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1. Subsequent ischemic stroke and tobacco smoking: A secondary analysis of the POINT trial.

Author: Lang, Adam Edward, Lang, Adam Edward, de Havenon, Adam, Mac Grory, Brian, Henninger, Nils, Shu, Liqi, Furie, Karen L, Easton, J Donald, Kim, Anthony, Johnston, S Claiborne, Yaghi, Shadi, Lang, Adam Edward, Lang, Adam Edward, de Havenon, Adam, Mac Grory, Brian, Henninger, Nils, Shu, Liqi, Furie, Karen L, Easton, J Donald, Kim, Anthony, Johnston, S Claiborne, and Yaghi, Shadi
Abstract: BackgroundThe aim of this study was to determine the effect of smoking status on subsequent stroke risk in patients with minor ischemic stroke or TIA and to determine whether smoking modifies the effect of clopidogrel-based DAPT on subsequent stroke risk.MethodsThis was a post-hoc analysis of the Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, which had a 90-day follow-up period. We used multivariable Cox regression and subgroup interaction analysis to determine the effect of smoking on the risk of subsequent ischemic stroke and major hemorrhage, respectively.ResultsData from 4877 participants enrolled in the POINT trial were analyzed. Among these, 1004 were current smokers and 3873 were non-smokers at the time of index event. Smoking was associated with a non-significant trend toward an increased risk of subsequent ischemic stroke during follow up (adjusted HR, 1.31 (95% CI, 0.97-1.78), p = 0.076). The effect of clopidogrel on ischemic stroke did not differ between non-smokers (HR, 0.74 (95% CI, 0.56-0.98), p = 0.03) and smokers (HR, 0.63 (95% CI, 0.37-1.05), p = 0.078), p for interaction = 0.572. Similarly, the effect of clopidogrel on major hemorrhage did not differ between non-smokers (hazard ratio, 1.67 (95% CI, 0.40-7.00), p = 0.481) and smokers (HR, 2.59 (95% CI, 1.08-6.21), p = 0.032), p for interaction = 0.613.ConclusionsIn this post-hoc analysis of the POINT trial we found that the effect of clopidogrel on reducing subsequent ischemic stroke as well as risk of major hemorrhage did not depend on smoking status, indicating that smokers benefit to a similar degree from DAPT as non-smokers.
Published: 2023

2. Stroke genetics informs drug discovery and risk prediction across ancestries

Author: Mishra, Aniket, Malik, Rainer, Hachiya, Tsuyoshi, Jurgenson, Tuuli, Namba, Shinichi, Posner, Daniel C, Kamanu, Frederick K, Koido, Masaru, Le Grand, Quentin, Shi, Mingyang, He, Yunye, Georgakis, Marios K, Caro, Ilana, Krebs, Kristi, Liaw, Yi-Ching, Vaura, Felix C, Lin, Kuang, Winsvold, Bendik Slagsvold, Srinivasasainagendra, Vinodh, Parodi, Livia, Bae, Hee-Joon, Chauhan, Ganesh, Chong, Michael R, Tomppo, Liisa, Akinyemi, Rufus, Roshchupkin, Gennady V, Habib, Naomi, Jee, Yon Ho, Thomassen, Jesper Qvist, Abedi, Vida, Carcel-Marquez, Jara, Nygaard, Marianne, Leonard, Hampton L, Yang, Chaojie, Yonova-Doing, Ekaterina, Knol, Maria J, Lewis, Adam J, Judy, Renae L, Ago, Tetsuro, Amouyel, Philippe, Armstrong, Nicole D, Bakker, Mark K, Bartz, Traci M, Bennett, David A, Bis, Joshua C, Bordes, Constance, Borte, Sigrid, Cain, Anael, Ridker, Paul M, Cho, Kelly, Chen, Zhengming, Cruchaga, Carlos, Cole, John W, de Jager, Phil L, de Cid, Rafael, Endres, Matthias, Ferreira, Leslie E, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, Hata, Jun, He, Jing, Heath, Alicia K, Ho, Yuk-Lam, Havulinna, Aki S, Hopewell, Jemma C, Hyacinth, Hyacinth I, Inouye, Michael, Jacob, Mina A, Jeon, Christina E, Jern, Christina, Kamouchi, Masahiro, Keene, Keith L, Kitazono, Takanari, Kittner, Steven J, Konuma, Takahiro, Kumar, Amit, Lacaze, Paul, Launer, Lenore J, Lee, Keon-Joo, Lepik, Kaido, Li, Jiang, Li, Liming, Manichaikul, Ani, Markus, Hugh S, Marston, Nicholas A, Meitinger, Thomas, Mitchell, Braxton D, Montellano, Felipe A, Morisaki, Takayuki, Mosley, Thomas H, Nalls, Mike A, Nordestgaard, Borge G, O'Donnell, Martin J, Okada, Yukinori, Onland-Moret, N Charlotte, Ovbiagele, Bruce, Peters, Annette, Psaty, Bruce M, Rich, Stephen S, Rosand, Jonathan, Sabatine, Marc S, Sacco, Ralph L, Saleheen, Danish, Sandset, Else Charlotte, Salomaa, Veikko, Sargurupremraj, Muralidharan, Sasaki, Makoto, Satizabal, Claudia L, Schmidt, Carsten O, Shimizu, Atsushi, Smith, Nicholas L, Sloane, Kelly L, Sutoh, Yoichi, Sun, Yan V, Tanno, Kozo, Tiedt, Steffen, Tatlisumak, Turgut, Torres-Aguila, Nuria P, Tiwari, Hemant K, Tregouet, David-Alexandre, Trompet, Stella, Tuladhar, Anil Man, Tybjaerg-Hansen, Anne, van Vugt, Marion, Vibo, Riina, Verma, Shefali S, Wiggins, Kerri L, Wennberg, Patrik, Woo, Daniel, Wilson, Peter WF, Xu, Huichun, Yang, Qiong, Yoon, Kyungheon, Lee, Jin-Moo, Cheng, Yu-Ching, Meschia, James F, Chen, Wei Min, Sale, Michele M, Zonderman, Alan B, Evans, Michele K, Wilson, James G, Correa, Adolfo, Traylor, Matthew, Lewis, Cathryn M, Carty, Cara L, Reiner, Alexander, Haessler, Jeffrey, Langefeld, Carl D, Gottesman, Rebecca F, Yaffe, Kristine, Liu, Yong Mei, Kooperberg, Charles, Lange, Leslie A, Furie, Karen L, Arnett, Donna K, Benavente, Oscar R, Grewal, Raji P, Peddareddygari, Leema Reddy, Hveem, Kristian, Lindstrom, Sara, Wang, Lu, Smith, Erin N, Gordon, William, van Hylckama Vlieg, Astrid, de Andrade, Mariza, Brody, Jennifer A, Pattee, Jack W, Brumpton, Ben M, Suchon, Pierre, Chen, Ming-Huei, Frazer, Kelly A, Turman, Constance, Germain, Marine, MacDonald, James, Braekkan, Sigrid K, Armasu, Sebastian M, Pankratz, Nathan, Jackson, Rebecca D, Nielsen, Jonas B, Giulianini, Franco, Puurunen, Marja K, Ibrahim, Manal, Heckbert, Susan R, Bammler, Theo K, McCauley, Bryan M, Taylor, Kent D, Pankow, James S, Reiner, Alexander P, Gabrielsen, Maiken E, Deleuze, Jean-Francois, O'Donnell, Chris J, Kim, Jihye, McKnight, Barbara, Kraft, Peter, Hansen, John-Bjarne, Rosendaal, Frits R, Heit, John A, Tang, Weihong, Morange, Pierre-Emmanuel, Johnson, Andrew D, Kabrhel, Christopher, van Dijk, Ewoud J, Koudstaal, Peter J, Luijckx, Gert-Jan, Nederkoorn, Paul J, van Oostenbrugge, Robert J, Visser, Marieke C, Wermer, Marieke JH, Kappelle, L Jaap, Esko, Tonu, Metspalu, Andres, Magi, Reedik, Nelis, Mari, Irvin, Marguerite R, de Leeuw, Frank-Erik, Levi, Christopher R, Maguire, Jane, Jimenez-Conde, Jordi, Sharma, Pankaj, Sudlow, Cathie LM, Rannikmae, Kristiina, Schmidt, Reinhold, Slowik, Agnieszka, Pera, Joanna, Thijs, Vincent NS, Lindgren, Arne G, Ilinca, Andreea, Melander, Olle, Engstrom, Gunnar, Rexrode, Kathryn M, Rothwell, Peter M, Stanne, Tara M, Johnson, Julie A, Danesh, John, Butterworth, Adam S, Heitsch, Laura, Boncoraglio, Giorgio B, Kubo, Michiaki, Pezzini, Alessandro, Rolfs, Arndt, Giese, Anne-Katrin, Weir, David, Ross, Owen A, Lemmons, Robin, Soderholm, Martin, Cushman, Mary, Jood, Katarina, McDonough, Caitrin W, Bell, Steven, Linkohr, Birgit, Lee, Tsong-Hai, Putaala, Jukka, Anderson, Christopher D, Lopez, Oscar L, Jian, Xueqiu, Schminke, Ulf, Cullell, Natalia, Delgado, Pilar, Ibanez, Laura, Krupinski, Jerzy, Lioutas, Vasileios, Matsuda, Koichi, Montaner, Joan, Muino, Elena, Roquer, Jaume, Sarnowski, Chloe, Sattar, Naveed, Sibolt, Gerli, Teumer, Alexander, Rutten-Jacobs, Loes, Kanai, Masahiro, Gretarsdottir, Solveig, Rost, Natalia S, Yusuf, Salim, Almgren, Peter, Ay, Hakan, Bevan, Steve, Brown, Robert D, Carrera, Caty, Buring, Julie E, Chen, Wei-Min, Cotlarciuc, Ioana, de Bakker, Paul IW, DeStefano, Anita L, den Hoed, Marcel, Duan, Qing, Engelter, Stefan T, Falcone, Guido J, Gustafsson, Stefan, Hassan, Ahamad, Holliday, Elizabeth G, Howard, George, Hsu, Fang-Chi, Ingelsson, Erik, Harris, Tamara B, Kissela, Brett M, Kleindorfer, Dawn O, Langenberg, Claudia, Lemmens, Robin, Leys, Didier, Lin, Wei-Yu, Lorentzen, Erik, Magnusson, Patrik K, McArdle, Patrick F, Pulit, Sara L, Rice, Kenneth, Sakaue, Saori, Sapkota, Bishwa R, Tanislav, Christian, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Tzourio, Christophe, van Duijn, Cornelia M, Walters, Matthew, Wareham, Nicholas J, Amin, Najaf, Aparicio, Hugo J, Attia, John, Beiser, Alexa S, Berr, Claudine, Bustamante, Mariana, Caso, Valeria, Choi, Seung Hoan, Chowhan, Ayesha, Dartigues, Jean-Francois, Delavaran, Hossein, Dorr, Marcus, Ford, Ian, Gurpreet, Wander S, Hamsten, Anders, Hozawa, Atsushi, Ingelsson, Martin, Iwasaki, Motoki, Kaffashian, Sara, Kalra, Lalit, Kjartansson, Olafur, Kloss, Manja, Labovitz, Daniel L, Laurie, Cathy C, Li, Linxin, Lind, Lars, Lindgren, Cecilia M, Makoto, Hirata, Minegishi, Naoko, Morris, Andrew P, Muller-Nurasyid, Martina, Norrving, Bo, Ogishima, Soichi, Parati, Eugenio A, Pedersen, Nancy L, Perola, Markus, Jousilahti, Pekka, Pileggi, Silvana, Rabionet, Raquel, Riba-Llena, Iolanda, Ribases, Marta, Romero, Jose R, Rudd, Anthony G, Sarin, Antti-Pekka, Sarju, Ralhan, Satoh, Mamoru, Sawada, Norie, Sigurdsson, Asgeir, Smith, Albert, Stine, O Colin, Stott, David J, Strauch, Konstantin, Takai, Takako, Tanaka, Hideo, Touze, Emmanuel, Tsugane, Shoichiro, Uitterlinden, Andre G, Valdimarsson, Einar M, van der Lee, Sven J, Wakai, Kenji, Williams, Stephen R, Wolfe, Charles DA, Wong, Quenna, Yamaji, Taiki, Sanghera, Dharambir K, Stefansson, Kari, Martinez-Majander, Nicolas, Sobue, Kenji, Soriano-Tarraga, Carolina, Volzke, Henry, Akpa, Onoja, Sarfo, Fred S, Akpalu, Albert, Obiako, Reginald, Wahab, Kolawole, Osaigbovo, Godwin, Owolabi, Lukman, Komolafe, Morenikeji, Jenkins, Carolyn, Arulogun, Oyedunni, Ogbole, Godwin, Adeoye, Abiodun M, Akinyemi, Joshua, Agunloye, Atinuke, Fakunle, Adekunle G, Uvere, Ezinne, Olalere, Abimbola, Adebajo, Olayinka J, Chen, Junshi, Clarke, Robert, Collins, Rory, Guo, Yu, Wang, Chen, Lv, Jun, Peto, Richard, Chen, Yiping, Fairhurst-Hunter, Zammy, Hill, Michael, Pozarickij, Alfred, Schmidt, Dan, Stevens, Becky, Turnbull, Iain, Yu, Canqing, Nagai, Akiko, Murakami, Yoishinori, Shiroma, Eric J, Sigurdsson, Sigurdur, Ghanbari, Mohsen, Boerwinkle, Eric, Fongang, Bernard, Wang, Ruiqi, Ikram, Mohammad K, Volker, Uwe, de Laat, Karlijn F, van Norden, Anouk GW, de Kort, Paul L, Vermeer, Sarah E, Brouwers, Paul JAM, Gons, Rob AR, den Heijer, Tom, van Dijk, Gert W, van Rooij, Frank GW, Aamodt, Anne H, Skogholt, Anne H, Willer, Cristen J, Heuch, Ingrid, Hagen, Knut, Fritsche, Lars G, Pedersen, Linda M, Ellekjaer, Hanne, Zhou, Wei, Martinsen, Amy E, Kristoffersen, Espen S, Thomas, Laurent F, Kleinschnitz, Christoph, Frantz, Stefan, Ungethum, Kathrin, Gallego-Fabrega, Cristina, Lledos, Miquel, Llucia-Carol, Laia, Sobrino, Tomas, Campos, Francisco, Castillo, Jose, Freijo, Marimar, Arenillas, Juan Francisco, Obach, Victor, Alvarez-Sabin, Jose, Molina, Carlos A, Ribo, Marc, Munoz-Narbona, Lucia, Lopez-Cancio, Elena, Millan, Monica, Diaz-Navarro, Rosa, Vives-Bauza, Cristofol, Serrano-Heras, Gemma, Segura, Tomas, Dhar, Rajat, Delgado-Mederos, Raquel, Prats-Sanchez, Luis, Camps-Renom, Pol, Blay, Natalia, Sumoy, Lauro, Marti-Fabregas, Joan, Schnohr, Peter, Jensen, Gorm B, Benn, Marianne, Afzal, Shoaib, Kamstrup, Pia R, van Setten, Jessica, van der Laan, Sander W, Vonk, Jet MJ, Kim, Bong-Jo, Curtze, Sami, Tiainen, Marjaana, Kinnunen, Janne, Menon, Vilas, Sung, Yun Ju, Yang, Chengran, Saillour-Glenisson, Florence, Gravel, Simon, Millwood, Iona Y, Gieger, Christian, Ninomiya, Toshiharu, Grabe, Hans J, Jukema, J Wouter, Rissanen, Ina L, Strbian, Daniel, Kim, Young Jin, Chen, Pei-Hsin, Mayerhofer, Ernst, Howson, Joanna MM, Adams, Hieab, Wassertheil-Smoller, Sylvia, Christensen, Kaare, Ikram, Mohammad A, Rundek, Tatjana, Worrall, Bradford B, Lathrop, G Mark, Riaz, Moeen, Simonsick, Eleanor M, Korv, Janika, Franca, Paulo HC, Zand, Ramin, Prasad, Kameshwar, Frikke-Schmidt, Ruth, Liman, Thomas, Haeusler, Karl Georg, Ruigrok, Ynte M, Heuschmann, Peter Ulrich, Longstreth, WT, Jung, Keum Ji, Bastarache, Lisa, Pare, Guillaume, Damrauer, Scott M, Chasman, Daniel I, Rotter, Jerome I, Zwart, John-Anker, Niiranen, Teemu J, Fornage, Myriam, Liaw, Yung-Po, Seshadri, Sudha, Fernandez-Cadenas, Israel, Walters, Robin G, Ruff, Christian T, Owolabi, Mayowa O, Huffman, Jennifer E, Milani, Lili, Kamatani, Yoichiro, Dichgans, Martin, Debette, Stephanie, Mishra, Aniket, Malik, Rainer, Hachiya, Tsuyoshi, Jurgenson, Tuuli, Namba, Shinichi, Posner, Daniel C, Kamanu, Frederick K, Koido, Masaru, Le Grand, Quentin, Shi, Mingyang, He, Yunye, Georgakis, Marios K, Caro, Ilana, Krebs, Kristi, Liaw, Yi-Ching, Vaura, Felix C, Lin, Kuang, Winsvold, Bendik Slagsvold, Srinivasasainagendra, Vinodh, Parodi, Livia, Bae, Hee-Joon, Chauhan, Ganesh, Chong, Michael R, Tomppo, Liisa, Akinyemi, Rufus, Roshchupkin, Gennady V, Habib, Naomi, Jee, Yon Ho, Thomassen, Jesper Qvist, Abedi, Vida, Carcel-Marquez, Jara, Nygaard, Marianne, Leonard, Hampton L, Yang, Chaojie, Yonova-Doing, Ekaterina, Knol, Maria J, Lewis, Adam J, Judy, Renae L, Ago, Tetsuro, Amouyel, Philippe, Armstrong, Nicole D, Bakker, Mark K, Bartz, Traci M, Bennett, David A, Bis, Joshua C, Bordes, Constance, Borte, Sigrid, Cain, Anael, Ridker, Paul M, Cho, Kelly, Chen, Zhengming, Cruchaga, Carlos, Cole, John W, de Jager, Phil L, de Cid, Rafael, Endres, Matthias, Ferreira, Leslie E, Geerlings, Mirjam I, Gasca, Natalie C, Gudnason, Vilmundur, Hata, Jun, He, Jing, Heath, Alicia K, Ho, Yuk-Lam, Havulinna, Aki S, Hopewell, Jemma C, Hyacinth, Hyacinth I, Inouye, Michael, Jacob, Mina A, Jeon, Christina E, Jern, Christina, Kamouchi, Masahiro, Keene, Keith L, Kitazono, Takanari, Kittner, Steven J, Konuma, Takahiro, Kumar, Amit, Lacaze, Paul, Launer, Lenore J, Lee, Keon-Joo, Lepik, Kaido, Li, Jiang, Li, Liming, Manichaikul, Ani, Markus, Hugh S, Marston, Nicholas A, Meitinger, Thomas, Mitchell, Braxton D, Montellano, Felipe A, Morisaki, Takayuki, Mosley, Thomas H, Nalls, Mike A, Nordestgaard, Borge G, O'Donnell, Martin J, Okada, Yukinori, Onland-Moret, N Charlotte, Ovbiagele, Bruce, Peters, Annette, Psaty, Bruce M, Rich, Stephen S, Rosand, Jonathan, Sabatine, Marc S, Sacco, Ralph L, Saleheen, Danish, Sandset, Else Charlotte, Salomaa, Veikko, Sargurupremraj, Muralidharan, Sasaki, Makoto, Satizabal, Claudia L, Schmidt, Carsten O, Shimizu, Atsushi, Smith, Nicholas L, Sloane, Kelly L, Sutoh, Yoichi, Sun, Yan V, Tanno, Kozo, Tiedt, Steffen, Tatlisumak, Turgut, Torres-Aguila, Nuria P, Tiwari, Hemant K, Tregouet, David-Alexandre, Trompet, Stella, Tuladhar, Anil Man, Tybjaerg-Hansen, Anne, van Vugt, Marion, Vibo, Riina, Verma, Shefali S, Wiggins, Kerri L, Wennberg, Patrik, Woo, Daniel, Wilson, Peter WF, Xu, Huichun, Yang, Qiong, Yoon, Kyungheon, Lee, Jin-Moo, Cheng, Yu-Ching, Meschia, James F, Chen, Wei Min, Sale, Michele M, Zonderman, Alan B, Evans, Michele K, Wilson, James G, Correa, Adolfo, Traylor, Matthew, Lewis, Cathryn M, Carty, Cara L, Reiner, Alexander, Haessler, Jeffrey, Langefeld, Carl D, Gottesman, Rebecca F, Yaffe, Kristine, Liu, Yong Mei, Kooperberg, Charles, Lange, Leslie A, Furie, Karen L, Arnett, Donna K, Benavente, Oscar R, Grewal, Raji P, Peddareddygari, Leema Reddy, Hveem, Kristian, Lindstrom, Sara, Wang, Lu, Smith, Erin N, Gordon, William, van Hylckama Vlieg, Astrid, de Andrade, Mariza, Brody, Jennifer A, Pattee, Jack W, Brumpton, Ben M, Suchon, Pierre, Chen, Ming-Huei, Frazer, Kelly A, Turman, Constance, Germain, Marine, MacDonald, James, Braekkan, Sigrid K, Armasu, Sebastian M, Pankratz, Nathan, Jackson, Rebecca D, Nielsen, Jonas B, Giulianini, Franco, Puurunen, Marja K, Ibrahim, Manal, Heckbert, Susan R, Bammler, Theo K, McCauley, Bryan M, Taylor, Kent D, Pankow, James S, Reiner, Alexander P, Gabrielsen, Maiken E, Deleuze, Jean-Francois, O'Donnell, Chris J, Kim, Jihye, McKnight, Barbara, Kraft, Peter, Hansen, John-Bjarne, Rosendaal, Frits R, Heit, John A, Tang, Weihong, Morange, Pierre-Emmanuel, Johnson, Andrew D, Kabrhel, Christopher, van Dijk, Ewoud J, Koudstaal, Peter J, Luijckx, Gert-Jan, Nederkoorn, Paul J, van Oostenbrugge, Robert J, Visser, Marieke C, Wermer, Marieke JH, Kappelle, L Jaap, Esko, Tonu, Metspalu, Andres, Magi, Reedik, Nelis, Mari, Irvin, Marguerite R, de Leeuw, Frank-Erik, Levi, Christopher R, Maguire, Jane, Jimenez-Conde, Jordi, Sharma, Pankaj, Sudlow, Cathie LM, Rannikmae, Kristiina, Schmidt, Reinhold, Slowik, Agnieszka, Pera, Joanna, Thijs, Vincent NS, Lindgren, Arne G, Ilinca, Andreea, Melander, Olle, Engstrom, Gunnar, Rexrode, Kathryn M, Rothwell, Peter M, Stanne, Tara M, Johnson, Julie A, Danesh, John, Butterworth, Adam S, Heitsch, Laura, Boncoraglio, Giorgio B, Kubo, Michiaki, Pezzini, Alessandro, Rolfs, Arndt, Giese, Anne-Katrin, Weir, David, Ross, Owen A, Lemmons, Robin, Soderholm, Martin, Cushman, Mary, Jood, Katarina, McDonough, Caitrin W, Bell, Steven, Linkohr, Birgit, Lee, Tsong-Hai, Putaala, Jukka, Anderson, Christopher D, Lopez, Oscar L, Jian, Xueqiu, Schminke, Ulf, Cullell, Natalia, Delgado, Pilar, Ibanez, Laura, Krupinski, Jerzy, Lioutas, Vasileios, Matsuda, Koichi, Montaner, Joan, Muino, Elena, Roquer, Jaume, Sarnowski, Chloe, Sattar, Naveed, Sibolt, Gerli, Teumer, Alexander, Rutten-Jacobs, Loes, Kanai, Masahiro, Gretarsdottir, Solveig, Rost, Natalia S, Yusuf, Salim, Almgren, Peter, Ay, Hakan, Bevan, Steve, Brown, Robert D, Carrera, Caty, Buring, Julie E, Chen, Wei-Min, Cotlarciuc, Ioana, de Bakker, Paul IW, DeStefano, Anita L, den Hoed, Marcel, Duan, Qing, Engelter, Stefan T, Falcone, Guido J, Gustafsson, Stefan, Hassan, Ahamad, Holliday, Elizabeth G, Howard, George, Hsu, Fang-Chi, Ingelsson, Erik, Harris, Tamara B, Kissela, Brett M, Kleindorfer, Dawn O, Langenberg, Claudia, Lemmens, Robin, Leys, Didier, Lin, Wei-Yu, Lorentzen, Erik, Magnusson, Patrik K, McArdle, Patrick F, Pulit, Sara L, Rice, Kenneth, Sakaue, Saori, Sapkota, Bishwa R, Tanislav, Christian, Thorleifsson, Gudmar, Thorsteinsdottir, Unnur, Tzourio, Christophe, van Duijn, Cornelia M, Walters, Matthew, Wareham, Nicholas J, Amin, Najaf, Aparicio, Hugo J, Attia, John, Beiser, Alexa S, Berr, Claudine, Bustamante, Mariana, Caso, Valeria, Choi, Seung Hoan, Chowhan, Ayesha, Dartigues, Jean-Francois, Delavaran, Hossein, Dorr, Marcus, Ford, Ian, Gurpreet, Wander S, Hamsten, Anders, Hozawa, Atsushi, Ingelsson, Martin, Iwasaki, Motoki, Kaffashian, Sara, Kalra, Lalit, Kjartansson, Olafur, Kloss, Manja, Labovitz, Daniel L, Laurie, Cathy C, Li, Linxin, Lind, Lars, Lindgren, Cecilia M, Makoto, Hirata, Minegishi, Naoko, Morris, Andrew P, Muller-Nurasyid, Martina, Norrving, Bo, Ogishima, Soichi, Parati, Eugenio A, Pedersen, Nancy L, Perola, Markus, Jousilahti, Pekka, Pileggi, Silvana, Rabionet, Raquel, Riba-Llena, Iolanda, Ribases, Marta, Romero, Jose R, Rudd, Anthony G, Sarin, Antti-Pekka, Sarju, Ralhan, Satoh, Mamoru, Sawada, Norie, Sigurdsson, Asgeir, Smith, Albert, Stine, O Colin, Stott, David J, Strauch, Konstantin, Takai, Takako, Tanaka, Hideo, Touze, Emmanuel, Tsugane, Shoichiro, Uitterlinden, Andre G, Valdimarsson, Einar M, van der Lee, Sven J, Wakai, Kenji, Williams, Stephen R, Wolfe, Charles DA, Wong, Quenna, Yamaji, Taiki, Sanghera, Dharambir K, Stefansson, Kari, Martinez-Majander, Nicolas, Sobue, Kenji, Soriano-Tarraga, Carolina, Volzke, Henry, Akpa, Onoja, Sarfo, Fred S, Akpalu, Albert, Obiako, Reginald, Wahab, Kolawole, Osaigbovo, Godwin, Owolabi, Lukman, Komolafe, Morenikeji, Jenkins, Carolyn, Arulogun, Oyedunni, Ogbole, Godwin, Adeoye, Abiodun M, Akinyemi, Joshua, Agunloye, Atinuke, Fakunle, Adekunle G, Uvere, Ezinne, Olalere, Abimbola, Adebajo, Olayinka J, Chen, Junshi, Clarke, Robert, Collins, Rory, Guo, Yu, Wang, Chen, Lv, Jun, Peto, Richard, Chen, Yiping, Fairhurst-Hunter, Zammy, Hill, Michael, Pozarickij, Alfred, Schmidt, Dan, Stevens, Becky, Turnbull, Iain, Yu, Canqing, Nagai, Akiko, Murakami, Yoishinori, Shiroma, Eric J, Sigurdsson, Sigurdur, Ghanbari, Mohsen, Boerwinkle, Eric, Fongang, Bernard, Wang, Ruiqi, Ikram, Mohammad K, Volker, Uwe, de Laat, Karlijn F, van Norden, Anouk GW, de Kort, Paul L, Vermeer, Sarah E, Brouwers, Paul JAM, Gons, Rob AR, den Heijer, Tom, van Dijk, Gert W, van Rooij, Frank GW, Aamodt, Anne H, Skogholt, Anne H, Willer, Cristen J, Heuch, Ingrid, Hagen, Knut, Fritsche, Lars G, Pedersen, Linda M, Ellekjaer, Hanne, Zhou, Wei, Martinsen, Amy E, Kristoffersen, Espen S, Thomas, Laurent F, Kleinschnitz, Christoph, Frantz, Stefan, Ungethum, Kathrin, Gallego-Fabrega, Cristina, Lledos, Miquel, Llucia-Carol, Laia, Sobrino, Tomas, Campos, Francisco, Castillo, Jose, Freijo, Marimar, Arenillas, Juan Francisco, Obach, Victor, Alvarez-Sabin, Jose, Molina, Carlos A, Ribo, Marc, Munoz-Narbona, Lucia, Lopez-Cancio, Elena, Millan, Monica, Diaz-Navarro, Rosa, Vives-Bauza, Cristofol, Serrano-Heras, Gemma, Segura, Tomas, Dhar, Rajat, Delgado-Mederos, Raquel, Prats-Sanchez, Luis, Camps-Renom, Pol, Blay, Natalia, Sumoy, Lauro, Marti-Fabregas, Joan, Schnohr, Peter, Jensen, Gorm B, Benn, Marianne, Afzal, Shoaib, Kamstrup, Pia R, van Setten, Jessica, van der Laan, Sander W, Vonk, Jet MJ, Kim, Bong-Jo, Curtze, Sami, Tiainen, Marjaana, Kinnunen, Janne, Menon, Vilas, Sung, Yun Ju, Yang, Chengran, Saillour-Glenisson, Florence, Gravel, Simon, Millwood, Iona Y, Gieger, Christian, Ninomiya, Toshiharu, Grabe, Hans J, Jukema, J Wouter, Rissanen, Ina L, Strbian, Daniel, Kim, Young Jin, Chen, Pei-Hsin, Mayerhofer, Ernst, Howson, Joanna MM, Adams, Hieab, Wassertheil-Smoller, Sylvia, Christensen, Kaare, Ikram, Mohammad A, Rundek, Tatjana, Worrall, Bradford B, Lathrop, G Mark, Riaz, Moeen, Simonsick, Eleanor M, Korv, Janika, Franca, Paulo HC, Zand, Ramin, Prasad, Kameshwar, Frikke-Schmidt, Ruth, Liman, Thomas, Haeusler, Karl Georg, Ruigrok, Ynte M, Heuschmann, Peter Ulrich, Longstreth, WT, Jung, Keum Ji, Bastarache, Lisa, Pare, Guillaume, Damrauer, Scott M, Chasman, Daniel I, Rotter, Jerome I, Zwart, John-Anker, Niiranen, Teemu J, Fornage, Myriam, Liaw, Yung-Po, Seshadri, Sudha, Fernandez-Cadenas, Israel, Walters, Robin G, Ruff, Christian T, Owolabi, Mayowa O, Huffman, Jennifer E, Milani, Lili, Kamatani, Yoichiro, Dichgans, Martin, and Debette, Stephanie
Abstract: Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries.
Published: 2022

3. Carotid Stenosis and Recurrent Ischemic Stroke: A Post-Hoc Analysis of the POINT Trial.

Author: Yaghi, Shadi, Yaghi, Shadi, de Havenon, Adam, Rostanski, Sara, Kvernland, Alexandra, Mac Grory, Brian, Furie, Karen L, Kim, Anthony S, Easton, J Donald, Johnston, S Claiborne, Henninger, Nils, Yaghi, Shadi, Yaghi, Shadi, de Havenon, Adam, Rostanski, Sara, Kvernland, Alexandra, Mac Grory, Brian, Furie, Karen L, Kim, Anthony S, Easton, J Donald, Johnston, S Claiborne, and Henninger, Nils
Abstract: Background and purposeRandomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated with increased risk of ischemic stroke and whether the addition of clopidogrel to aspirin was associated with more benefit in patients with versus without carotid stenosis.MethodsThis is a post-hoc analysis of the POINT trial (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) that randomized patients with minor ischemic stroke or high-risk transient ischemic attack within 12 hours from last known normal to receive either clopidogrel plus aspirin or aspirin alone. The primary predictor was the presence of ≥50% stenosis in either cervical internal carotid artery. The primary outcome was ischemic stroke. We built Cox regression models to determine the association between carotid stenosis and ischemic stroke and whether the effect of clopidogrel was modified by ≥50% carotid stenosis.ResultsAmong 4881 patients enrolled POINT, 3941 patients met the inclusion criteria. In adjusted models, ≥50% carotid stenosis was associated with ischemic stroke risk (hazard ratio, 2.45 [95% CI, 1.68-3.57], P<0.001). The effect of clopidogrel (versus placebo) on ischemic stroke risk was not significantly different in patients with <50% carotid stenosis (adjusted hazard ratio, 0.68 [95% CI, 0.50-0.93], P=0.014) versus those with ≥50% carotid stenosis (adjusted hazard ratio, 0.88 [95% CI, 0.45-1.72], P=0.703), P value for interaction=0.573.ConclusionsThe presence of carotid stenosis was associated with increased risk of ischemic stroke during follow-up. The effect of added clopidogrel was not significantly different in patients with versus without carotid stenosis. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03354429.
Published: 2021

4. Segmentation of Cerebrovascular Pathologies in Stroke Patients with Spatial and Shape Priors

Author: Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory, Dalca, Adrian Vasile, Sridharan, Ramesh, Cloonan, Lisa, Fitzpatrick, Kaitlin M., Kanakis, Allison, Furie, Karen L., Rosand, Jonathan, Wu, Ona, Sabuncu, Mert, Rost, Natalia S., Golland, Polina, Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory, Dalca, Adrian Vasile, Sridharan, Ramesh, Cloonan, Lisa, Fitzpatrick, Kaitlin M., Kanakis, Allison, Furie, Karen L., Rosand, Jonathan, Wu, Ona, Sabuncu, Mert, Rost, Natalia S., and Golland, Polina
Abstract: We propose and demonstrate an inference algorithm for the automatic segmentation of cerebrovascular pathologies in clinical MR images of the brain. Identifying and differentiating pathologies is important for understanding the underlying mechanisms and clinical outcomes of cerebral ischemia. Manual delineation of separate pathologies is infeasible in large studies of stroke that include thousands of patients. Unlike normal brain tissues and structures, the location and shape of the lesions vary across patients, presenting serious challenges for prior-driven segmentation. Our generative model captures spatial patterns and intensity properties associated with different cerebrovascular pathologies in stroke patients. We demonstrate the resulting segmentation algorithm on clinical images of a stroke patient cohort., NIH (Grants 1K25EB013649-01, NAC-P41EB015902, U54-EB005149, NS082285, K23NS064052 and U01NS069208)
Published: 2020

5. Translational Stroke Research: Vision and Opportunities.

Author: Bosetti, Francesca, Bosetti, Francesca, Koenig, James I, Ayata, Cenk, Back, Stephen A, Becker, Kyra, Broderick, Joseph P, Carmichael, S Thomas, Cho, Sunghee, Cipolla, Marilyn J, Corbett, Dale, Corriveau, Roderick A, Cramer, Steven C, Ferguson, Adam R, Finklestein, Seth P, Ford, Byron D, Furie, Karen L, Hemmen, Thomas M, Iadecola, Costantino, Jakeman, Lyn B, Janis, Scott, Jauch, Edward C, Johnston, Karen C, Kochanek, Patrick M, Kohn, Harold, Lo, Eng H, Lyden, Patrick D, Mallard, Carina, McCullough, Louise D, McGavern, Linda M, Meschia, James F, Moy, Claudia S, Perez-Pinzon, Miguel A, Ramadan, Ipolia, Savitz, Sean I, Schwamm, Lee H, Steinberg, Gary K, Stenzel-Poore, Mary P, Tymianski, Michael, Warach, Steven, Wechsler, Lawrence R, Zhang, John H, Koroshetz, Walter, Bosetti, Francesca, Bosetti, Francesca, Koenig, James I, Ayata, Cenk, Back, Stephen A, Becker, Kyra, Broderick, Joseph P, Carmichael, S Thomas, Cho, Sunghee, Cipolla, Marilyn J, Corbett, Dale, Corriveau, Roderick A, Cramer, Steven C, Ferguson, Adam R, Finklestein, Seth P, Ford, Byron D, Furie, Karen L, Hemmen, Thomas M, Iadecola, Costantino, Jakeman, Lyn B, Janis, Scott, Jauch, Edward C, Johnston, Karen C, Kochanek, Patrick M, Kohn, Harold, Lo, Eng H, Lyden, Patrick D, Mallard, Carina, McCullough, Louise D, McGavern, Linda M, Meschia, James F, Moy, Claudia S, Perez-Pinzon, Miguel A, Ramadan, Ipolia, Savitz, Sean I, Schwamm, Lee H, Steinberg, Gary K, Stenzel-Poore, Mary P, Tymianski, Michael, Warach, Steven, Wechsler, Lawrence R, Zhang, John H, and Koroshetz, Walter
Published: 2017

6. Translational Stroke Research: Vision and Opportunities.

Author: Bosetti, Francesca, Bosetti, Francesca, Koenig, James I, Ayata, Cenk, Back, Stephen A, Becker, Kyra, Broderick, Joseph P, Carmichael, S Thomas, Cho, Sunghee, Cipolla, Marilyn J, Corbett, Dale, Corriveau, Roderick A, Cramer, Steven C, Ferguson, Adam R, Finklestein, Seth P, Ford, Byron D, Furie, Karen L, Hemmen, Thomas M, Iadecola, Costantino, Jakeman, Lyn B, Janis, Scott, Jauch, Edward C, Johnston, Karen C, Kochanek, Patrick M, Kohn, Harold, Lo, Eng H, Lyden, Patrick D, Mallard, Carina, McCullough, Louise D, McGavern, Linda M, Meschia, James F, Moy, Claudia S, Perez-Pinzon, Miguel A, Ramadan, Ipolia, Savitz, Sean I, Schwamm, Lee H, Steinberg, Gary K, Stenzel-Poore, Mary P, Tymianski, Michael, Warach, Steven, Wechsler, Lawrence R, Zhang, John H, Koroshetz, Walter, Bosetti, Francesca, Bosetti, Francesca, Koenig, James I, Ayata, Cenk, Back, Stephen A, Becker, Kyra, Broderick, Joseph P, Carmichael, S Thomas, Cho, Sunghee, Cipolla, Marilyn J, Corbett, Dale, Corriveau, Roderick A, Cramer, Steven C, Ferguson, Adam R, Finklestein, Seth P, Ford, Byron D, Furie, Karen L, Hemmen, Thomas M, Iadecola, Costantino, Jakeman, Lyn B, Janis, Scott, Jauch, Edward C, Johnston, Karen C, Kochanek, Patrick M, Kohn, Harold, Lo, Eng H, Lyden, Patrick D, Mallard, Carina, McCullough, Louise D, McGavern, Linda M, Meschia, James F, Moy, Claudia S, Perez-Pinzon, Miguel A, Ramadan, Ipolia, Savitz, Sean I, Schwamm, Lee H, Steinberg, Gary K, Stenzel-Poore, Mary P, Tymianski, Michael, Warach, Steven, Wechsler, Lawrence R, Zhang, John H, and Koroshetz, Walter
Published: 2017

7. Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.

Author: Gorelick, Philip B, Gorelick, Philip B, Furie, Karen L, Iadecola, Costantino, Smith, Eric E, Waddy, Salina P, Lloyd-Jones, Donald M, Bae, Hee-Joon, Bauman, Mary Ann, Dichgans, Martin, Duncan, Pamela W, Girgus, Meighan, Howard, Virginia J, Lazar, Ronald M, Seshadri, Sudha, Testai, Fernando D, van Gaal, Stephen, Yaffe, Kristine, Wasiak, Hank, Zerna, Charlotte, American Heart Association/American Stroke Association, Gorelick, Philip B, Gorelick, Philip B, Furie, Karen L, Iadecola, Costantino, Smith, Eric E, Waddy, Salina P, Lloyd-Jones, Donald M, Bae, Hee-Joon, Bauman, Mary Ann, Dichgans, Martin, Duncan, Pamela W, Girgus, Meighan, Howard, Virginia J, Lazar, Ronald M, Seshadri, Sudha, Testai, Fernando D, van Gaal, Stephen, Yaffe, Kristine, Wasiak, Hank, Zerna, Charlotte, and American Heart Association/American Stroke Association
Abstract: Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA's Life's Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index <25 kg/m2) and 3 ideal health factors (untreated blood pressure <120/<80 mm Hg, untreated total cholesterol <200 mg/dL, and fasting blood glucose <100 mg/dL). In addition, in relation to maintenance of cognitive health, we recommend following previously published guidance from the AHA/American Stroke Association, Institute of Medicine, and Alzheimer's Association that incorporates control of cardiovascular risks and suggest social engagement and other related strategies. We define optimal brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA's Life's Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to ca
Published: 2017

8. Segmentation of Cerebrovascular Pathologies in Stroke Patients with Spatial and Shape Priors

Author: Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science, Dalca, Adrian Vasile, Sridharan, Ramesh, Golland, Polina, Cloonan, Lisa, Fitzpatrick, Kaitlin M., Kanakis, Allison, Furie, Karen L., Rosand, Jonathan, Wu, Ona, Sabuncu, Mert, Rost, Natalia S., Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science, Dalca, Adrian Vasile, Sridharan, Ramesh, Golland, Polina, Cloonan, Lisa, Fitzpatrick, Kaitlin M., Kanakis, Allison, Furie, Karen L., Rosand, Jonathan, Wu, Ona, Sabuncu, Mert, and Rost, Natalia S.
Abstract: We propose and demonstrate an inference algorithm for the automatic segmentation of cerebrovascular pathologies in clinical MR images of the brain. Identifying and differentiating pathologies is important for understanding the underlying mechanisms and clinical outcomes of cerebral ischemia. Manual delineation of separate pathologies is infeasible in large studies of stroke that include thousands of patients. Unlike normal brain tissues and structures, the location and shape of the lesions vary across patients, presenting serious challenges for prior-driven segmentation. Our generative model captures spatial patterns and intensity properties associated with different cerebrovascular pathologies in stroke patients. We demonstrate the resulting segmentation algorithm on clinical images of a stroke patient cohort., Natural Sciences and Engineering Research Council of Canada (Canada Graduate Scholarships-Doctoral), National Science Foundation (U.S.). Graduate Research Fellowship, National Institutes of Health (U.S.) (National Institute for Biomedical Imaging and Bioengineering (U.S.) 1K25EB013649-01), BrightFocus Foundation (Grant AHAF-A201233), National Institutes of Health (U.S.) (National Institute for Biomedical Imaging and Bioengineering (U.S.)/Neuroimaging Analysis Center (U.S.) P41EB015902), National Institutes of Health (U.S.) (National Institute for Biomedical Imaging and Bioengineering (U.S.)/National Alliance for Medical Image Computing (U.S.) U54-EB005149), National Institutes of Health (U.S.) (National Institute of Neurological Disorders and Stroke (U.S.) NS082285), National Institutes of Health (U.S.) (National Institute of Neurological Disorders and Stroke (U.S.) K23NS064052), National Institutes of Health (U.S.) (National Institute of Neurological Disorders and Stroke (U.S.) U01NS06920), American Stroke Association (Bugher Foundation Centers for Stroke Prevention Research)
Published: 2015

9. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

Author: Bushnell, Cheryl, Bushnell, Cheryl, McCullough, Louise D, Awad, Issam A, Chireau, Monique V, Fedder, Wende N, Furie, Karen L, Howard, Virginia J, Lichtman, Judith H, Lisabeth, Lynda D, Piña, Ileana L, Reeves, Mathew J, Rexrode, Kathryn M, Saposnik, Gustavo, Singh, Vineeta, Towfighi, Amytis, Vaccarino, Viola, Walters, Matthew R, American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council for High Blood Pressure Research, Bushnell, Cheryl, Bushnell, Cheryl, McCullough, Louise D, Awad, Issam A, Chireau, Monique V, Fedder, Wende N, Furie, Karen L, Howard, Virginia J, Lichtman, Judith H, Lisabeth, Lynda D, Piña, Ileana L, Reeves, Mathew J, Rexrode, Kathryn M, Saposnik, Gustavo, Singh, Vineeta, Towfighi, Amytis, Vaccarino, Viola, Walters, Matthew R, American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research
Abstract: PurposeThe aim of this statement is to summarize data on stroke risk factors that are unique to and more common in women than men and to expand on the data provided in prior stroke guidelines and cardiovascular prevention guidelines for women. This guideline focuses on the risk factors unique to women, such as reproductive factors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial fibrillation.MethodsWriting group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through May 15, 2013. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA Stroke Council methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee.ResultsWe provide current evidence, research gaps, and recommendations on risk of stroke related to preeclampsia, oral contraceptives, menopause, and hormone replacement, as well as those risk factors more common in women, such as obesity/metabolic syndrome, atrial fibrillation, and migraine with aura.ConclusionsTo more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted.
Published: 2014

10. World Stroke Organization Global Stroke Services Guidelines and Action Plan

Author: Lindsay, Patrice, Furie, Karen L., Davis, Stephen M., Donnan, Geoffrey A., Norrving, Bo, Lindsay, Patrice, Furie, Karen L., Davis, Stephen M., Donnan, Geoffrey A., and Norrving, Bo
Abstract: Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models. At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them. This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done, parti
Published: 2014

11. Statin Therapy and Outcome After Ischemic Stroke : Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

Author: Chróinín, Danielle Ní, Asplund, Kjell, Åsberg, Signild, Callaly, Elizabeth, Cuadrado-Godia, Elisa, Diez-Tejedor, Exuperio, Di Napoli, Mario, Engelter, Stefan T., Furie, Karen L., Giannopoulos, Sotirios, Gotto, Antonio M., Jr., Hannon, Niamh, Jonsson, Fredrik, Kapral, Moira K., Martí-Fàbregas, Joan, Martínez-Sánchez, Patricia, Milionis, Haralampos J., Montaner, Joan, Muscari, Antonio, Pikija, Slaven, Probstfield, Jeffrey, Rost, Natalia S., Thrift, Amanda G., Vemmos, Konstantinos, Kelly, Peter J., Chróinín, Danielle Ní, Asplund, Kjell, Åsberg, Signild, Callaly, Elizabeth, Cuadrado-Godia, Elisa, Diez-Tejedor, Exuperio, Di Napoli, Mario, Engelter, Stefan T., Furie, Karen L., Giannopoulos, Sotirios, Gotto, Antonio M., Jr., Hannon, Niamh, Jonsson, Fredrik, Kapral, Moira K., Martí-Fàbregas, Joan, Martínez-Sánchez, Patricia, Milionis, Haralampos J., Montaner, Joan, Muscari, Antonio, Pikija, Slaven, Probstfield, Jeffrey, Rost, Natalia S., Thrift, Amanda G., Vemmos, Konstantinos, and Kelly, Peter J.
Abstract: Background and Purpose: Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. Methods: The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (≤72 hours after stroke), and (2) thrombolysis-treated patients. Results: The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29–1.56; P<0.001), but not 1 year (OR, 1.12; 95% CI, 0.9–1.4; P=0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62–0.82; P<0.001) and 1 year (OR, 0.80; 95% CI, 0.67–0.95; P=0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0–2.24; P=0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials (P=0.9). In studies restricted to of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02–1.52; P=0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90–1.44; 4012 patients). Conclusion: In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute i
Published: 2013
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12. Statin Therapy and Outcome After Ischemic Stroke : Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

Author: Chroinin, Danielle Ni, Asplund, Kjell, Asberg, Signild, Callaly, Elizabeth, Cuadrado-Godia, Elisa, Diez-Tejedor, Exuperio, Di Napoli, Mario, Engelter, Stefan T., Furie, Karen L., Giannopoulos, Sotirios, Gotto, Antonio M., Jr., Hannon, Niamh, Jonsson, Fredrik, Kapral, Moira K., Marti-Fabregas, Joan, Martinez-Sanchez, Patricia, Milionis, Haralampos J., Montaner, Joan, Muscari, Antonio, Pikija, Slaven, Probstfield, Jeffrey, Rost, Natalia S., Thrift, Amanda G., Vemmos, Konstantinos, Kelly, Peter J., Chroinin, Danielle Ni, Asplund, Kjell, Asberg, Signild, Callaly, Elizabeth, Cuadrado-Godia, Elisa, Diez-Tejedor, Exuperio, Di Napoli, Mario, Engelter, Stefan T., Furie, Karen L., Giannopoulos, Sotirios, Gotto, Antonio M., Jr., Hannon, Niamh, Jonsson, Fredrik, Kapral, Moira K., Marti-Fabregas, Joan, Martinez-Sanchez, Patricia, Milionis, Haralampos J., Montaner, Joan, Muscari, Antonio, Pikija, Slaven, Probstfield, Jeffrey, Rost, Natalia S., Thrift, Amanda G., Vemmos, Konstantinos, and Kelly, Peter J.
Abstract: Background and Purpose-Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. Methods-The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (<= 72 hours after stroke), and (2) thrombolysis-treated patients. Results-The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29-1.56; P<0.001), but not 1 year (OR, 1.12; 95% CI, 0.9-1.4; P=0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62-0.82; P<0.001) and 1 year (OR, 0.80;95% CI, 0.67-0.95; P=0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0-2.24; P=0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials (P=0.9). In studies restricted to of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02-1.52; P=0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90-1.44; 4012 patients). Conclusion-In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute i
Published: 2013
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13. Ischemic stroke is associated with the ABO locus : the EuroCLOT study

Author: Williams, Frances M. K., Carter, Angela M., Hysi, Pirro G., Surdulescu, Gabriela, Hodgkiss, Dylan, Soranzo, Nicole, Traylor, Matthew, Bevan, Steve, Dichgans, Martin, Rothwell, Peter M. W., Sudlow, Cathie, Farrall, Martin, Silander, Kaisa, Kaunisto, Mari, Wagner, Peter, Saarela, Olli, Kuulasmaa, Kari, Virtamo, Jarmo, Salomaa, Veikko, Amouyel, Philippe, Arveiler, Dominique, Ferrieres, Jean, Wiklund, Per-Gunnar, Ikram, M. Arfan, Hofman, Albert, Boncoraglio, Giorgio B., Parati, Eugenio A., Helgadottir, Anna, Gretarsdottir, Solveig, Thorsteinsdottir, Unnur, Thorleifsson, Gudmar, Stefansson, Kari, Seshadri, Sudha, DeStefano, Anita, Gschwendtner, Andreas, Psaty, Bruce, Longstreth, Will, Mitchell, Braxton D., Cheng, Yu-Ching, Clarke, Robert, Ferrario, Marco, Bis, Joshua C., Levi, Christopher, Attia, John, Holliday, Elizabeth G., Scott, Rodney J., Fornage, Myriam, Sharma, Pankaj, Furie, Karen L., Rosand, Jonathan, Nalls, Mike, Meschia, James, Mosely, Thomas H., Evans, Alun, Palotie, Aarno, Markus, Hugh S., Grant, Peter J., Spector, Tim D., Williams, Frances M. K., Carter, Angela M., Hysi, Pirro G., Surdulescu, Gabriela, Hodgkiss, Dylan, Soranzo, Nicole, Traylor, Matthew, Bevan, Steve, Dichgans, Martin, Rothwell, Peter M. W., Sudlow, Cathie, Farrall, Martin, Silander, Kaisa, Kaunisto, Mari, Wagner, Peter, Saarela, Olli, Kuulasmaa, Kari, Virtamo, Jarmo, Salomaa, Veikko, Amouyel, Philippe, Arveiler, Dominique, Ferrieres, Jean, Wiklund, Per-Gunnar, Ikram, M. Arfan, Hofman, Albert, Boncoraglio, Giorgio B., Parati, Eugenio A., Helgadottir, Anna, Gretarsdottir, Solveig, Thorsteinsdottir, Unnur, Thorleifsson, Gudmar, Stefansson, Kari, Seshadri, Sudha, DeStefano, Anita, Gschwendtner, Andreas, Psaty, Bruce, Longstreth, Will, Mitchell, Braxton D., Cheng, Yu-Ching, Clarke, Robert, Ferrario, Marco, Bis, Joshua C., Levi, Christopher, Attia, John, Holliday, Elizabeth G., Scott, Rodney J., Fornage, Myriam, Sharma, Pankaj, Furie, Karen L., Rosand, Jonathan, Nalls, Mike, Meschia, James, Mosely, Thomas H., Evans, Alun, Palotie, Aarno, Markus, Hugh S., Grant, Peter J., and Spector, Tim D.
Abstract: Objective: End-stage coagulation and the structure/function of fibrin are implicated in the pathogenesis of ischemic stroke. We explored whether genetic variants associated with end-stage coagulation in healthy volunteers account for the genetic predisposition to ischemic stroke and examined their influence on stroke subtype. Methods: Common genetic variants identified through genome-wide association studies of coagulation factors and fibrin structure/function in healthy twins (n = 2,100, Stage 1) were examined in ischemic stroke (n = 4,200 cases) using 2 independent samples of European ancestry (Stage 2). A third clinical collection having stroke subtyping (total 8,900 cases, 55,000 controls) was used for replication (Stage 3). Results: Stage 1 identified 524 single nucleotide polymorphisms (SNPs) from 23 linkage disequilibrium blocks having significant association (p < 5 x 10(-8)) with 1 or more coagulation/fibrin phenotypes. The most striking associations included SNP rs5985 with factor XIII activity (p = 2.6 x 10(-186)), rs10665 with FVII (p = 2.4 x 10(-47)), and rs505922 in the ABO gene with both von Willebrand factor (p = 4.7 x 10(-57)) and factor VIII (p = 1.2 x 10(-36)). In Stage 2, the 23 independent SNPs were examined in stroke cases/noncases using MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Wellcome Trust Case Control Consortium 2 collections. SNP rs505922 was nominally associated with ischemic stroke (odds ratio = 0.94, 95% confidence interval = 0.88-0.99, p = 0.023). Independent replication in Meta-Stroke confirmed the rs505922 association with stroke, beta (standard error, SE) = 0.066 (0.02), p = 0.001, a finding specific to large-vessel and cardioembolic stroke (p = 0.001 and p = < 0.001, respectively) but not seen with small-vessel stroke (p = 0.811). Interpretation: ABO gene variants are associated with large-vessel and cardioembolic stroke but not small-vessel disease. This work sheds light on the different pathogenic mechanis, Errata Annals of Neurology, 2014: 75 (1), 166-167. doi:10.1002/ana.24105
Published: 2013
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14. Good outcome rate of 35% in IV-tPA-treated patients with computed tomography angiography confirmed severe anterior circulation occlusive stroke.

Author: González, R Gilberto, González, R Gilberto, Furie, Karen L, Goldmacher, Gregory V, Smith, Wade S, Kamalian, Shervin, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, Lev, Michael H, González, R Gilberto, González, R Gilberto, Furie, Karen L, Goldmacher, Gregory V, Smith, Wade S, Kamalian, Shervin, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, and Lev, Michael H
Abstract: Background and purposeTo determine the effect of intravenous tissue plasminogen activator (IV-tPA) on outcomes in patients with severe major anterior circulation ischemic stroke.MethodsProspectively, 649 patients with acute stroke had admission National Institutes of Health stroke scale (NIHSS) scores, noncontrast computed tomography (CT), CT angiography (CTA), and 6-month outcome assessed using modified Rankin scale. IV-tPA treatment decisions were made before CTA, at the time of noncontrast CT scanning, as per routine clinical protocol. Severe symptoms were defined as NIHSS>10. Poor outcome was defined as modified Rankin scale >2. Major occlusions were identified on CTA. Univariate and multivariate stepwise-forward logistic regression analyses of the full cohort were performed.ResultsOf 649 patients, 188 (29%) patients presented with NIHSS>10, and 64 out of 188 (34%) patients received IV-tPA. Admission NIHSS, large artery occlusion, and IV-tPA all independently predicted good outcomes; however, a significant interaction existed between IV-tPA and occlusion (P<0.001). Of the patients who presented with NIHSS>10 with anterior circulation occlusion, twice the percentage had good outcomes if they received IV-tPA (17 out of 49 patients, 35%) than if they did not (13 out of 77 patients, 17%; P=0.031). The number needed to treat was 7 (95% confidence interval, 3-60).ConclusionsIV-tPA treatment resulted in significantly better outcomes in patients with severely symptomatic stroke with major anterior circulation occlusions. The 35% good outcome rate was similar to rates found in endovascular therapy trials. Vascular imaging may help in patient selection and stratification for trials of IV-thrombolytic and endovascular therapies.
Published: 2013

15. Improved outcome prediction using CT angiography in addition to standard ischemic stroke assessment: results from the STOPStroke study.

Author: González, R Gilberto, González, R Gilberto, Lev, Michael H, Goldmacher, Gregory V, Smith, Wade S, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, Furie, Karen L, González, R Gilberto, González, R Gilberto, Lev, Michael H, Goldmacher, Gregory V, Smith, Wade S, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, and Furie, Karen L
Abstract: PurposeTo improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA).MethodsIn a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as "major" by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was ≤7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores >10.ResultsOf 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p<0.0001). Combining NIHSS with BASIS was highly predictive: 77.6% (114/147) classified as NIHSS>10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS≤10/BASIS- (p<0.0001), regardless of treatment. The odds ratios for poor outcome is 12.6 (95% CI: 7.9 to 20.0) in patients who are NIHSS>10/BASIS+ compared to patients who are NIHSS≤10/BASIS-; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+.ConclusionsBASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment.
Published: 2012

16. Improved outcome prediction using CT angiography in addition to standard ischemic stroke assessment: results from the STOPStroke study.

Author: González, R Gilberto, Kiechl, Stefan1, González, R Gilberto, Lev, Michael H, Goldmacher, Gregory V, Smith, Wade S, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, Furie, Karen L, González, R Gilberto, Kiechl, Stefan1, González, R Gilberto, Lev, Michael H, Goldmacher, Gregory V, Smith, Wade S, Payabvash, Seyedmehdi, Harris, Gordon J, Halpern, Elkan F, Koroshetz, Walter J, Camargo, Erica CS, Dillon, William P, and Furie, Karen L
Abstract: PurposeTo improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA).MethodsIn a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as "major" by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was ≤7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores >10.ResultsOf 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p<0.0001). Combining NIHSS with BASIS was highly predictive: 77.6% (114/147) classified as NIHSS>10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS≤10/BASIS- (p<0.0001), regardless of treatment. The odds ratios for poor outcome is 12.6 (95% CI: 7.9 to 20.0) in patients who are NIHSS>10/BASIS+ compared to patients who are NIHSS≤10/BASIS-; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+.ConclusionsBASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment.
Published: 2012

17. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Stroke Synergium, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, and Stroke Synergium
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized
Published: 2010

18. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, and Tuomilehto, Jaakko
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by seven working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralize
Published: 2010

19. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, and Tuomilehto, Jaakko
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent "silo" mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized el
Published: 2010

20. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Stroke Synergium, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, and Stroke Synergium
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized
Published: 2010

21. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, and Tuomilehto, Jaakko
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent "silo" mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized el
Published: 2010

22. Stroke: working toward a prioritized world agenda.

Author: Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, Tuomilehto, Jaakko, Hachinski, Vladimir, Hachinski, Vladimir, Donnan, Geoffrey A, Gorelick, Philip B, Hacke, Werner, Cramer, Steven C, Kaste, Markku, Fisher, Marc, Brainin, Michael, Buchan, Alastair M, Lo, Eng H, Skolnick, Brett E, Furie, Karen L, Hankey, Graeme J, Kivipelto, Miia, Morris, John, Rothwell, Peter M, Sacco, Ralph L, Smith, Sidney C, Wang, Yulun, Bryer, Alan, Ford, Gary A, Iadecola, Costantino, Martins, Sheila CO, Saver, Jeff, Skvortsova, Veronika, Bayley, Mark, Bednar, Martin M, Duncan, Pamela, Enney, Lori, Finklestein, Seth, Jones, Theresa A, Kalra, Lalit, Kleim, Jeff, Nitkin, Ralph, Teasell, Robert, Weiller, Cornelius, Desai, Bhupat, Goldberg, Mark P, Heiss, Wolf-Dieter, Saarelma, Osmo, Schwamm, Lee H, Shinohara, Yukito, Trivedi, Bhargava, Wahlgren, Nils, Wong, Lawrence K, Hakim, Antoine, Norrving, Bo, Prudhomme, Stephen, Bornstein, Natan M, Davis, Stephen M, Goldstein, Larry B, Leys, Didier, and Tuomilehto, Jaakko
Abstract: Background and purposeThe aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke.MethodsPreliminary work was performed by seven working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium.ResultsRecommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralize
Published: 2010

23. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study.

Author: Cramer, Steven C, Cramer, Steven C, Rordorf, Guy, Maki, Jeffrey H, Kramer, Larry A, Grotta, James C, Burgin, W Scott, Hinchey, Judith A, Benesch, Curtis, Furie, Karen L, Lutsep, Helmi L, Kelly, Ellen, Longstreth, WT, Cramer, Steven C, Cramer, Steven C, Rordorf, Guy, Maki, Jeffrey H, Kramer, Larry A, Grotta, James C, Burgin, W Scott, Hinchey, Judith A, Benesch, Curtis, Furie, Karen L, Lutsep, Helmi L, Kelly, Ellen, and Longstreth, WT
Abstract: Cryptogenic stroke is associated with an increased prevalence of patent foramen ovale. The Paradoxical Emboli From Large Veins in Ischemic Stroke (PELVIS) study hypothesized that patients with cryptogenic stroke have an increased prevalence of pelvic deep venous thrombosis (DVT).At 5 sites, patients 18 to 60 years of age received an MRI venogram (MRV) of the pelvis within 72 hours of new symptom onset. Clinical data were then determined. Radiologists blinded to clinical data later read the scans.The 95 patients who met entry criteria were scanned. Their mean+/-SD age was 46+/-10 years, and time from stroke onset to pelvic MRV scan was 49+/-16 hours. Compared with those with stroke of determined origin (n=49), patients with cryptogenic stroke (n=46) were significantly younger, had a higher prevalence of patent foramen ovale (61% versus 19%), and had less atherosclerosis risk factors. Cryptogenic patients had more MRV scans with a high probability for pelvic DVT (20%) than patients with stroke of determined origin (4%, P<0.03), with most having an appearance of a chronic DVT.In this study of young stroke patients evaluated early after stroke, patients with cryptogenic stroke showed differences in several clinical features compared with patients with stroke of determined origin, including increased prevalence of pelvic DVT. The results require confirmation but suggest that paradoxical embolus from the pelvic veins may be the cause of stroke in a subset of patients classified as having cryptogenic stroke.
Published: 2004

24. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study.

Author: Cramer, Steven C, Cramer, Steven C, Rordorf, Guy, Maki, Jeffrey H, Kramer, Larry A, Grotta, James C, Burgin, W Scott, Hinchey, Judith A, Benesch, Curtis, Furie, Karen L, Lutsep, Helmi L, Kelly, Ellen, Longstreth, WT, Cramer, Steven C, Cramer, Steven C, Rordorf, Guy, Maki, Jeffrey H, Kramer, Larry A, Grotta, James C, Burgin, W Scott, Hinchey, Judith A, Benesch, Curtis, Furie, Karen L, Lutsep, Helmi L, Kelly, Ellen, and Longstreth, WT
Abstract: Cryptogenic stroke is associated with an increased prevalence of patent foramen ovale. The Paradoxical Emboli From Large Veins in Ischemic Stroke (PELVIS) study hypothesized that patients with cryptogenic stroke have an increased prevalence of pelvic deep venous thrombosis (DVT).At 5 sites, patients 18 to 60 years of age received an MRI venogram (MRV) of the pelvis within 72 hours of new symptom onset. Clinical data were then determined. Radiologists blinded to clinical data later read the scans.The 95 patients who met entry criteria were scanned. Their mean+/-SD age was 46+/-10 years, and time from stroke onset to pelvic MRV scan was 49+/-16 hours. Compared with those with stroke of determined origin (n=49), patients with cryptogenic stroke (n=46) were significantly younger, had a higher prevalence of patent foramen ovale (61% versus 19%), and had less atherosclerosis risk factors. Cryptogenic patients had more MRV scans with a high probability for pelvic DVT (20%) than patients with stroke of determined origin (4%, P<0.03), with most having an appearance of a chronic DVT.In this study of young stroke patients evaluated early after stroke, patients with cryptogenic stroke showed differences in several clinical features compared with patients with stroke of determined origin, including increased prevalence of pelvic DVT. The results require confirmation but suggest that paradoxical embolus from the pelvic veins may be the cause of stroke in a subset of patients classified as having cryptogenic stroke.
Published: 2004

25. Genome-wide meta-analysis of cerebral white matter hyperintensities in patients with stroke

Author: Traylor, Matthew, Zhang, Cathy R., Adib-Samii, Poneh, Devan, William J., Parsons, Owen E., Lanfranconi, Silvia, Gregory, Sarah, Cloonan, Lisa, Falcone, Guido J., Radmanesh, Farid, Fitzpatrick, Kaitlin, Kanakis, Allison, Barrick, Thomas R., Moynihan, Barry, Lewis, Cathryn M., Boncoraglio, Giorgio B., Lemmens, Robin, Thijs, Vincent, Sudlow, Cathie, Wardlaw, Joanna, Rothwell, Peter M., Meschia, James F., Worrall, Bradford B., Levi, Christopher, Bevan, Steve, Furie, Karen L., Dichgans, Martin, Rosand, Jonathan, Markus, Hugh S., Rost, Natalia, Traylor, Matthew, Zhang, Cathy R., Adib-Samii, Poneh, Devan, William J., Parsons, Owen E., Lanfranconi, Silvia, Gregory, Sarah, Cloonan, Lisa, Falcone, Guido J., Radmanesh, Farid, Fitzpatrick, Kaitlin, Kanakis, Allison, Barrick, Thomas R., Moynihan, Barry, Lewis, Cathryn M., Boncoraglio, Giorgio B., Lemmens, Robin, Thijs, Vincent, Sudlow, Cathie, Wardlaw, Joanna, Rothwell, Peter M., Meschia, James F., Worrall, Bradford B., Levi, Christopher, Bevan, Steve, Furie, Karen L., Dichgans, Martin, Rosand, Jonathan, Markus, Hugh S., and Rost, Natalia
Abstract: OBJECTIVE: For 3,670 stroke patients from the United Kingdom, United States, Australia, Belgium, and Italy, we performed a genome-wide meta-analysis of white matter hyperintensity volumes (WMHV) on data imputed to the 1000 Genomes reference dataset to provide insights into disease mechanisms. METHODS: We first sought to identify genetic associations with white matter hyperintensities in a stroke population, and then examined whether genetic loci previously linked to WMHV in community populations are also associated in stroke patients. Having established that genetic associations are shared between the 2 populations, we performed a meta-analysis testing which associations with WMHV in stroke-free populations are associated overall when combined with stroke populations. RESULTS: There were no associations at genome-wide significance with WMHV in stroke patients. All previously reported genome-wide significant associations with WMHV in community populations shared direction of effect in stroke patients. In a meta-analysis of the genome-wide significant and suggestive loci (p < 5 × 10(-6)) from community populations (15 single nucleotide polymorphisms in total) and from stroke patients, 6 independent loci were associated with WMHV in both populations. Four of these are novel associations at the genome-wide level (rs72934505 [NBEAL1], p = 2.2 × 10(-8); rs941898 [EVL], p = 4.0 × 10(-8); rs962888 [C1QL1], p = 1.1 × 10(-8); rs9515201 [COL4A2], p = 6.9 × 10(-9)). CONCLUSIONS: Genetic associations with WMHV are shared in otherwise healthy individuals and patients with stroke, indicating common genetic susceptibility in cerebral small vessel disease.

26. Genome-wide meta-analysis of cerebral white matter hyperintensities in patients with stroke

Author: Traylor, Matthew, Zhang, Cathy R., Adib-Samii, Poneh, Devan, William J., Parsons, Owen E., Lanfranconi, Silvia, Gregory, Sarah, Cloonan, Lisa, Falcone, Guido J., Radmanesh, Farid, Fitzpatrick, Kaitlin, Kanakis, Allison, Barrick, Thomas R., Moynihan, Barry, Lewis, Cathryn M., Boncoraglio, Giorgio B., Lemmens, Robin, Thijs, Vincent, Sudlow, Cathie, Wardlaw, Joanna, Rothwell, Peter M., Meschia, James F., Worrall, Bradford B., Levi, Christopher, Bevan, Steve, Furie, Karen L., Dichgans, Martin, Rosand, Jonathan, Markus, Hugh S., Rost, Natalia, Traylor, Matthew, Zhang, Cathy R., Adib-Samii, Poneh, Devan, William J., Parsons, Owen E., Lanfranconi, Silvia, Gregory, Sarah, Cloonan, Lisa, Falcone, Guido J., Radmanesh, Farid, Fitzpatrick, Kaitlin, Kanakis, Allison, Barrick, Thomas R., Moynihan, Barry, Lewis, Cathryn M., Boncoraglio, Giorgio B., Lemmens, Robin, Thijs, Vincent, Sudlow, Cathie, Wardlaw, Joanna, Rothwell, Peter M., Meschia, James F., Worrall, Bradford B., Levi, Christopher, Bevan, Steve, Furie, Karen L., Dichgans, Martin, Rosand, Jonathan, Markus, Hugh S., and Rost, Natalia
Abstract: OBJECTIVE For 3,670 stroke patients from the United Kingdom, United States, Australia, Belgium, and Italy, we performed a genome-wide meta-analysis of white matter hyperintensity volumes (WMHV) on data imputed to the 1000 Genomes reference dataset to provide insights into disease mechanisms. METHODS We first sought to identify genetic associations with white matter hyperintensities in a stroke population, and then examined whether genetic loci previously linked to WMHV in community populations are also associated in stroke patients. Having established that genetic associations are shared between the 2 populations, we performed a meta-analysis testing which associations with WMHV in stroke-free populations are associated overall when combined with stroke populations. RESULTS There were no associations at genome-wide significance with WMHV in stroke patients. All previously reported genome-wide significant associations with WMHV in community populations shared direction of effect in stroke patients. In a meta-analysis of the genome-wide significant and suggestive loci (p < 5 × 10(-6)) from community populations (15 single nucleotide polymorphisms in total) and from stroke patients, 6 independent loci were associated with WMHV in both populations. Four of these are novel associations at the genome-wide level (rs72934505 [NBEAL1], p = 2.2 × 10(-8); rs941898 [EVL], p = 4.0 × 10(-8); rs962888 [C1QL1], p = 1.1 × 10(-8); rs9515201 [COL4A2], p = 6.9 × 10(-9)). CONCLUSIONS Genetic associations with WMHV are shared in otherwise healthy individuals and patients with stroke, indicating common genetic susceptibility in cerebral small vessel disease.

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26 results on '"Furie, Karen L."'

1. Subsequent ischemic stroke and tobacco smoking: A secondary analysis of the POINT trial.

2. Stroke genetics informs drug discovery and risk prediction across ancestries

3. Carotid Stenosis and Recurrent Ischemic Stroke: A Post-Hoc Analysis of the POINT Trial.

4. Segmentation of Cerebrovascular Pathologies in Stroke Patients with Spatial and Shape Priors

5. Translational Stroke Research: Vision and Opportunities.

6. Translational Stroke Research: Vision and Opportunities.

7. Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.

8. Segmentation of Cerebrovascular Pathologies in Stroke Patients with Spatial and Shape Priors

9. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

10. World Stroke Organization Global Stroke Services Guidelines and Action Plan

11. Statin Therapy and Outcome After Ischemic Stroke : Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

12. Statin Therapy and Outcome After Ischemic Stroke : Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials

13. Ischemic stroke is associated with the ABO locus : the EuroCLOT study

14. Good outcome rate of 35% in IV-tPA-treated patients with computed tomography angiography confirmed severe anterior circulation occlusive stroke.

15. Improved outcome prediction using CT angiography in addition to standard ischemic stroke assessment: results from the STOPStroke study.

16. Improved outcome prediction using CT angiography in addition to standard ischemic stroke assessment: results from the STOPStroke study.

17. Stroke: working toward a prioritized world agenda.

18. Stroke: working toward a prioritized world agenda.

19. Stroke: working toward a prioritized world agenda.

20. Stroke: working toward a prioritized world agenda.

21. Stroke: working toward a prioritized world agenda.

22. Stroke: working toward a prioritized world agenda.

23. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study.

24. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study.

25. Genome-wide meta-analysis of cerebral white matter hyperintensities in patients with stroke

26. Genome-wide meta-analysis of cerebral white matter hyperintensities in patients with stroke

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26 results on '"Furie, Karen L."'

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