Polypill with or without Aspirin in Persons without #Cardiovascular Disease

..Using a 2-by-2-by-2 factorial design, we randomly assigned participants without cardiovascular disease who had an elevated INTERHEART Risk Score to receive a polypill (containing 40 mg of simvastatin, 100 mg of atenolol, 25 mg of hydrochlorothiazide, and 10 mg of ramipril) or placebo daily, aspirin (75 mg) or placebo daily, and vitamin D or placebo monthly. We report here the outcomes for the polypill alone … Continue reading Polypill with or without Aspirin in Persons without #Cardiovascular Disease

#Ticagrelor Added to #Aspirin in Acute Ischemic #Stroke or Transient Ischemic Attack in Prevention of Disabling Stroke A Randomized Clinical Trial

Reduction of subsequent disabling stroke is the main goal of preventive treatment in the acute setting after transient ischemic attack (TIA) or minor ischemic stroke.. ..Ticagrelor (180-mg loading dose on day 1 followed by 90 mg twice daily for days 2-30) or placebo within 24 hours of symptom onset. All patients received aspirin, 300 to 325 mg on day 1 followed by 75 to 100 … Continue reading #Ticagrelor Added to #Aspirin in Acute Ischemic #Stroke or Transient Ischemic Attack in Prevention of Disabling Stroke A Randomized Clinical Trial

Characteristics of Recurrent Ischemic #Stroke After Embolic Stroke of Undetermined Source Secondary Analysis of a Randomized Clinical Trial

The concept of embolic stroke of undetermined source (ESUS) unifies a subgroup of cryptogenic strokes based on neuroimaging, a defined minimum set of diagnostic tests, and exclusion of certain causes. Despite an annual stroke recurrence rate of 5%, little is known about the etiology underlying recurrent stroke after ESUS.. ..A total of 309 patients (205 men [66%]; mean [SD] age, 68 [10] years) had ischemic … Continue reading Characteristics of Recurrent Ischemic #Stroke After Embolic Stroke of Undetermined Source Secondary Analysis of a Randomized Clinical Trial

#Anticoagulation Timing in Cardioembolic #Stroke and Recurrent Event Risk

Guidelines recommend initiating anticoagulation within 4 to 14 days after cardioembolic stroke. Data supporting this did not account for key factors potentially affecting the decision to initiate anticoagulation, such as infarct size, hemorrhagic transformation, or high‐risk features on echocardiography.. ..We pooled data from stroke registries of 8 comprehensive stroke centers across the United States. We included consecutive patients admitted with ischemic stroke and atrial fibrillation. The … Continue reading #Anticoagulation Timing in Cardioembolic #Stroke and Recurrent Event Risk

Increased risk of acute #stroke among patients with severe #COVID‐19: a multicenter study and meta‐analysis

Recent observations linked coronavirus disease 2019 (COVID‐19) to thromboembolic complications possibly mediated by increased blood coagulability and inflammatory endothelial impairment. We aimed to define the risk of acute stroke in patients with severe and non‐severe COVID‐19.. ..Of 165 patients hospitalized for COVID‐19 (49.1% males, median age 67 [57‐79], 72.1% severe or critical) included in the multicenter study, overall stroke rate was 4.2% (95%CI: 1.9‐8.7). Systematic … Continue reading Increased risk of acute #stroke among patients with severe #COVID‐19: a multicenter study and meta‐analysis

Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

Outcomes of postoperative atrial fibrillation (AF) after noncardiac surgery are not well defined.. ..The median age of the 452 matched patients was 75 years (IQR, 67-82 years) and 51.8% of patients were men. Patients with postoperative AF had significantly higher CHA2DS2-VASc scores than those in the no AF group (median, 4 [IQR, 2-5] vs 3 [IQR, 2-5]; P < .001). Over a median follow-up of 5.4 years … Continue reading Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

#Cerebrovascular and Neurological Dysfunction under the Threat of #COVID-19: Is There a Comorbid Role for #Smoking and Vaping?

The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are … Continue reading #Cerebrovascular and Neurological Dysfunction under the Threat of #COVID-19: Is There a Comorbid Role for #Smoking and Vaping?

Different predictors after stroke depending on functional dependency at discharge: a 5-year follow up study

Level of dependency after a stroke is important for long-term outcome in several aspects, but less is known about important predictors for outcome depending on functional dependency. The aim of the current study was to investigate self-perceived outcome and identify possible predictors of strength, participation, and emotional outcome 5 years after stroke based on functional dependency at discharge from hospital.. A total of 266 participants … Continue reading Different predictors after stroke depending on functional dependency at discharge: a 5-year follow up study

Atrial Cardiopathy in the Absence of Atrial Fibrillation Increases Risk of Ischemic Stroke, Incident Atrial Fibrillation, and Mortality and Improves Stroke Risk Prediction

Atrial fibrillation (AF) is a major, often undetected, cardiac cause of stroke. Markers of atrial cardiopathy, including left atrial enlargement (LAE) or excessive atrial ectopy (EAE) increase the risk of AF and have shown associations with stroke. We sought to determine whether these markers improve stroke risk prediction beyond traditional vascular risk factors (eg CHA2DS2‐VASc score).. ..Each 10 mm increase in left atrial diameter increased … Continue reading Atrial Cardiopathy in the Absence of Atrial Fibrillation Increases Risk of Ischemic Stroke, Incident Atrial Fibrillation, and Mortality and Improves Stroke Risk Prediction

Cigarette Smoking and Incident Stroke in Blacks of the Jackson Heart Study

Blacks are disproportionately affected by stroke compared with whites; however, less is known about the relationship between stroke and cigarette smoking in blacks. Therefore, we evaluated the relationship between cigarette smoking and all incident stroke in the JHS (Jackson Heart Study).. JHS participants without a history of stroke (n=4410) were classified by self‐reported baseline smoking status into current, past (smoked at least 400 cigarettes/life), or … Continue reading Cigarette Smoking and Incident Stroke in Blacks of the Jackson Heart Study

Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic #Stroke

Earlier administration of intravenous tissue plasminogen activator (tPA) in acute ischemic stroke is associated with reduced mortality by the time of hospital discharge and better functional outcomes at 3 months. However, it remains unclear whether shorter door-to-needle times translate into better long-term outcomes.. ..Among the 61 426 patients treated with tPA within 4.5 hours, the median age was 80 years and 43.5% were male. The median … Continue reading Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic #Stroke

Complement-Dependent Synaptic Uptake and Cognitive Decline after #Stroke and Reperfusion Therapy

..This study addresses two major challenges facing the treatment of stroke in the era of reperfusion therapy: hemorrhagic transformation and the disconnect between successful revascularization and functional outcomes. We studied how complement-dependent neuroinflammation drives the pathophysiology behind these challenges using a translationally relevant strategy. Complement inhibition was achieved using B4Crry, an injury site-targeted inhibitor of C3 activation. Following embolic stroke, pharmacological thrombolysis limited infarct size, … Continue reading Complement-Dependent Synaptic Uptake and Cognitive Decline after #Stroke and Reperfusion Therapy