Malaver, Natalia, additional, Molina de Salazar, Dora Inés, additional, Rosero, Ricardo, additional, Terront Lozano, Monica Alexandra, additional, Valderrama Cometa, Luis, additional, Valenzuela, Alex, additional, Vargas Alonso, Ruben Dario, additional, Villegas, Ivan, additional, Yupanqui, Hernan, additional, Bartaskova, Dagmar, additional, Barton, Petr, additional, Belobradkova, Jana, additional, Dohnalova, Lenka, additional, Drasnar, Tomas, additional, Ferkl, Richard, additional, Halciakova, Katarina, additional, Klokocnikova, Vera, additional, Kovar, Richard, additional, Lastuvka, Jiri, additional, Lukac, Martin, additional, Pesickova, Satu, additional, Peterka, Karel, additional, Pumprla, Jiri, additional, Rychlik, Ivan, additional, Saudek, Frantisek, additional, Tesar, Vladimir, additional, Valis, Martin, additional, Weiner, Pavel, additional, Zemek, Stanislav, additional, Alamartine, Eric, additional, Borot, Sophie, additional, Cariou, Bertrand, additional, Dussol, Bertrand, additional, Fauvel, Jean-Pierre, additional, Gourdy, Pierre, additional, Klein, Alexandre, additional, Le Meur, Yannick, additional, Penfornis, Alfred, additional, Roussel, Ronan, additional, Saulnier, Pierre-Jean, additional, Thervet, Eric, additional, Zaoui, Philippe, additional, Burst, Volker, additional, Faghih, Markus, additional, Faulmann, Grit, additional, Haller, Hermann, additional, Jerwan-Keim, Reinhold, additional, Maxeiner, Stephan, additional, Paschen, Björn, additional, Plassmann, Georg, additional, Rose, Ludger, additional, Gonzalez Orellana, Ronaldo Arturo, additional, Haase, Franklin Paul, additional, Moreira Diaz, Juan Pablo, additional, Ramirez Roca, Luis Alberto, additional, Sánchez Arenales, Jose Antonio, additional, Sanchez Polo, José Vicente, additional, Turcios Juarez, Erick, additional, Csecsei, Gyongyi, additional, Csiky, Botond, additional, Danos, Peter, additional, Deak, Laszlo, additional, Dudas, Mihaly, additional, Harcsa, Eleonora, additional, Keltai, Katalin, additional, Keresztesi, Sandor, additional, Kiss, Krisztian, additional, Konyves, Laszlo, additional, Major, Lajos, additional, Mileder, Margit, additional, Molnar, Marta, additional, Mucsi, Janos, additional, Oroszlan, Tamas, additional, Ory, Ivan, additional, Paragh, Gyorgy, additional, Peterfai, Eva, additional, Petro, Gizella, additional, Revesz, Katalin, additional, Takacs, Robert, additional, Vangel, Sandor, additional, Vasas, Szilard, additional, Zsom, Marianna, additional, Oomman, Abraham, additional, Raju, Sree Bhushan, additional, Dewan, Deepak, additional, Fernando, M. Edwin, additional, Gopalakrishnan, Natarajan, additional, Gracious, Noble, additional, Alva, Hansraj, additional, Jain, Dinesh, additional, Keshavamurthy, C. B., additional, Khullar, Dinesh, additional, Sahay, Manisha, additional, Peringat, Jayameena, additional, Prasad, Narayan, additional, Rao, K. Satyanarayana, additional, Reddy, Sreedhar, additional, Melemadathil, Sreelatha, additional, Sudhakar, Bhimavarapu, additional, Vyasam, Ramesh Chandra, additional, Bonadonna, Riccardo, additional, Castellino, Pietro, additional, Ceriello, Antonio, additional, Chiovato, Luca, additional, De Cosmo, Salvatore, additional, De Nicola, Luca, additional, Derosa, Giuseppe, additional, Di Carlo, Alberto, additional, Di Cianni, Graziano, additional, Frascà, Giovanni, additional, Fuiano, Giorgio, additional, Gambaro, Giovanni, additional, Garibotto, Giacomo, additional, Giorda, Carlo, additional, Malberti, Fabio, additional, Mandreoli, Marcora, additional, Mannucci, Edoardo, additional, Orsi, Emanuela, additional, Piatti, Piermarco, additional, Santoro, Domenico, additional, Sasso, Ferdinando Carlo, additional, Serviddio, Gaetano, additional, Stella, Andrea, additional, Trevisan, Roberto, additional, Veronelli, Anna Maria, additional, Zanoli, Luca, additional, Akiyama, Hitoshi, additional, Aoki, Hiromi, additional, Asano, Akimichi, additional, Iitsuka, Tadashi, additional, Kajiyama, Shizuo, additional, Kashine, Susumu, additional, Kawada, Toshio, additional, Kodera, Takamoto, additional, Kono, Hiroshi, additional, Koyama, Kazunori, additional, Kumeda, Yasuro, additional, Miyauchi, Shozo, additional, Mizuyama, Kazuyuki, additional, Niiya, Tetsuji, additional, Oishi, Hiroko, additional, Ota, Satoshi, additional, Sakakibara, Terue, additional, Takai, Masahiko, additional, Tomonaga, Osamu, additional, Tsujimoto, Mitsuru, additional, Wada, Takashi, additional, Wakasugi, Masakiyo, additional, Wakida, Yasushi, additional, Watanabe, Takayuki, additional, Yamada, Masayo, additional, Yanagida, Kazuhiro, additional, Yanase, Toshihiko, additional, Yumita, Wataru, additional, Gaupsiene, Egle, additional, Kozloviene, Dalia, additional, Navickas, Antanas, additional, Urbanaviciene, Egle, additional, Abdul Ghani, Rohana, additional, Abdul Kadir, Khalid, additional, Ali, Norsiah, additional, Che Yusof, Mohd Daud, additional, Gan, Chye Lee, additional, Ismail, Mastura, additional, Kong, Wei Yen, additional, Lam, Swee Win, additional, Lee, Li Yuan, additional, Lim, Soo Kun, additional, Loh, Chek Loong, additional, Manocha, Anita Bhajan, additional, Ng, Kee Sing, additional, Nik Ahmad, Nik Nur Fatnoon, additional, Ratnasingam, Vanassa, additional, Shudim, Saiful Shahrizal Bin, additional, Vengadasalam, Paranthaman, additional, Abraira Munoz, Luis David, additional, Alpizar Salazar, Melchor, additional, Baas Cruz, Juan, additional, Burgos Soto, Mario, additional, Chevaile Ramos, Jose, additional, Chew Wong, Alfredo, additional, Correa Rotter, Jose Ricardo, additional, Diaz Escalante, Tonatiu, additional, Enriquez Sosa, Favio Edmundo, additional, Flores Lozano, Fernando, additional, Flota Cervera, Luis Fernando, additional, Frenk Baron, Paul, additional, Garcia Ballesteros, Cecilia, additional, Gomez Rangel, Jose David, additional, Herrera Jimenez, Luis Enrique, additional, Irizar Santana, Sergio Saul, additional, Jimenez Flores, Fernando, additional, Laviada Molina, Hugo, additional, Luna Ceballos, Rosa Isela, additional, Martin del Campo Blanco, Belia, additional, Morales Franco, Guadalupe, additional, Moreno Loza, Oscar Tarsicio, additional, Mustieles Rocha, Cynthia, additional, Obrador Vera, Gregorio, additional, Orozco Castellanos, Ricardo, additional, Peralta Calcaneo, Juan, additional, Reyes Rosano, Miguel Angel, additional, Rodriguez Pattzi, Hiromi, additional, Rosas Guzman, Juan, additional, Rucker Joerg, Isabel Erika, additional, Saavedra Sanchez, Sandra Berenice, additional, Sanchez Mijangos, Jose Hector, additional, Serrano Sanson, Pablo, additional, Tamayo y Orozco, Juan Alfredo, additional, Tellez Chavez, Eloisa, additional, Valdes Cepeda, Alejandro, additional, Venegas Carrillo, Luis, additional, Villagordoa Mesa, Juan, additional, Zamarripa Escobedo, Rolando, additional, Baker, John, additional, Noonan, Paul, additional, Scott, Russell, additional, Walker, Robert, additional, Watson, Edward, additional, Williams, Michael, additional, Young, Simon, additional, Abejuela, Zaynab, additional, Agra, Jeimeen, additional, Aquitania, Grace, additional, Caringal, Clodoaido, additional, Comia, Rhea Severina, additional, Delos Santos, Lalaine, additional, Gomez, Olivert, additional, Jimeno, Cecilia, additional, Santos, Florence, additional, Tan, Gerry, additional, Tolentino, Marsha, additional, Yao, Christy, additional, Yap, Yvette Ethel, additional, Ygpuara, Ma. Dovie Lallaine, additional, Bijata-Bronisz, Renata, additional, Hotlos, Lucyna, additional, Januszewicz, Andrzej, additional, Kaczmarek, Barbara, additional, Kaminska, Anna, additional, Lazuka, Lech, additional, Madej, Andrzej, additional, Mazur, Stanislaw, additional, Mlodawska-Choluj, Dorota, additional, Nowicki, Michal, additional, Orlowska-Kowalik, Grazyna, additional, Popenda, Grazyna, additional, Rewerska, Barbara, additional, Sowinski, Dariusz, additional, Angelescu, Liliana Monica, additional, Anghel, Veronica, additional, Avram, Rodica-Ioana, additional, Busegeanu, Mihaela-Magdalena, additional, Cif, Adriana, additional, Cosma, Dana, additional, Crisan, Carmen, additional, Demian, Luiza Despina, additional, Ferariu, Ioana Emilia, additional, Halmagyi, Ildiko, additional, Hancu, Nicolae, additional, Munteanu, Mircea, additional, Negru, Doru, additional, Onaca, Adriana Gabriela, additional, Petrica, Ligia, additional, Popa, Amorin Remus, additional, Ranetti, Aurelian-Emil, additional, Serafinceanu, Cristian, additional, Toarba, Cristina, additional, Agafyina, Alina, additional, Barbarash, Olga, additional, Barysheva, Olga, additional, Chizhov, Daniil, additional, Dobronravov, Vladimir, additional, Dreval, Alexander, additional, Glinkina, Irina, additional, Grineva, Elena, additional, Khirmanov, Vladimir, additional, Kolmakova, Elena, additional, Koroleva, Tatiana, additional, Kvitkova, Liudmila, additional, Marasaev, Viacheslav, additional, Mkrtumyan, Ashot, additional, Morugova, Tatiana, additional, Nagibovich, Galina, additional, Nagibovich, Oleg, additional, Nedogoda, Sergei, additional, Osipova, Irina, additional, Raskina, Tatiana, additional, Samoylova, Yulia, additional, Sazonova, Olga, additional, Shamkhalova, Minara, additional, Shutemova, Elena, additional, Shwartz, Yuriy, additional, Uriasyev, Oleg, additional, Vorobyev, Sergey, additional, Zateyshchikova, Anna, additional, Zateyshshikov, Dmitry, additional, Zykova, Tatyana, additional, Antic, Slobodan, additional, Djordjevic, Miodrag, additional, Kendereski, Aleksandra, additional, Lalic, Katarina, additional, Lalic, Nebojsa, additional, Popovic-Radinovic, Vesna, additional, Babikova, Jana, additional, Benusova, Olga, additional, Buganova, Ingrid, additional, Culak, Jan, additional, Dzupina, Andrej, additional, Dzuponova, Jana, additional, Fulop, Peter, additional, Ilavska, Adriana, additional, Martinka, Emil, additional, Ochodnicka, Zuzana, additional, Pella, Daniel, additional, Smatanova, Iveta, additional, Ahmed, Fayzal, additional, Badat, Aysha, additional, Breedt, Johannes, additional, Distiller, Lawrence, additional, Govender, Vimladhevi, additional, Govender, Ravendran, additional, Joshi, Mukesh, additional, Jurgens, Jaco, additional, Latiff, Gulam, additional, Lombard, Landman, additional, Mookadam, Mohamed, additional, Ngcakani, Nomangesi, additional, Nortje, Hendrik, additional, Oosthuizen, Helena, additional, Pillay-Ramaya, Larisha, additional, Prozesky, Hans, additional, Reddy, Jeevren, additional, Rheeder, Paul, additional, Seeber, Mary, additional, Chae, Dong-Wan, additional, Cho, Young Min, additional, Jeong, In-Kyung, additional, Kim, Sin Gon, additional, Kim, Yeong Hoon, additional, Kwon, Hyuk-Sang, additional, Kwon, Min Jeong, additional, Lee, Byung-Wan, additional, Lee, JungEun, additional, Lee, Moon-Kyu, additional, Nam, Moon-Suk, additional, Oh, Kook-Hwan, additional, Park, Cheol-Young, additional, Park, Sun-Hee, additional, Yoon, Kun Ho, additional, Alvarez Garcia, Pere, additional, Asmarats Mercadal, Luis, additional, Barrios, Clara, additional, Cereto Castro, Fernando, additional, Cigarran Guldris, Secundino, additional, Dominguez Lopez, Marta, additional, Egido de los Rios, Jesus, additional, Fernandez Fresnedo, Gema, additional, Galan Serrano, Antonio, additional, Garcia, Isabel, additional, Gonzalez Martinez, Francisco Javier, additional, Jodar Gimeno, Jose Esteban, additional, Lopez Mendoza, Manuel, additional, Malek Marin, Tamara, additional, Morales Portillo, Cristobal, additional, Munar Vila, Maria Antonia, additional, Muñoz Torres, Manuel, additional, Nieto Iglesias, Javier, additional, Pantoja Perez, Jonay, additional, Perez Vera, Merce, additional, Portoles Perez, Jose Mª, additional, Quesada Simón, María Angustias, additional, Simo Canonge, Rafael, additional, Soto Gonzalez, Alfonso, additional, Terns Riera, Manel, additional, Tinahones Madueno, Francisco Jose, additional, Velo Plaza, Mercedes, additional, Chang, Chwen-Tzuei, additional, Chuang, Lee-Ming, additional, Hsia, Te-Lin, additional, Hsieh, Chang-Hsun, additional, Hwang, Shang-Jyh, additional, Lin, Chih-Ching, additional, Lu, Yung-Chuan, additional, Sheu, Wayne H-H, additional, Barna, Olga, additional, Bilyk, Svitlana D., additional, Botsyurko, Volodymyr, additional, Dudar, Iryna, additional, Fushtey, Ivan, additional, Godlevska, Olga, additional, Golovchenko, Oleksandr, additional, Gyrina, Olga, additional, Kazmirchuk, Anatoliy, additional, Kolesnyk, Mykola, additional, Komisarenko, Iuliia, additional, Korzh, Oleksii, additional, Kravchun, Nonna, additional, Legun, Oleg, additional, Mankovskyy, Borys, additional, Martynyuk, Liliya, additional, Mostovoy, Yuriy, additional, Pashkovska, Nataliia, additional, Pererva, Larysa, additional, Pertseva, Tetyana, additional, Samoylov, Oleksandr, additional, Smirnov, Ivan, additional, Svyshchenko, Yevgeniya, additional, Tomashkevych, Halyna, additional, Topchii, Ivan, additional, Tryshchuk, Nadiya, additional, Tseluyko, Vira, additional, Vizir, Vadym, additional, Vlasenko, Maryna, additional, Zlova, Tetiana, additional, Zub, Liliia, additional, Abusnana, Salah, additional, Railey, Mohamed, additional, Abouglila, Kamal, additional, Ainsworth, Paul, additional, Ali, Zishan, additional, Arutchelvam, Vijayaraman, additional, Barnard, Maria, additional, Bellary, Srikanth, additional, Davies, Emyr, additional, Davies, Mark, additional, Davies, Simon, additional, Dawson, Alison, additional, El Kossi, Mohsen, additional, English, Patrick, additional, Fraser, Donald, additional, Gnudi, Luigi, additional, Gunstone, Anthony, additional, Hall, Timothy, additional, Hanif, Wasim, additional, Jackson, Alan, additional, Johnson, Andrew, additional, Joseph, Franklin, additional, Krishnan, Singhan, additional, Kumwenda, Mick, additional, MacDougall, Iain, additional, Nixon, Paul, additional, O’Hare, Joseph, additional, Philip, Sam, additional, Ramtoola, Shenaz, additional, Saxena, Manish, additional, Sennik, Davesh, additional, Simon, Godwin, additional, Singh, Baldev, additional, Stephens, Jeffrey, additional, Strzelecka, Anna, additional, Symonds, Rehan, additional, Turner, Wayne, additional, Wahba, Mona, additional, Wakeling, John, additional, Wheeler, David, additional, Winocour, Peter, additional, Abdallah, Joseph, additional, Abdullah, Raied, additional, Abramowitz, Matthew, additional, Acosta, Idalia, additional, Aiello, Joseph, additional, Akright, Laura, additional, Akyea-Djamson, Ayim, additional, Alappan, Rajendran, additional, Alicic, Radica, additional, Al-Karadsheh, Amer, additional, Allison, Dale Crawford, additional, Arauz-Pacheco, Carlos, additional, Arfeen, Shahabul, additional, Arif, Ahmed, additional, Arvind, Moogali, additional, Atray, Naveen, additional, Awad, Ahmed, additional, Bakris, George, additional, Barnhill, Peggy, additional, Barranco, Elizabeth, additional, Barrera, Carlos, additional, Beacom, Matthew, additional, Behara, Venkata, additional, Belo, Diogo, additional, Bentley-Lewis, Rhonda, additional, Berenguer, Ramon, additional, Bermudez, Lidia, additional, Bernardo, Marializa, additional, Biscoveanu, Mihaela, additional, Bowman-Stroud, Cynthia, additional, Brandon, Donald, additional, Brusco, Osvaldo, additional, Busch, Robert, additional, Canaan, Yamil, additional, Chilito, Alicia, additional, Christensen, Tom, additional, Christiano, Cynthia, additional, Christofides, Elena, additional, Chuateco, Caroucel, additional, Cohen, Kenneth, additional, Cohen, Robert, additional, Cohen-Stein, Debbie, additional, Cook, Charles, additional, Coyne, Daniel, additional, Daboul, Nizar, additional, Darwish, Riad, additional, Daswani, Adarsh, additional, Deck, Kenneth, additional, Desouza, Cyrus, additional, Dev, Devasmita, additional, Dhillon, Monika, additional, Dua, Sohan, additional, Eder, Frank, additional, Elosegui, Ana Maria, additional, El-Shahawy, Mohamed, additional, Ervin, John, additional, Esquenazi, Alberto, additional, Evans, John, additional, Fishbane, Steven, additional, Frias, Juan, additional, Galindo-Ramos, Eugenia, additional, Galphin, Claude, additional, Ghazi, Adline, additional, Gonzalez, Enrique, additional, Gorson, David, additional, Gowda, Anupama, additional, Greco, Barbara, additional, Grubb, Stephen, additional, Gulati, Rakesh, additional, Hammoud, Jamal, additional, Handelsman, Stuart, additional, Hartman, Israel, additional, Hershon, Kenneth, additional, Hiser, Daniel, additional, Hon, George, additional, Jacob, Radu, additional, Jaime, Maria, additional, Jamal, Aamir, additional, Kaupke, Charles, additional, Keightley, Gerald, additional, Kern, Elizabeth, additional, Khanna, Rakhi, additional, Khitan, Zeid, additional, Kim, Sun, additional, Kopyt, Nelson, additional, Kovesdy, Csaba, additional, Krishna, Gopal, additional, Kropp, Jeffrey (Jay), additional, Kumar, Amrendra, additional, Kumar, Jayant, additional, Kumar, Neil, additional, Kusnir, Jorge, additional, Lane, Wendy, additional, Lawrence, Mary, additional, Lehrner, Lawrence, additional, Lentz, John, additional, Levinson, Dennis, additional, Lewis, Derek, additional, Liss, Kenneth, additional, Maddux, Andreas, additional, Maheshwari, Hiralal, additional, Mandayam, Sreedhar, additional, Marar, Isam, additional, Mehta, Bhasker, additional, Middleton, John, additional, Mordujovich, Jorge, additional, Moreda, Ramon, additional, Moustafa, Moustafa, additional, Mujica Trenche, Samuel, additional, Narayanan, Mohanram, additional, Narvarte, Javier, additional, Nassar, Tareq, additional, Newman, George, additional, Nichol, Brian, additional, Nicol, Philip, additional, Nisnisan, Josier, additional, Nossuli, A. Kaldun, additional, Obialo, Chamberlain, additional, Olelewe, Sarah, additional, Oliver, Michael, additional, O’Shaughnessy, Andrew, additional, Padron, John, additional, Pankhaniya, Rohit, additional, Parker, Reginald, additional, Patel, Devesh, additional, Patel, Gnyandev, additional, Patel, Nina, additional, Pavon, Humberto, additional, Perez, Armando, additional, Perez, Carlos, additional, Perlman, Alan, additional, Pettis, Karlton, additional, Pharr, Walter, additional, Phillips, Andrea, additional, Purighalla, Raman, additional, Quesada-Suarez, Luis, additional, Ranjan, Rajiv, additional, Rastogi, Sanjeev, additional, Reddy, Jakkidi, additional, Rendell, Marc, additional, Rich, Lisa, additional, Robinson, Michael, additional, Rodriguez, Hector, additional, Rosas, Sylvia, additional, Saba, Fadi, additional, Sankaram, Rallabhandi, additional, Sarin, Ravi, additional, Schreiman, Robert, additional, Scott, David, additional, Sekkarie, Mohamed, additional, Sensenbrenner, John, additional, Shakeel, Muhammad, additional, Shanik, Michael, additional, Shaw, Sylvia, additional, Smith, Stephen, additional, Solomon, Richard, additional, Sprague, Amy, additional, Spry, Leslie, additional, Suchinda, Pusadee, additional, Sultan, Senan, additional, Surampudi, Prasanth, additional, Sussman, Sherry, additional, Tan, Anjanette, additional, Terrelonge, Antonio, additional, Thompson, Michael, additional, Trespalacios, Fernando, additional, Trippe, Bruce, additional, Trueba, Pilar, additional, Twahirwa, Marcel, additional, Updegrove, John, additional, Van Buren, Peter, additional, Vannorsdall, Mark, additional, Varghese, Freemu, additional, Velasquez-Mieyer, Pedro, additional, Ventrapragada, Sailaja, additional, Vukotic, Goga, additional, Wadud, Khurram, additional, Warren, Mark, additional, Watson, Henry, additional, Watts, Ronald, additional, Weiner, Daniel, additional, Welker, James, additional, Welsh, Jean, additional, Williams, Shelley, additional, and Zaniewski-Singh, Michelle, additional

Published
2021
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26. Thrombolysis outcomes according to arterial characteristics of acute ischemic stroke by alteplase dose and blood pressure target.

Author

Zhou, Zien, Xia, Chao, Mair, Grant, Delcourt, Candice, Yoshimura, Sohei, Liu, Xiaosheng, Chen, Zengai, Malavera, Alejandra, Carcel, Cheryl, Chen, Xiaoying, Wang, Xia, Al-Shahi Salman, Rustam, Robinson, Thompson G, Lindley, Richard I, Chalmers, John, Wardlaw, Joanna M, Parsons, Mark W, Demchuk, Andrew M, and Anderson, Craig S

Subjects
*ISCHEMIC stroke, *BLOOD pressure, *MAGNETIC resonance angiography, *ALTEPLASE, *MAGNETIC resonance imaging
Abstract

Background: We explored the influence of low-dose intravenous alteplase and intensive blood pressure lowering on outcomes of acute ischemic stroke according to status/location of vascular obstruction in participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: ENCHANTED was a multicenter, quasi-factorial, randomized trial to determine efficacy and safety of low- versus standard-dose intravenous alteplase and intensive- versus guideline-recommended blood pressure lowering in acute ischemic stroke patients. In those who had baseline computed tomography or magnetic resonance imaging angiography, the degree of vascular occlusion was grouped according to being no (NVO), medium (MVO), or large (LVO). Logistic regression models were used to determine 90-day outcomes (modified Rankin scale [mRS] shift [primary], other mRS cut-scores, intracranial hemorrhage, early neurologic deterioration, and recanalization) by vascular obstruction status/site. Heterogeneity in associations for outcomes across subgroups was estimated by adding an interaction term to the models. Results: There were 940 participants: 607 in alteplase arm only, 243 in blood pressure arm only, and 90 assigned to both arms. Compared to the NVO group, functional outcome was worse in LVO (mRS shift, adjusted OR [95% CI] 2.13 [1.56–2.90]) but comparable in MVO (1.34 [0.96–1.88]) groups. There were no differences in associations of alteplase dose or blood pressure lowering and outcomes across NVO/MVO/LVO groups (mRS shift: low versus standard alteplase dose 0.84 [0.54–1.30]/0.48 [0.25–0.91]/0.99 [0.75–2.09], Pinteraction = 0.28; intensive versus standard blood pressure lowering 1.32 [0.74–2.38]/0.78 [0.31–1.94]/1.24 [0.64–2.41], Pinteraction = 0.41), except for a borderline significant difference for intensive blood pressure lowering and increased early neurologic deterioration (0.63 [0.14–2.72]/0.17 [0.02–1.47]/2.69 [0.90–8.04], Pinteraction = 0.05). Conclusions: Functional outcome by dose of alteplase or intensity of blood pressure lowering is not modified by vascular obstruction status/site according to analyses from ENCHANTED, although these results are compromised by low statistical power. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifiers: NCT01422616 [ABSTRACT FROM AUTHOR]

Published
2022
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27. Abstract MP3: Low Dose versus Standard Dose Alteplase in Acute Lacunar Ischemic Stroke

Author

Zhou, Zien, primary, Delcourt, Candice, additional, Xia, Chao, additional, Yoshimura, Sohei, additional, Carcel, Cheryl, additional, Torii-Yoshimura, Takako, additional, you, shoujiang, additional, Malavera, Alejandra, additional, Chen, Xiaoying, additional, Hackett, Maree, additional, Woodward, Mark, additional, Chalmers, John, additional, Xu, Jianrong, additional, Robinson, Thompson G, additional, Parsons, Mark W, additional, Demchuk, Andrew M, additional, Lindley, Richard I, additional, Mair, Grant, additional, Wardlaw, Joanna M, additional, and Anderson, Craig S, additional

Published
2021
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28. EFFECTS OF CANAGLIFLOZIN ON CARDIOVASCULAR, RENAL AND SAFETY OUTCOMES BY BASELINE LOOP DIURETIC USE: DATA FROM THE CREDENCE TRIAL

Author

Neuen, Brendon, Mahaffey, Kenneth, Cannon, Christopher P., Jardine, Meg, Heerspink, Hiddo L., Neal, Bruce, Arnott, Clare, Zhou, Zien, Charytan, David M., Agarwal, Rajiv, Bakris, George L., De Zeeuw, Dick, Greene, Tom, Levin, Adeera, Wheeler, David C., Rosenthal, Norman, Zhang, Hong, Zinman, Bernard, Perkovic, Vlado, Pollock, Carol, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Groningen Kidney Center (GKC)

Published
2020

29. Brain Imaging Signs and Health-Related Quality of Life after Acute Ischemic Stroke: Analysis of ENCHANTED Alteplase Dose Arm.

Author

Chen, Xiaoying, Delcourt, Candice, Sun, Lingli, Zhou, Zien, Yoshimura, Sohei, You, Shoujiang, Malavera, Alejandra, Torii-Yoshimura, Takako, Carcel, Cheryl, Arima, Hisatomi, Hackett, Maree, Robinson, Thompson, Song, Lili, Wang, Xia, Lindley, Richard I, Chalmers, John, Anderson, Craig S, Chen, Xiaoying, Delcourt, Candice, Sun, Lingli, Zhou, Zien, Yoshimura, Sohei, You, Shoujiang, Malavera, Alejandra, Torii-Yoshimura, Takako, Carcel, Cheryl, Arima, Hisatomi, Hackett, Maree, Robinson, Thompson, Song, Lili, Wang, Xia, Lindley, Richard I, Chalmers, John, and Anderson, Craig S

Abstract

The influence of specific brain lesions on health-related quality of life (HRQoL) after acute ischemic stroke (AIS) is uncertain. We aimed to identify imaging predictors of poor HRQoL in alteplase-treated participants of the alteplase dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). ENCHANTED was an international trial of low- versus standard-dose intravenous alteplase in AIS patients, with functional outcome (modified Rankin scale [mRS]) and HRQoL on the 5-dimension European Quality of Life Scale (EQ-5D) assessed at 90 days post-randomization. Brain images were analyzed centrally by trained assessors. Multivariable logistic regression was undertaken in the study population randomly divided (2:1) into training (development) and validation (performance) groups, with age (per 10-year increase), ethnicity, baseline National Institutes of Health Stroke Scale (NIHSS) score, diabetes mellitus, premorbid function (mRS score 0 or 1), and proxy respondent, forced into all models. Data are presented with odds ratios (ORs) and 95% confidence intervals (CIs). Eight prediction models were developed and validated in 2,526 AIS patients (median age 67.5 years; 38.4% female; 61.7% Asian) with complete brain imaging and 90-day EQ-5D utility score data. The best performance model included acute ischemic changes in the right (OR 1.69, 95% CI: 1.24-2.29) and deep (OR 1.50, 95% CI: 1.03-2.19) middle cerebral artery (MCA) regions. Several background features of brain frailty - atrophy, white matter change, and old infarcts - were significantly associated with adverse physical but not emotional HRQoL domains. In thrombolysed AIS patients, right-sided and deep ischemia within the MCA territory predict poor overall HRQoL, whilst features of old cerebral ischemia are associated with reduced physical HRQoL. [Abstract copyright: © 2020 S. Karger AG, Basel.]

Published
2020

30. Effects of sodium-glucose co-transporter-2 inhibitors in type 2 diabetes in women versus men

Author

Rådholm, Karin, Zhou, Zien, Clemens, Kristin, Neal, Bruce, Woodward, Mark, Rådholm, Karin, Zhou, Zien, Clemens, Kristin, Neal, Bruce, and Woodward, Mark

Abstract

Sodium-glucose co-transporter-2 (SGLT2) inhibitors prevent cardiovascular complications in type 2 diabetes. We aimed to study whether they have similar effects in women and men by summarizing the effects of SGLT2 inhibitors compared to placebo on vascular and safety outcomes stratified by sex. We included patients with type 2 diabetes enrolled in the EMPA-REG OUTCOME, CANVAS Program, DECLARE TIMI-58 and CREDENCE trials. There were no differences in the risk ratios between men and women, SGLT2 versus control (placebo), for vascular efficacy outcomes or death (all P for interaction amp;gt;=.12), with clear protection shown against major adverse cardiovascular events, heart failure, vascular death and total mortality. SGLT2 inhibitor treatment was also associated with similar relative risks in women and men for the safety outcomes of amputation, fracture, genital infection and urinary tract infection (all P for interaction amp;gt;=.17). SGLT2 inhibition provided similar protection against vascular risks and death, and similar risks of serious adverse events, for women and men.

Published
2020
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31. Kidney, Cardiovascular, and Safety Outcomes of Canagliflozin according to Baseline Albuminuria

Author

Jardine, Meg, primary, Zhou, Zien, additional, Lambers Heerspink, Hiddo J., additional, Hockham, Carinna, additional, Li, Qiang, additional, Agarwal, Rajiv, additional, Bakris, George L., additional, Cannon, Christopher P., additional, Charytan, David M., additional, Greene, Tom, additional, Levin, Adeera, additional, Li, Jing-Wei, additional, Neuen, Brendon L., additional, Neal, Bruce, additional, Oh, Richard, additional, Oshima, Megumi, additional, Pollock, Carol, additional, Wheeler, David C., additional, de Zeeuw, Dick, additional, Zhang, Hong, additional, Zinman, Bernard, additional, Mahaffey, Kenneth W., additional, and Perkovic, Vlado, additional

Published
2021
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32. Low-Dose vs Standard-Dose Alteplase in Acute Lacunar Ischemic Stroke

Author

Zhou, Zien, primary, Delcourt, Candice, additional, Xia, Chao, additional, Yoshimura, Sohei, additional, Carcel, Cheryl, additional, Torii-Yoshimura, Takako, additional, You, Shoujiang, additional, Malavera, Alejandra, additional, Chen, Xiaoying, additional, Hackett, Maree L., additional, Woodward, Mark, additional, Chalmers, John, additional, Xu, Jianrong, additional, Robinson, Thompson G., additional, Parsons, Mark W., additional, Demchuk, Andrew M., additional, Lindley, Richard I., additional, Mair, Grant, additional, Wardlaw, Joanna M., additional, and Anderson, Craig S., additional

Published
2021
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33. An exploration of the heterogeneity in effects of SGLT2 inhibition on cardiovascular and all-cause mortality in the EMPA-REG OUTCOME, CANVAS Program, DECLARE-TIMI 58, and CREDENCE trials

Author

Yu, Jie, primary, Zhou, Zien, additional, Mahaffey, Kenneth W., additional, Matthews, David R., additional, Neuen, Brendon L., additional, Heerspink, Hiddo J.L., additional, Jardine, Meg J., additional, Li, JingWei, additional, Perkovic, Vlado, additional, Neal, Bruce, additional, and Arnott, Clare, additional

Published
2021
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34. Intensive versus guideline‐recommended blood pressure reduction in acute lacunar stroke with intravenous thrombolysis therapy: The ENCHANTED trial

Author

Zhou, Zien, primary, Xia, Chao, additional, Carcel, Cheryl, additional, Yoshimura, Sohei, additional, Wang, Xia, additional, Delcourt, Candice, additional, Malavera, Alejandra, additional, Chen, Xiaoying, additional, Mair, Grant, additional, Woodward, Mark, additional, Chalmers, John, additional, Demchuk, Andrew M., additional, Lindley, Richard I., additional, Robinson, Thompson G., additional, Parsons, Mark W., additional, Wardlaw, Joanna M., additional, and Anderson, Craig S., additional

Published
2020
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36. Brain imaging abnormalities and outcome after acute ischaemic stroke: the ENCHANTED trial

Author

Delcourt, Candice, primary, Wang, Xia, additional, Zhou, Zien, additional, Wardlaw, Joanna M, additional, Mair, Grant, additional, Robinson, Thompson G, additional, Chen, Xiaoying, additional, Yoshimura, Sohei, additional, Torii-Yoshimura, Takako, additional, Carcel, Cheryl, additional, Calic, Zeljka, additional, Tan, Wee Yong, additional, Malavera, Alejandra, additional, Anderson, Craig S, additional, and Lindley, Richard I, additional

Published
2020
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37. Sodium‐glucose co‐transporter‐2 inhibition and ocular outcomes in patients with type 2 diabetes: A systematic review and meta‐analysis

Author

Li, Chao, primary, Zhou, Zien, additional, Neuen, Brendon L., additional, Yu, Jie, additional, Huang, Yuli, additional, Young, Tamara, additional, Li, Jingwei, additional, Li, Lin, additional, Perkovic, Vlado, additional, Jardine, Meg J., additional, Keay, Lisa, additional, Markoulli, Maria, additional, Rosenthal, Norm, additional, Capuano, George, additional, Yavin, Yshai, additional, Neal, Bruce, additional, and Arnott, Clare, additional

Published
2020
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40. EFFECTS OF CANAGLIFLOZIN ON STROKE IN THE CREDENCE TRIAL

Author

Zhou, Zien, primary, Jardine, Meg, additional, Li, Qiang, additional, Lindley, Richard, additional, Neuen, Brendon, additional, Cannon, Christopher P., additional, De Zeeuw, Dick, additional, Edwards, Robert, additional, Greene, Tom, additional, Levin, Adeera, additional, Mahaffey, Kenneth, additional, Perkovic, Vlado, additional, and Neal, Bruce, additional

Published
2020
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41. Standards for Detecting, Interpreting and Reporting NCCT Markers of ICH Expansion

Author

Morotti, Andrea, Boulouis, Gregoire, Dowlatshahi, Dar, Li, Qi, Barras, Christen D., Delcourt, Candice, Yu, Zhiyuan, Zheng, Jun, Zhou, Zien, Aviv, Richard I., Shoamanesh, Ashkan, Sporns, Peter B., Rosand, Jonathan, Greenberg, Steven M., Al‐shahi Salman, Rustam, Qureshi, Adnan I., Demchuk, Andrew M., Anderson, Craig S., Goldstein, Joshua N., and Charidimou, Andreas

Published
2019

42. Comparison of treatment rates of depression after stroke versus myocardial infarction

Author

Ladwig, Simon, Zhou, Zien, Xu, Ying, Wang, Xia, Chow, Clara K., Werheid, Katja, and Hackett, Maree L.

Subjects
Department Psychologie, ddc:150
Abstract

Objective Depression after stroke and myocardial infarction (MI) is common but often assumed to be undertreated without reliable evidence being available. Thus, we aimed to determine treatment rates and investigate the application of guidelines in these conditions. Methods Databases MEDLINE, EMBASE, PsycInfo, Web of Science, CINAHL, and Scopus were systematically searched without language restriction from inception to June 30, 2017. Prospective observational studies with consecutive recruitment reporting any antidepressant treatment in adults with depression after stroke or MI were included. Random-effects models were used to calculate pooled estimates of treatment rates. Results Fifty-five studies reported 32 stroke cohorts (n = 8938; pooled frequency of depression = 34%, 95% confidence interval [CI] = 29%-38%) and 17 MI cohorts (n = 10,767; pooled frequency of depression = 24%, 95% CI = 20%-28%). In 29 stroke cohorts, 24% (95% CI = 20%-27%) of 2280 depressed people used antidepressant medication. In 15 MI cohorts, 14% (95% CI = 8%-19%) of 2381 depressed people used antidepressant medication indicating a lower treatment rate than in stroke. Two studies reported use of psychosocial interventions, indicating that less than 10% of participants were treated. Conclusions Despite the high frequency of depression after stroke and MI and the existence of efficacious treatment strategies, people often remain untreated. Innovative strategies are needed to increase the use of effective antidepressive interventions in patients with cardiovascular disease.

Published
2018

47. Intensive versus guideline‐recommended blood pressure reduction in acute lacunar stroke with intravenous thrombolysis therapy: The ENCHANTED trial.

Author

Zhou, Zien, Xia, Chao, Carcel, Cheryl, Yoshimura, Sohei, Wang, Xia, Delcourt, Candice, Malavera, Alejandra, Chen, Xiaoying, Mair, Grant, Woodward, Mark, Chalmers, John, Demchuk, Andrew M., Lindley, Richard I., Robinson, Thompson G., Parsons, Mark W., Wardlaw, Joanna M., and Anderson, Craig S.

Subjects
*LACUNAR stroke, *BLOOD pressure, *INTRAVENOUS therapy, *TREATMENT effectiveness, *LOGISTIC regression analysis, *REGRESSION analysis
Abstract

Background and purpose: This was an investigation of the differential effects of early intensive versus guideline‐recommended blood pressure (BP) lowering between lacunar and non‐lacunar acute ischaemic stroke (AIS) in the BP arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: In 1,632 participants classified as having definite or probable lacunar (n = 454 [27.8%]) or non‐lacunar AIS according to pre‐specified definitions based upon clinical and adjudicated imaging findings, mean BP changes over days 0–7 were plotted, and systolic BP differences by treatment between subgroups were estimated in generalized linear models. Logistic regression models were used to estimate the BP treatment effects on 90‐day outcomes (primary, an ordinal shift of modified Rankin scale scores) across lacunar and non‐lacunar AIS after adjustment for baseline covariables. Results: Most baseline characteristics, acute BP and other management differed between lacunar and non‐lacunar AIS, but mean systolic BP differences by treatment were comparable at each time point (all pinteraction > 0.12) and over 24 h post‐randomization (−5.5, 95% CI −6.5, −4.4 mmHg in lacunar AIS vs. −5.6, 95% CI −6.3, −4.8 mmHg in non‐lacunar AIS, pinteraction = 0.93). The neutral effect of intensive BP lowering on functional outcome and the beneficial effect on intracranial haemorrhage were similar for the two subgroups (all pinteraction > 0.19). Conclusions: There were no differences in the treatment effect of early intensive versus guideline‐recommended BP lowering across lacunar and non‐lacunar AIS. [ABSTRACT FROM AUTHOR]

Published
2021
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48. Effectiveness and Safety of Antibiotics for Preventing Pneumonia and Improving Outcome after Acute Stroke: Systematic Review and Meta-analysis

Author

Badve, Monica S, Zhou, Zien, Anderson, Craig, Hackett, Maree, Badve, Monica S, Zhou, Zien, Anderson, Craig, and Hackett, Maree

Abstract

Pneumonia is a common complication after stroke which increases morbidity and mortality. This systematic review was conducted to evaluate the efficacy and safety of antibiotics for the prevention of pneumonia after acute stroke. Medline, EMBASE, and Cochrane databases were searched for randomized controlled trials comparing preventive antibiotics to placebo or no antibiotics after acute stroke. The primary outcome was poststroke pneumonia. Secondary outcomes were all infections, urinary tract infections, death, dependency, length of hospital stay, and adverse events. Treatment effects were summarized using random effects metaanalysis. Six trials (4111 patients) were eligible for inclusion. The median National Institute of Health Stroke Scale score in included trials ranged from 5 to 16.5. The proportion of dysphagia ranged from 26% to 100%. Preventive antibiotics were commenced within 48 hours after acute stroke. Compared to control, preventive antibiotics reduced the risk of poststroke pneumonia (RR .75, 95%CI ·.57-.99), and all infections (RR .58, 95%CI .48-.69). There was no significant difference in the risks of dependency (RR 0.99, 95%CI 0·80-1·11), or mortality (RR .96, 95%CI .78-1.19) between the preventive antibiotics and control groups. Preventive antibiotics did not increase the risk of elevated liver enzymes (RR 1.20, 95% CI .97-1.49). Preventive antibiotics had uncertain effects on the risks of other adverse events. Preventive antibiotics reduced the risk of post-stroke pneumonia. However, there is insufficient evidence to currently recommend routine use of preventive antibiotics after acute stroke. [Abstract copyright: Copyright © 2018. Published by Elsevier Inc.]

Published
2018

49. Sodium‐glucose co‐transporter‐2 inhibition and ocular outcomes in patients with type 2 diabetes: A systematic review and meta‐analysis.

Author

Li, Chao, Zhou, Zien, Neuen, Brendon L., Yu, Jie, Huang, Yuli, Young, Tamara, Li, Jingwei, Li, Lin, Perkovic, Vlado, Jardine, Meg J., Keay, Lisa, Markoulli, Maria, Rosenthal, Norm, Capuano, George, Yavin, Yshai, Neal, Bruce, and Arnott, Clare

Subjects
*TYPE 2 diabetes, *META-analysis, *GLYCOSYLATED hemoglobin, *DIABETES, *THERAPEUTIC complications
Abstract

Sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors are effective for the treatment of macrovascular complications and nephropathy in type 2 diabetes, but effects on microvascular eye outcomes are unclear. We conducted a systematic review and meta‐analysis of randomized placebo‐controlled trials to evaluate the effect of SGLT2 inhibition on total ocular events and retinopathy in patients with type 2 diabetes. We searched MEDLINE and Embase for the period from database inception date to October 11, 2019. Two reviewers working independently extracted relevant data. Random‐effects models with inverse variance weighting were selected to estimate summary risk ratios (RRs) and 95% confidence intervals (CIs). We included nine studies, involving 39 982 patients with a mean follow‐up of 2.8 years. There were 1414 total ocular events, of which 624 were retinopathy events. SGLT2 inhibition was not associated with a change in the risk of total ocular events (RR 0.97, 95% CI 0.85, 1.11) or retinopathy (RR 0.98, 95% CI 0.84, 1.16), with consistent effects across studies (P for heterogeneity = 0.35 and 0.45, respectively). The effects of SGLT2 inhibition on eye disease in individuals with type 2 diabetes are probably null, although the available data cannot exclude small to moderate benefits or harms. [ABSTRACT FROM AUTHOR]

Published
2021
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50. Clinical prognosis of FLAIR hyperintense arteries in ischaemic stroke patients: a systematic review and meta-analysis.

Author

Zien Zhou, Malavera, Alejandra, Yoshimura, Sohei, Delcourt, Candice, Mair, Grant, Al-Shahi Salman, Rustam, Demchuk, Andrew M., Wardlaw, Joanna M., Lindley, Richard I., Anderson, Craig S., and Zhou, Zien

Subjects
META-analysis, STROKE patients, CLINICAL trial registries, ARTERIES, PROGNOSIS, ADOLESCENT idiopathic scoliosis
Abstract

Objective: We performed a systematic review and meta-analysis to determine the association of fluid-attenuated inversion recovery (FLAIR) hyperintense arteries (FLAIR-HAs) on brain MRI and prognosis after acute ischaemic stroke (AIS).Methods: We searched Medline, Embase and Cochrane Central Register of Controlled Trials for studies reporting clinical or imaging outcomes with presence of FLAIR-HAs after AIS. Two researchers independently assessed eligibility of retrieved studies and extracted data, including from the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Outcomes were unfavourable functional outcome (primary, modified Rankin scale scores 3-6 or 2-6), death, intermediate clinical and imaging outcomes. We performed subgroup analyses by treatment or types of FLAIR-HAs defined by location (at proximal/distal middle cerebral artery (MCA), within/beyond diffusion-weighted imaging (DWI) lesion) or extent.Results: We included 36 cohort studies (33 prospectively collected) involving 3577 patients. FLAIR-HAs were not associated with functional outcome overall (pooled risk ratio 0.87, 95% CI 0.71 to 1.06), but were significantly associated with better outcome in those receiving endovascular therapy (0.56, 95% CI 0.41 to 0.75). Contrary to FLAIR-HAs at proximal MCA or within DWI lesions, FLAIR-HAs beyond DWI lesions were associated with better outcome (0.67, 95% CI 0.57 to 0.79). FLAIR-HAs favoured recanalisation (1.21, 95% CI 1.06 to 1.38) with increased risk of intracerebral haemorrhage (2.07, 95% CI 1.37 to 3.13) and early neurological deterioration (1.93, 95% CI 1.30 to 2.85).Conclusions: FLAIR-HAs were not associated with functional outcome overall but were associated with outcome after endovascular therapy for AIS. FLAIR-HAs were also associated with early recanalisation or haemorrhagic complications, and early neurologic deterioration.Prospero Registration Number: CRD42019131168. [ABSTRACT FROM AUTHOR]

Published
2020
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