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36 results on '"Weimar, Christian"'

1. sj-docx-1-wso-10.1177_17474930231184366 – Supplemental material for Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study

Author: Grosse, Gerrit M, Hüsing, Anika, Stang, Andreas, Kuklik, Nils, Brinkmann, Marcus, Nabavi, Darius, Sparenberg, Paul, Weissenborn, Karin, Gröschel, Klaus, Royl, Georg, Poli, Sven, Michalski, Dominik, Eschenfelder, Christoph C, Weimar, Christian, and Diener, Hans-Christoph
Subjects: Neurology and Neuromuscular Diseases, FOS: Clinical medicine, Cardiology, Medicine
Abstract: Supplemental material, sj-docx-1-wso-10.1177_17474930231184366 for Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study by Gerrit M Grosse, Anika Hüsing, Andreas Stang, Nils Kuklik, Marcus Brinkmann, Darius Nabavi, Paul Sparenberg, Karin Weissenborn, Klaus Gröschel, Georg Royl, Sven Poli, Dominik Michalski, Christoph C Eschenfelder, Christian Weimar and Hans-Christoph Diener in International Journal of Stroke
Published: 2023
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2. sj-docx-1-wso-10.1177_17474930231184366 – Supplemental material for Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study

Author: Grosse, Gerrit M, Hüsing, Anika, Stang, Andreas, Kuklik, Nils, Brinkmann, Marcus, Nabavi, Darius, Sparenberg, Paul, Weissenborn, Karin, Gröschel, Klaus, Royl, Georg, Poli, Sven, Michalski, Dominik, Eschenfelder, Christoph C, Weimar, Christian, and Diener, Hans-Christoph
Subjects: Neurology and Neuromuscular Diseases, FOS: Clinical medicine, Cardiology, Medicine
Abstract: Supplemental material, sj-docx-1-wso-10.1177_17474930231184366 for Early or late initiation of dabigatran versus vitamin-K-antagonists in acute ischemic stroke or TIA: The PRODAST study by Gerrit M Grosse, Anika Hüsing, Andreas Stang, Nils Kuklik, Marcus Brinkmann, Darius Nabavi, Paul Sparenberg, Karin Weissenborn, Klaus Gröschel, Georg Royl, Sven Poli, Dominik Michalski, Christoph C Eschenfelder, Christian Weimar and Hans-Christoph Diener in International Journal of Stroke
Published: 2023
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3. Fluctuation of depressive symptoms in cognitively unimpaired participants and the risk of mild cognitive impairment 5 years later: Results of the Heinz Nixdorf Recall study

Author: Jokisch, Martha, Schramm, Sara, Weimar, Christian, Moebus, Susanne, Gronewold, Janine, Dragano, Nico, and Jöckel, Karl-Heinz
Subjects: Behavioral Neuroscience, Medizinische Fakultät » Universitätsklinikum Essen » Institut für Urban Public Health (InUPH), Neuropsychology and Physiological Psychology, Medizinische Fakultät » Universitätsklinikum Essen » Klinik für Neurologie, Cognitive Neuroscience, depression -- mild cognitive impairment -- prevention -- cognitive decline -- epidemiology, Medizin, ddc:610, Medizinische Fakultät » Universitätsklinikum Essen » Institut für Medizinische Informatik, Biometrie und Epidemiologie
Abstract: BackgroundDepression might be an independent risk factor for cognitive decline, a prodromal dementia symptom or a reaction to cognitive/functional impairment.ObjectiveTo investigate the association between (1) depressive symptoms and (2) depressive symptom patterns over 13 years with incident mild cognitive impairment (MCI) 5 years later.Materials and methodsWe included 724/823 cognitively unimpaired men/women who participated in the population-based Heinz Nixdorf Recall study (t1: 2005–2008, ø62.9 years; t2: 2010–2015, ø68.1 years). Depressive symptoms were assessed in the study center and during six postal follow-ups using the short form of the Center for Epidemiologic Studies Depression Scale (CES-D). Relative risks (RR; 95% confidence intervals) for MCI at t2 (men/women: 71/76) were estimated for CES-D at t1 (linear and dichotomized at ≥17, cut-off for clinically relevant depressive symptoms) and CES-D fluctuations over 13 years (stable low, large fluctuations, stable high/stable around cut-off) using log-linear regression models with Poisson working likelihood adjusted for age, sex, education, diabetes mellitus, coronary heart disease, and stroke.ResultsFully adjusted risk for MCI at t2 (per CES-D point increase at t1) was elevated for the total cohort (1.053, 1.031–1.076), men (1.046, 1.012–1.081), and women (1.059, 1.029–1.090). Applying the dichotomized CES-D, risk for MCI was substantially increased for the total cohort [2.22 (1.38–3.58)] and in women [2.59 (1.46–4.58)]. Large CES-D fluctuations and stable high/stable around cut-off were associated with increased RR for MCI in the total cohort and in women compared to stable low symptoms.ConclusionDepressive symptoms predicted MCI in cognitively unimpaired participants of our population-based study. Adequate treatment of depression may therefore contribute to the maintenance of normal cognition and delay dementia onset.
Published: 2022

4. Validity of the Early Functional Ability scale (EFA) among critically ill patients undergoing early neurological rehabilitation

Author: Boltzmann, Melanie, Schmidt, Simone B., Gutenbrunner, Christoph, Krauss, Joachim K., Höglinger, Günter U., Weimar, Christian, and Rollnik, Jens D.
Subjects: Male, Critical Illness, Medizin, Neurological Rehabilitation, General Medicine, Recovery of Function, Middle Aged, Prognosis, Treatment Outcome, Activities of Daily Living, Humans, Glasgow Coma Scale, Neurology (clinical), Coma, Aged
Abstract: Background A reliable assessment of the functional abilities of patients after severe brain damage is crucial for valid prognostication and treatment decisions, but most clinical scales are of limited use among this specific group of patients. Aim The present study investigates the usefulness of the Early Functional Ability (EFA) scale, which determines the functional abilities of severely impaired patients. Methods Critically ill patients consecutively admitted to early neurological rehabilitation were screened for eligibility. We assessed the correlation between the EFA scale and (i) the Early Rehabilitation Barthel Index (ERBI), and (ii) the Coma Recovery Scale-Revised (CRS-R). The 1-year outcome on the Glasgow Outcome Scale-extended (GOSE) was used to examine the predictive validity. Demographical and medical variables were entered into univariate and multivariate binary regression models to identify independent predictors of 1-year outcome. Results Two hundred fifty-seven patients (168 men) with a median age of 62 years (IQR = 51–75) were enrolled. The correlation of the EFA scale with the CRS-R was high but low with the ERBI upon admission. Multivariate regression analysis yielded the vegetative subscale of the EFA scale as the only independent predictor for the 1-year outcome of patients admitted to early neurological rehabilitation. Conclusions This study shows a high correlation of the EFA scale with the CRS-R but a weak correlation with the ERBI in patients with low functional abilities. With improving patient abilities, these correlations were partly reversed. Thus, the EFA scale is a useful tool to assess the functional abilities and the prognosis of critically ill patients adequately and may be more feasible than other scales.
Published: 2022

5. sj-pdf-1-eso-10.1177_2396987320972566 - Supplemental material for Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) – study protocol for a randomised controlled trial

Author: Kelly, Peter, Weimar, Christian, Lemmens, Robin, Murphy, Sean, Purroy, Francisco, Arsovska, Anita, Bornstein, Natan M, Czlonkowska, Anna, Fischer, Urs, Fonseca, Ana Catarina, Forbes, John, Hill, Michael D, Jatuzis, Dalius, Kõrv, Janika, Kruuse, Christina, Mikulik, Robert, J Nederkoorn, Paul, O’Donnell, Martin, Sandercock, Peter, Tanne, David, Tsivgoulis, Georgios, Walsh, Cathal, Williams, David, Zedde, Marialuisa, and Price, Christopher I
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental material, sj-pdf-1-eso-10.1177_2396987320972566 for Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) – study protocol for a randomised controlled trial by Peter Kelly, Christian Weimar, Robin Lemmens, Sean Murphy, Francisco Purroy, Anita Arsovska, Natan M Bornstein, Anna Czlonkowska, Urs Fischer, Ana Catarina Fonseca, John Forbes, Michael D Hill, Dalius Jatuzis, Janika Kõrv, Christina Kruuse, Robert Mikulik, Paul J Nederkoorn, Martin O’Donnell, Peter Sandercock, David Tanne, Georgios Tsivgoulis, Cathal Walsh, David Williams, Marialuisa Zedde and Christopher I Price in European Stroke Journal
Published: 2021
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6. sj-pdf-1-eso-10.1177_23969873211060219 �� Supplemental Material for Rationale, Design and Methods of the Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA (PRODAST) Study

Author: Grosse, Gerrit M., Weimar, Christian, Kuklik, Nils, H��sing, Anika, Stang, Andreas, Brinkmann, Marcus, Eschenfelder, Christoph C., and Diener, Hans-Christoph
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental Material, sj-pdf-1-eso-10.1177_23969873211060219 for Rationale, Design and Methods of the Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA (PRODAST) Study by Gerrit M. Grosse, Christian Weimar, Nils Kuklik, Anika H��sing, Andreas Stang, Marcus Brinkmann, Christoph C. Eschenfelder, Hans-Christoph Diener and on behalf of the PRODAST Investigators in European Stroke Journal
Published: 2021
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7. sj-pdf-1-eso-10.1177_23969873211060219 �� Supplemental Material for Rationale, Design and Methods of the Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA (PRODAST) Study

Author: Grosse, Gerrit M., Weimar, Christian, Kuklik, Nils, H��sing, Anika, Stang, Andreas, Brinkmann, Marcus, Eschenfelder, Christoph C., and Diener, Hans-Christoph
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental Material, sj-pdf-1-eso-10.1177_23969873211060219 for Rationale, Design and Methods of the Prospective Record of the Use of Dabigatran in Patients with Acute Stroke or TIA (PRODAST) Study by Gerrit M. Grosse, Christian Weimar, Nils Kuklik, Anika H��sing, Andreas Stang, Marcus Brinkmann, Christoph C. Eschenfelder, Hans-Christoph Diener and on behalf of the PRODAST Investigators in European Stroke Journal
Published: 2021
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8. sj-pdf-1-eso-10.1177_2396987320972566 - Supplemental material for Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) – study protocol for a randomised controlled trial

Author: Kelly, Peter, Weimar, Christian, Lemmens, Robin, Murphy, Sean, Purroy, Francisco, Arsovska, Anita, Bornstein, Natan M, Czlonkowska, Anna, Fischer, Urs, Fonseca, Ana Catarina, Forbes, John, Hill, Michael D, Jatuzis, Dalius, Kõrv, Janika, Kruuse, Christina, Mikulik, Robert, J Nederkoorn, Paul, O’Donnell, Martin, Sandercock, Peter, Tanne, David, Tsivgoulis, Georgios, Walsh, Cathal, Williams, David, Zedde, Marialuisa, and Price, Christopher I
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental material, sj-pdf-1-eso-10.1177_2396987320972566 for Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) – study protocol for a randomised controlled trial by Peter Kelly, Christian Weimar, Robin Lemmens, Sean Murphy, Francisco Purroy, Anita Arsovska, Natan M Bornstein, Anna Czlonkowska, Urs Fischer, Ana Catarina Fonseca, John Forbes, Michael D Hill, Dalius Jatuzis, Janika Kõrv, Christina Kruuse, Robert Mikulik, Paul J Nederkoorn, Martin O’Donnell, Peter Sandercock, David Tanne, Georgios Tsivgoulis, Cathal Walsh, David Williams, Marialuisa Zedde and Christopher I Price in European Stroke Journal
Published: 2021
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9. Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group

Author: Cadilhac, Dominique A, Kim, Joosup, Wilson, Alastair, Berge, Eivind, Patel, Anita, Ali, Myzoon, Saver, Jeffrey, Christensen, Hanne, Cuche, Matthieu, Crews, Sean, Wu, Olivia, Provoyeur, Marine, McMeekin, Peter, Durand-Zaleski, Isabelle, Ford, Gary A, Muhlemann, Natalia, Bath, Philip M, Abdul-Rahim, Azmil H, Sunnerhagen, Katharina, Meretoja, Atte, Thijs, Vincent, Weimar, Christian, Massaro, Ayrton, Ranta, Annemarei, Lees, Kennedy R, and ESO Health Economics Working group
Subjects: Stroke, modified Rankin Scale, economic evaluation, Good Health and Well Being, ESO Health Economics Working group, Clinical Research, health outcomes, EuroQol, health policy
Abstract: IntroductionApproaches to economic evaluations of stroke therapies are varied and inconsistently described. An objective of the European Stroke Organisation (ESO) Health Economics Working Group is to standardise and improve the economic evaluations of interventions for stroke.MethodsThe ESO Health Economics Working Group and additional experts were contacted to develop a protocol and a guidance document for data collection for economic evaluations of stroke therapies. A modified Delphi approach, including a survey and consensus processes, was used to agree on content. We also asked the participants about resources that could be shared to improve economic evaluations of interventions for stroke.ResultsOf 28 experts invited, 16 (57%) completed the initial survey, with representation from universities, government, and industry. More than half of the survey respondents endorsed 13 specific items to include in a standard resource use questionnaire. Preferred functional/quality of life outcome measures to use for economic evaluations were the modified Rankin Scale (14 respondents, 88%) and the EQ-5D instrument (11 respondents, 69%). Of the 12 respondents who had access to data used in economic evaluations, 10 (83%) indicated a willingness to share data. A protocol template and a guidance document for data collection were developed and are presented in this article.ConclusionThe protocol template and guidance document for data collection will support a more standardised and transparent approach for economic evaluations of stroke care.
Published: 2020

10. ESO897466 Supplemental Figure - Supplemental material for Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group

Author: Cadilhac, Dominique A, Joosup Kim, Wilson, Alastair, Berge, Eivind, Patel, Anita, Myzoon Ali, Saver, Jeffrey, Christensen, Hanne, Cuche, Matthieu, Crews, Sean, Wu, Olivia, Provoyeur, Marine, McMeekin, Peter, Durand-Zaleski, Isabelle, Ford, Gary A, Muhlemann, Natalia, Bath, Philip M, Azmil H Abdul-Rahim, Sunnerhagen, Katharina, Meretoja, Atte, Thijs, Vincent, Weimar, Christian, Ayrton Massaro, Annemarei Ranta, and Lees, Kennedy R
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental material, ESO897466 Supplemental Figure for Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group by Dominique A Cadilhac, Joosup Kim, Alastair Wilson, Eivind Berge, Anita Patel, Myzoon Ali, Jeffrey Saver, Hanne Christensen, Matthieu Cuche, Sean Crews, Olivia Wu, Marine Provoyeur, Peter McMeekin, Isabelle Durand-Zaleski, Gary A Ford, Natalia Muhlemann, Philip M Bath, Azmil H Abdul-Rahim, Katharina Sunnerhagen, Atte Meretoja, Vincent Thijs, Christian Weimar, Ayrton Massaro, Annemarei Ranta and Kennedy R Lees; on behalf of the ESO Health Economics Working group in European Stroke Journal
Published: 2020
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11. SUPPLEMENTARY_MATERIAL – Supplemental material for Cost-benefit of outcome adjudication in nine randomised stroke trials

Author: Godolphin, Peter J, Bath, Philip M, Algra, Ale, Berge, Eivind, Chalmers, John, Eliasziw, Misha, Hankey, Graeme J, Hosomi, Naohisa, Annamarei Ranta, Weimar, Christian, Woodhouse, Lisa J, and Montgomery, Alan A
Subjects: FOS: Clinical medicine, 160807 Sociological Methodology and Research Methods, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, FOS: Sociology
Abstract: Supplemental material, SUPPLEMENTARY_MATERIAL for Cost-benefit of outcome adjudication in nine randomised stroke trials by Peter J Godolphin, Philip M Bath, Ale Algra, Eivind Berge, John Chalmers, Misha Eliasziw, Graeme J Hankey, Naohisa Hosomi, Annamarei Ranta, Christian Weimar, Lisa J Woodhouse and Alan A Montgomery in Clinical Trials
Published: 2020
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12. <scp>close</scp>: Closure of patent foramen ovale, oral anticoagulants or antiplatelet therapy to prevent stroke recurrence: Study design

Author: Mas, Jean-Louis, Derumeaux, Geneviève, Amarenco, Pierre, Arquizan, Caroline, Aubry, Pierre, Barthelet, Martine, Bertrand, Bernard, Brochet, Eric, Cabanes, Laure, Donal, Erwan, Dubois-Randé, Jean-Luc, Durand-Zaleski, Isabelle, Ernande, Laura, Finet, Gérard, Fraisse, Alain, Giroud, Maurice, Guérin, Patrice, Habib, Gilbert, Juliard, Jean-Michel, Leys, Didier, Lièvre, Michel, Lusson, Jean-René, Marcon, François, Michel, Patrick, Moulin, Thierry, Mounier-Vehier, François, Pierard, Luc, Piot, Christophe, Rey, Christian, Rodier, Gilles, Roudaut, Raymond, Schleich, Jean-Marc, Teiger, Emmanuel, Turc, Guillaume, Vuillier, Fabrice, Weimar, Christian, Woimant, France, Chatellier, Gilles, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bichat - Claude Bernard, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Aix Marseille Université (AMU), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Cardiologie interventionnelle [Montpellier], Clinique du Millénaire - Oc Santé [Montpellier], Oc Santé [Montpellier]-Oc Santé [Montpellier], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Département de physiologie (CHU Henri Mondor), Hôpital Henri Mondor, Ecole Nationale Supérieure de Chimie de Rennes (ENSCR), Department of Neurology and Stroke Center, Universität Duisburg-Essen = University of Duisburg-Essen [Essen], Service de neurologie [Univ. Paris VII], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Centre National de Référence pour la maladie de Wilson (CNR wilson), CNR Wilson, Service de Neurologie, Hôpital Lariboisière, Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS)-Clermont Université, Universität Duisburg-Essen [Essen], Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Laboratoire de Recherche Vasculaire Translationnelle ( LVTS ), Université Paris 13 ( UP13 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Hospices Civils de Lyon ( HCL ), Aix Marseille Université ( AMU ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), unité de recherche de l'institut du thorax UMR1087 UMR6291 ( ITX ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Troubles cognitifs dégénératifs et vasculaires ( DN2M ), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ) -INSERM, Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Gabriel Montpied ( CHU ), Image Science for Interventional Techniques ( ISIT ), Université d'Auvergne - Clermont-Ferrand I ( UdA ) -Clermont Université-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Groupe Interdisciplinaire de Génoprotéomique Appliquée ( GIGA-Research ), Université de Liège-Faculté de médecine vétérinaire, Clinique du Millénaire - OC Santé [Montpellier], Service de cardiologie et maladies vasculaires, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Département de physiologie ( CHU Henri Mondor ), Ecole Nationale Supérieure de Chimie de Rennes, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 ), Centre National de Référence pour la maladie de Wilson ( CNR wilson ), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques de l'Hopital Europeen Georges Pompidou, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Troubles cognitifs dégénératifs et vasculaires (U1171), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-INSERM, CHU Gabriel Montpied (CHU), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: Male, [SDV]Life Sciences [q-bio], Medizin, Administration, Oral, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, Superiority Trial, Secondary Prevention, guidelines, Stroke, accuracy, trials, Middle Aged, 3. Good health, Treatment Outcome, Neurology, cryptogenic stroke, Platelet aggregation inhibitor, Female, events, metaanalysis, Adult, medicine.medical_specialty, Adolescent, Foramen Ovale, Patent, percutaneous closure, Young Adult, 03 medical and health sciences, Paradoxical embolism, stomatognathic system, medicine, Foramen, Humans, cardiovascular diseases, Cardiac Surgical Procedures, [ SDV ] Life Sciences [q-bio], business.industry, Patient Selection, Anticoagulants, paradoxical embolism, medicine.disease, Surgery, medical therapy, Clinical trial, Patient recruitment, transient ischemic attack, Patent foramen ovale, business, Platelet Aggregation Inhibitors, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: Rationale Currently available data do not provide definitive evidence on the comparative benefits of closure of patent foramen ovale, oral anticoagulants and antiplatelet therapy in patients with patent foramen ovale-associated cryptogenic stroke Aim To assess whether transcatheter patent foramen ovale closure plus antiplatelet therapy is superior to antiplatelet therapy alone and whether oral anticoagulant therapy is superior to antiplatelet therapy, for secondary stroke prevention in patients aged 16 to 60 years with a large patent foramen ovale or a patent foramen ovale associated with an atrial septal aneurysm, and an otherwise unexplained ischaemic stroke or retinal ischaemia. Sample size Six hundred and sixty-four patients were included in the study. Methods and design CLOSE is an academic-driven, multicentre, randomized, open-label, three-group, superiority trial with blinded adjudication of outcome events. The trial has been registered with Clinical Trials Register (Clinicaltrials.gov, NCT00562289). Patient recruitment started in December 2007. Patient follow-up will continue until December 2016. Expected mean follow-up = 5.6 years. Study outcomes The primary efficacy outcome is the occurrence of fatal or nonfatal stroke. Safety outcomes include fatal, life-threatening or major procedure- or device-related complications and fatal, life-threatening or major haemorrhagic complications. Discussion CLOSE is the first specifically designed trial to assess the superiority of patent foramen ovale closure over antiplatelet therapy alone and the superiority of oral anticoagulants over antiplatelet therapy to prevent stroke recurrence in patients with patent foramen ovale-associated cryptogenic stroke.
Published: 2016
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13. Supplemental material for Building a European ‘network of networks’ for stroke clinical research – The European Stroke Organisation Trials Alliance (ESOTA)

Author: Kelly, Peter, Salman, Rustam A, Arsovska, Anita, Dippel, Diederik WJ, Fischer, Urs, Ford, Gary A, Fuentes, Blanca, Lemmens, Robin, Marshall, John C, Nederkoorn, Paul J, Thompson Robinson, Weimar, Christian, and Berge, Eivind
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental Material for Building a European ‘network of networks’ for stroke clinical research – The European Stroke Organisation Trials Alliance (ESOTA) by Peter Kelly, Rustam A Salman, Anita Arsovska, Diederik WJ Dippel, Urs Fischer, Gary A Ford, Blanca Fuentes, Robin Lemmens, John C Marshall, Paul J Nederkoorn, Thompson Robinson, Christian Weimar, Eivind Berge and on behalf of the ESO Trials Network Committee ESOTA Steering Group in European Stroke Journal
Published: 2019
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14. Building a European 'network of networks' for stroke clinical research - The European Stroke Organisation Trials Alliance (ESOTA)

Author: Kelly, Peter, Salman, Rustam A., Arsovska, Anita, Dippel, Diederik WJ, Fischer, Urs, Ford, Gary A., Fuentes, Blanca, Lemmens, Robin, Marshall, John C., Nederkoorn, Paul J., Robinson, Thompson, Weimar, Christian, Berge, Eivind, on behalf of the ESO Trials Network Committee ESOTA Steering Group, Neurology, ACS - Atherosclerosis & ischemic syndromes, and Amsterdam Neuroscience - Neurovascular Disorders
Subjects: medicine.medical_specialty, Clinical Neurology, INCREASING VALUE, Medizin, Guideline, Acute care, medicine, cardiovascular diseases, 610 Medicine & health, Stroke, RISK, Science & Technology, treatment, business.industry, medicine.disease, randomised trial, stroke, Clinical trial, Europe, Alliance, Clinical research, Stroke prevention, Family medicine, Neurology (clinical), Neurosciences & Neurology, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine
Abstract: Promoting research to improve stroke prevention, acute care, and recovery is a key mission of the European Stroke Organisation (ESO). Stroke research networks may increase efficiencies and reduce waste in randomised clinical trials of stroke treatments. Several European countries have established national or regional stroke research networks, or have informal groups or stroke registers which may serve as a foundation for establishing a research network. To increase international collaboration on randomised trials for stroke in Europe, the ESO Trials Network Committee is leading the development of an alliance of national networks, the ESO Trials Alliance (ESOTA). Following initial consultation work in 2017, this paper describes an overview of progress to date in the first year of ESOTA activity. Beginning with five founding networks in England, Ireland, Netherlands, Spain, and Switzerland, ESOTA aims to gradually grow, ultimately including several hundred stroke centres and affiliated investigators working collectively on randomised trials of new stroke treatments. ispartof: EUROPEAN STROKE JOURNAL vol:4 issue:3 pages:224-232 ispartof: location:England status: published
Published: 2019

15. Inpatient TIA and stroke care in adult patients in Germany - retrospective analysis of nationwide administrative data sets of 2011 to 2017

Author: Eyding, Jens Bartig, Dirk Weber, Ralph Katsanos, Aristeidis H. Weimar, Christian Hacke, Werner Krogias, Christos
Subjects: cardiovascular diseases, nervous system diseases
Abstract: BACKGROUND: Comprehensive administrative data on TIA and stroke cases and treatment modalities are fundamental for improving structural conditions and adjusting future strategies of stroke care. METHODS: The nationwide administrative database (German federal statistical office) was used to extract all adult inpatient TIA and stroke cases and corresponding procedural codes for the period 2011-2017. Numbers were specified according to age, sex, stroke unit (SU) and critical care treatment (ICU), early transfer, and in-hospital mortality. FINDINGS: Inpatient adult TIA/stroke cases increased from annually 102,406 / 250,199 (2011) to 106,245 / 264,208 (2017). 84% of strokes were ischemic (AIS) also having the highest relative increase most likely due to more accurate coding within the time period, 68.2% of AIS were treated on SUs. 78% of hemorrhagic strokes were intracerebral hematomas (ICH; rather than subarachnoid hemorrhages [SAH]). Hemorrhagic strokes were increasingly treated on SUs (32.6% [2011], 37.8% [2017]). 68.8% of SAH were treated on ICUs (ICH:36.3%, AIS:10.3%). Early transfer in AIS increased (2.0 to 3.1%). Hemorrhagic strokes were associated with higher in-hospital mortality (SAH:19.6%, ICH:28.2%, AIS:7.3%). INTERPRETATION: The absolute increase of strokes presumably reflects the aging society and more awareness for cerebrovascular disease. The relative increase of AIS may be attributable to an increased neurological expertise. The increasing amount of early transfers in AIS reflects new specialized treatment options. Our findings reflect the need for structural adjustments in inpatient stroke care.
Published: 2019

16. Outcome Assessment by Central Adjudicators Versus Site Investigators in Stroke Trials

Author: Godolphin, Peter J., Bath, Philip M., Algra, Ale, Berge, Eivind, Brown, Christopher Martin, Chalmers, John, Duley, Lelia, Eliashiw, Misha, Gregson, John, Greving, Jacoba P., Hankey, Graeme J., Hosomi, Naohisa, Johnston, S. Claiborne, Patsko, Emily, Ranta, Annamarei, Sandset, Per Morten, Serena, Joaquín, Weimar, Christian, and Montgomery, Alan A.
Abstract: Background and Purpose— In randomized stroke trials, central adjudication of a trial’s primary outcome is regularly implemented. However, recent evidence questions the importance of central adjudication in randomized trials. The aim of this review was to compare outcomes assessed by central adjudicators with outcomes assessed by site investigators. Methods— We included randomized stroke trials where the primary outcome had undergone an assessment by site investigators and central adjudicators. We searched MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, PsycINFO, and Google Scholar for eligible studies. We extracted information about the adjudication process as well as the treatment effect for the primary outcome, assessed both by central adjudicators and by site investigators. We calculated the ratio of these treatment effects so that a ratio of these treatment effects >1 indicated that central adjudication resulted in a more beneficial treatment effect than assessment by the site investigator. A random-effects meta-analysis model was fitted to estimate a pooled effect. Results— Fifteen trials, comprising 69 560 participants, were included. The primary outcomes included were stroke (8/15, 53%), a composite event including stroke (6/15, 40%) and functional outcome after stroke measured on the modified Rankin Scale (1/15, 7%). The majority of site investigators were blind to treatment allocation (9/15, 60%). On average, there was no difference in treatment effect estimates based on data from central adjudicators and site investigators (pooled ratio of these treatment effects=1.02; 95% CI, [0.95–1.09]). Conclusions— We found no evidence that central adjudication of the primary outcome in stroke trials had any impact on trial conclusions. This suggests that potential advantages of central adjudication may not outweigh cost and time disadvantages in stroke studies if the primary purpose of adjudication is to ensure validity of trial findings.
Published: 2019

17. Olfactory Function is Associated with Cognitive Performance: Results of the Heinz Nixdorf Recall Study

Author: Tebrügge, Sarah, Winkler, Angela, Gerards, Diana, Weimar, Christian, Moebus, Susanne, Jöckel, Karl-Heinz, Erbel, Raimund, Jokisch, Martha, and Heinz Nixdorf Recall Study Investigative Group
Subjects: Olfactory system, Male, medicine.medical_specialty, Population, Medizin, Olfaction, Audiology, Neuropsychological Tests, 050105 experimental psychology, Community Health Planning, 03 medical and health sciences, Olfaction Disorders, 0302 clinical medicine, Germany, Medicine, Dementia, Humans, 0501 psychology and cognitive sciences, Effects of sleep deprivation on cognitive performance, Cognitive decline, education, Aged, Aged, 80 and over, education.field_of_study, Analysis of Variance, Sex Characteristics, Recall, business.industry, General Neuroscience, 05 social sciences, Age Factors, Cognition, General Medicine, Middle Aged, medicine.disease, Smell, Psychiatry and Mental health, Clinical Psychology, Female, Geriatrics and Gerontology, business, Cognition Disorders, 030217 neurology & neurosurgery
Abstract: BACKGROUND There is strong evidence for an association of olfactory dysfunction and neurodegenerative diseases. Studies on the association of olfaction and cognition in the general population are rare. OBJECTIVE To evaluate gender- and age-specific associations of olfactory function and cognitive performance in a well characterized population-based study sample. METHODS At the third examination of the Heinz Nixdorf Recall study (n = 3,087), 2,640 participants (48% men; 68.2±7.2 years) underwent Sniffin' Sticks Screening Test measuring olfactory function on a scale of 0-12 points. Olfactory function was rated as anosmic, hyposmic, or normosmic (≤6, 7-10 or ≥11 points, respectively). All participants performed eight validated cognitive subtests. Age- (55-64 years, 65-74 years, 75-86 years) and gender-stratified multivariate analysis of covariance was used to evaluate group differences in cognitive performance. RESULTS Women showed better olfactory function than men (p
Published: 2018

18. Supplementary table 1 -Supplemental material for Stroke admission outside daytime working hours delays mechanical thrombectomy and worsens short-term outcome

Author: Hoepner, Robert, Weber, Ralph, Reimann, Gernot, Berger, Klaus, Kitzrow, Martin, Fischer, Sebastian, Weimar, Christian, Eyding, Jens, and Krogias, Christos
Subjects: FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract: Supplemental material, Supplementary table 1 for Stroke admission outside daytime working hours delays mechanical thrombectomy and worsens short-term outcome by Robert Hoepner, Ralph Weber, Gernot Reimann, Klaus Berger, Martin Kitzrow, Sebastian Fischer, Christian Weimar, Jens Eyding and Christos Krogias in International Journal of Stroke
Published: 2018
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19. Associations of chronic heart failure with outcome in acute ischaemic stroke patients who received systemic thrombolysis: analysis from VISTA

Author: Abdul-Rahim, Azmil H., Fulton, Rachael L., Frank, Benedikt, McMurray, John, Lees, Kennedy R., Alexandrov, A. V., Bath, P. W., Bluhmki, Erich, Claesson, L., Curram, John B., Davis, Stephen M., Donnan, G. A., Diener, Hans Christoph, Fisher, Marc J., Gregson, Barbara A., Grotta, James C., Hacke, Werner, Hennerici, Michael G., Hommel, Marc, Kaste, Markku, Lyden, Patrick D., Marler, John R., Muir, K., Sacco, R., Shuaib, Ashfaq, Teal, Philip A., Wahlgren, Nils G., Warach, Steven J., and Weimar, Christian
Subjects: Male, medicine.medical_specialty, Heart disease, medicine.medical_treatment, Medizin, Comorbidity, Brain Ischemia, Cohort Studies, Modified Rankin Scale, Internal medicine, Atrial Fibrillation, Outcome Assessment, Health Care, medicine, Humans, Thrombolytic Therapy, cardiovascular diseases, Stroke, Aged, Aged, 80 and over, Heart Failure, business.industry, Atrial fibrillation, Odds ratio, Thrombolysis, Middle Aged, medicine.disease, United States, Neurology, Heart failure, Chronic Disease, Cardiology, Female, Neurology (clinical), business, Cohort study
Abstract: Background and purpose There are concerns that systemic thrombolysis might not achieve clinically important outcome amongst chronic heart failure (CHF) patients with acute ischaemic stroke. Our aim was to investigate the relevance of CHF on the outcome of acute stroke patients who received thrombolysis. Methods A non-randomized cohort analysis was conducted using data obtained from the Virtual International Stroke Trials Archive. The association of outcome amongst CHF patients with thrombolysis treatment was described using the modified Rankin scale (mRS) distribution at day 90, stratified by the presence of atrial fibrillation. Dichotomized outcomes were considered as a secondary end-point. Results 5677 patients were identified, of whom 2366 (41.7%) received thombolysis. Five hundred and three (8.9%) patients had CHF, of whom 209 (41.6%) received thrombolysis. The presence of CHF was associated with a negative impact on overall stroke outcome [odds ratio (OR) 0.73 (95% confidence interval (CI) 0.62–0.87), P
Published: 2014
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20. Interdependence of Stroke Outcome Scales: Reliable Estimates from the Virtual International Stroke Trials Archive (VISTA)

Author: Goldie, F. C., Fulton, R. L., Frank, Benedikt, Lees, K. R., Alexandrov, A., Bath, P. W., Bluhmki, E., Claesson, L., Curram, J., Davis, S. M., Donnan, G., Diener, Hans Christoph, Fisher, M., Gregson, B., Grotta, J., Hacke, W., Hennerici, M. G., Hommel, M., Kaste, M., Lyden, P., Marler, J., Muir, K., Sacco, R., Shuaib, A., Teal, P., Wahlgren, N. G., Warach, S., and Weimar, Christian
Subjects: medicine.medical_specialty, Archives, business.industry, medicine.medical_treatment, Treatment outcome, Medizin, Outcome assessment, medicine.disease, Outcome (game theory), Clinical neurology, Stroke, Clinical trial, User-Computer Interface, Treatment Outcome, Neurology, Outcome Assessment, Health Care, Stroke outcome, Physical therapy, Humans, Medicine, cardiovascular diseases, business, Stroke recovery
Abstract: Background and Purpose Clinical deficits from stroke are diverse, prompting measurement in trials by a range of outcome scales. Statistical and clinical advantage can be gained by combining scales into a global outcome provided combinations are chosen with limited correlations. We aimed to clarify the interdependence of outcome scales by systematic review of published data and by novel analysis of data from completed acute trials. Summary of Review We systematically searched ScienceDirect and PubMed to summarize published data on correlations between stroke outcome scales. We generated new data on correlations among salient scales at 90 days poststroke in patients from the Virtual International Stroke Trials Archive (VISTA). We calculated Pearson and Spearman-Rank correlation coefficients for continuous and ordinal measures, respectively. We also assessed partial correlations, adjusted for baseline National Institute of Health Stroke Scale (NIHSS), and age. Published estimates of interdependence were limited to small single-trial cohorts and gave divergent results. From the more extensive VISTA dataset, we found that the modified Rankin Scale at 90 days poststroke explained 80.8% of the National Institute of Health Stroke Scale at 90 days poststroke and 86·5% of the European Stroke Scale. National Institute of Health Stroke Scale explained 75.9% of the Barthel Index and 81·2% of the Scandinavian Stroke Scale. After adjustment, modified Rankin Scale explained 56.6% of National Institute of Health Stroke Scale, 75.2% of Barthel Index. National Institute of Health Stroke Scale explained 60.2% of Barthel Index. Conclusion Correlations and partial correlations among stroke outcome scales in trial datasets are higher than previously reported. The new estimates are more reliable for trial planning due to the sample size and diversity.
Published: 2013
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21. New Findings in Primary and Secondary Stroke Prevention

Author: Weimar, Christian, Weber, Ralph, Hajjar, K., and Diener, Hans Christoph
Subjects: Medizin, Neurology (clinical)
Published: 2013
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22. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack

Author: Johnston, S Claiborne, Amarenco, Pierre, Albers, Gregory W, Denison, Hans, Easton, J Donald, Evans, Scott R, Held, Peter, Jonasson, Jenny, Minematsu, Kazuo, Molina, Carlos A, Wang, Yongjun, Wong, K S Lawrence, Ameriso, Sebastiá F, Donnan, Geoffrey, Lemmens, Robin, Massaro, Ayrton, Titianova, Ekaterina, Hill, Michael D, Lavados, Pablo, Skoloudik, David, Röther, Joachim, Norbert, Szegedi, Agnelli, Giancarlo, Bornstein, Natan, Tanahashi, Norio, Góngora, Angel Arauz, Pretell, Edwin, San Jose, Maria Cristina Z, Czlonkowska, Anna, Bajenaru, Ovidiu, Stakhovskaya, Ludmila, Brozman, Miroslav, Kim, Jong-Sung, Wahlgren, Nils, Michel, Patrik, Lee, Tsong Hai, Suwanwela, Nijasri Charnnarong, Kutluk, Kursad, Moskovko, Sergii, Kasner, Scott, Laskowitz, Daniel, Clark, Wayne, Nguyen, Huy Thang, Ameriso, Sebastián F, Ameriso, Sebastian, Lepera, Sandra, Romano, Marina, Paulon, David, Ioli, Pablo, Zurru, Cristina, Bruera, Guadalupe, Jure, Lorena, Klein, Francisco, Povedano, Guillermo, Levi, Christopher, Phan, Thanh, Markus, Romesh, Anderson, Craig, Sabet, Arman, Davis, Stephen, Lee, Andrew, Kleinig, Timothy, Wong, Andrew, Krause, Martin, Jannes, Jim, Wijeratne, Tissa, Hemelsoet, Dimitri, Peeters, André, Tack, Philippe, Vanacker, Peter, Laloux, Patrice, Van Landegem, William, Vanhooren, Geert, Desfontaines, Philippe, Van Orshoven, Marc, Oliveira, Fabio, Friedrich, Mauricio, Brondani, Rosane, Gagliardi, Rubens, Fabio, Soraia, Dracoulakis, Marianna, Bazan, Rodrigo, Marrone, Luiz, Pontes Neto, Octavio, Silva, Gisele, Kowacs, Pedro, Stamenova, Paraskeva, Daskalov, Marin, Staikov, Ivan, Baldaranov, Dimo, Maslarov, Dimitar, Lilovski, Hristo, Petkov, Plamen, Petrova, Neli, Mavrov, Radoslav, Markova, Veska, Petrova, Valeria, Beleva, Tanya, Kralev, Borislav, Sotirov, Nikolay, Lekova, Veska, Hristov, Dimcho, Ermenkova, Vera, Mateev, Lyudmil, Mitkova, Rumeliya, Haralanov, Liybomir, Ikonomov, Rosen, Mihailova, Margarita, Georgiev, Ivan, Shuaib, Ashfaq, Hachinski, Vladimir, Boulanger, Jean-Martin, Mann, Sharan, Hassan, Ayman, Mackey, Ariane, Menon, Bijoy, Minuk, Jeffrey, Siddiqui, Muzaffar, Eustace, Marsha, Vieira, Lucia, Selchen, Daniel, Beaudry, Michel, Stotts, Grant, Castro, Angel, Gasic, Kristo, Rivas, Rodrigo, Sanchez, Pablo, Roldan, Andres, Grossmann, Ingrid, Figueroa, Christian, Li, Jimei, Xu, Xiaolin, Chen, Huisheng, Li, Xiaohong, Yang, Yi, Zhang, Chunsheng, Wang, Baojun, Li, Guanglai, Wang, Dong, Lin, Hong, Tang, Yamei, Xu, Anding, Wang, Yanjiang, Hong, Wenke, Song, Zhi, Zhang, Xu, Jin, Xiaoping, Xu, Yun, Yan, Fuling, Zheng, Weihong, Wang, Xiaoping, Dong, Qiang, Zhao, Zhongxin, Zhang, Baorong, Zhong, Wangtao, Wen, Guoqiang, Xu, Jun, Li, Guozhong, Dong, Xueshuang, Tian, Xiangyang, Zhang, Zhaohui, Xu, En, Liu, Kaixiang, Chen, Jun, Skoda, Ondrej, Ehler, Edvard, Vaclavik, Daniel, Sanak, Daniel, Klimosova, Sylva, Vitkova, Eva, Fiksa, Jan, Mikulik, Robert, Neumann, Jiri, Plny, Richard, Leys, Didier, Sibon, Igor, Mas, Jean-Louis, Alamowitch, Sonia, Pico, Fernando, Hosseini, Hassan, Mahagne, Marie-Hélène, Touze, Emmanuel, Vadot, Wilfried, Vannier, Stéphane, Nighoghossian, Norbert, Samson, Yves, Garnier, Pierre, Ellie, Emmanuel, Guillon, Benoît, Timsit, Serge, Giroud, Maurice, Philippeau, Frédéric, Bagan-Triquenot, Aude, Wolff, Valérie, Raposo, Nicolas, Obadia, Michel, Debiais, Severine, Grimaud, Jérôme, Illouz, Stéphane, Smadja, Didier, Urbanczyk, Cédric, Berrouschot, Jörg, Weimar, Christian, Gahn, Georg, Soda, Hassan, Klimpe, Sven, Nabavi, Darius, Glahn, Jörg, Köhrmann, Martin, Krause, Lars, Terborg, Christoph, Urban, Peter, Steiner, Thorsten, Ferbert, Andreas, Dziewas, Rainer, Seidel, Günter, Thomalla, Götz, Wong, Ka Sing Lawrence, Li, Richard, Fong, Wing Chi, Cheung, Raymond, Szegedi, Norbert, Pozsegovits, Krisztián, Valikovics, Attila, Pánczél, Gyula, Rózsa, Csilla, Németh, László, Diószeghy, Péter, Óváry, Csaba, Csányi, Attila, Kerényi, Levente, Nagy, Valéria, Komoly, Sámuel, Bereczki, Dániel, Molnár, Sándor, Kondákor, István, Tanne, David, Raphaeli, Guy, Telman, Gregory, Leker, Ronen, Lampl, Yair, Corea, Francesco, Ricci, Stefano, Guidetti, Donata, Malferrari, Giovanni, Marcheselli, Simona, Micieli, Giuseppe, Zini, Andrea, Di Lazzaro, Vincenzo, Gandolfo, Carlo, Salmaggi, Andrea, Tassi, Rossana, Rasura, Maurizia, Orlandi, Giovanni, Comi, Giancarlo, Mancuso, Michelangelo, Delodovici, Marialuisa, Bovi, Paolo, Consoli, Domenico, Utsugisawa, Kimiaki, Fujita, Tsuneo, Kurihara, Hideyuki, Maruki, Chikashi, Hayashi, Takeshi, Ogiichi, Tsuneaki, Kumagai, Morio, Takenaka, Katsunobu, Toyoda, Kazunori, Takamatsu, Kazuhiro, Ogami, Ryo, Kin, Shigenari, Aoki, Takeshi, Takizawa, Katsumi, Omori, Shigehiro, Umezawa, Takehiko, Toba, Yasuyuki, Nonoyama, Yutaka, Nakagawa, Hidemitsu, Naka, Takashi, Morimoto, Masanori, Matsumoto, Shuichi, Hitotsumatsu, Tsutomu, Shingaki, Tatsuya, Okuda, Satoshi, Ota, Mamoru, Sakai, Nobuyuki, Yamada, Takeshi, Niwa, Jun, Fujita, Hitoshi, Moriki, Akihito, Yoshino, Kimihiro, Fukushima, Yoshihisa, Mori, Takahisa, Sato, Atsushi, Kusano, Yoshikazu, Kubo, Michiya, Yamazaki, Masashi, Ooasa, Takao, Nishizaki, Takafumi, Kitagawa, Naoki, Yasaka, Masahiro, Manabe, Yasuhiro, Yoshioka, Akira, Ishihara, Masayuki, Kagawa, Takato, Ichihashi, Toshikazu, Matsuoka, Hideki, Ito, Yasuhiro, Yamasaki, Masahiro, Takaba, Hitonori, Saito, Hisatoshi, Sato, Masahiro, Fukuda, Kazumasa, Endo, Sumio, Kidooka, Minoru, Umemura, Toshitaka, Kikkawa, Yuriko, Toru, Shuta, Yamada, Kentaro, Sakai, Hideki, Asari, Jun, Ezura, Masayuki, Nitta, Hisashi, Nagano, Keiko, Ochiai, Jun, Sakai, Keiichi, Kobayashi, Yasutaka, Yoshii, Yasuhiro, Miake, Hirotomo, Takita, Tomohiro, Taniguchi, Hidekazu, Kuroki, Kazuhiko, Mizota, Takamitsu, Yamamoto, Kenichi, Nakane, Hiroshi, Iwanaga, Takeshi, Chiba, Kei, Yoshimoto, Tetsuyuki, Torii, Tsuyoshi, Kitagawa, Takeo, Takashima, Hiroshi, Shirasaki, Naoki, Dehara, Makoto, Wada, Naomichi, Hamada, Kensuke, Kato, Noriyuki, Go, Yoshinori, Izumi, Ichiro, Ninomiya, Hirotomo, Kumai, Junichiro, Nakajima, Yoshikazu, Kaku, Yasuhiko, Isayama, Yukihiro, Kawanishi, Masahiro, Noda, Shinya, Yamamoto, Kazuhide, Hazama, Takanori, Takahashi, Hiroshi, Tanaka, Yohei, Hata, Takashi, Kazekawa, Kiyoshi, Furui, Eisuke, Hondo, Hideki, Sato, Nobuyuki, Kusunoki, Katsusuke, Nanri, Kazunori, Abe, Satoshi, Sasaoka, Noboru, Kuroyanagi, Takayuki, Suzuki, Hisahiko, Fukuyama, Kouzou, Nakahara, Kimihiro, Gongora, Fernando, Brito, Carlos Cantú, Careaga, Jorge Villarreal, Alfaro, Rosalia Vazquez, Leytte, Geronimo Aguayo, Berrospi, Percy, Chavez, Carlos, Rodriguez, Liliana, Custodio, Nilton, Castañeda, Cesar, Perez, Julio, Marquez, Sandra Vargas, San Jose, Maria Cristina, Baroque, Alejandro, Collantes, Ma Epifania, Aquino, Abdias, Díaz, Alejandro, Roxas, Artemio, Lokin, Johnny, Advincula, Joel, Calderon, Emerito, Navarro, Jose, Hiyadan, John, Surdilla, Arturo, Ryglewicz, Danuta, Krychowiak, Grzegorz, Fryze, Waldemar, Sobolewski, Piotr, Nowak, Ryszard, Fiszer, Urszula, Papierowska, Beata, Zieli?ska-Turek, Justyna, Lasek-Bal, Anetta, Ko?odziejska, Ewa, Kami?ska, Anna, Adamkiewicz, Bo?ena, Tutaj, Andrzej, Szkopek, Dorota, Musiatowicz, Krzysztof, B?k, Zbigniew, Brzozowski, S?awomir, Brola, Waldemar, Ferens, Antoni, Zalisz, Marek, Rejdak, Konrad, Rudzi?ska, Monika, Panea, Cristina, Simu, Mihaela, Balasa, Rodica, Cuciureanu, Iulian, Popescu, Bogdan, Sabau, Monica, Roman-Filip, Corina, Stakhovskaya, Liudmila, Pimenov, Leonid, Gekht, Alla, Milto, Anna, Shchukin, Ivan, Parfenov, Vladimir, Arkhipov, Mikhail, Vishneva, Elena, Sokolova, Nadezhda, Bogdanov, Enver, Esin, Radiy, Khasanova, Dina, Golikov, Konstantin, Melnikova, Elena, Zaslavskiy, Leonid, Voznyuk, Igor, Nazarov, Alexander, Akhmadeeva, Leila, Iakupova, Aida, Shamalov, Nikolay, Belskaya, Galina, Chuprina, Svetlana, Denisova, Olga, Drozdova, Ekaterina, Karakulova, Yuliya, Sholomov, Ilya, Spirin, Nikolay, Vostrikova, Elena, Mordvintseva, Elena, Grigoryeva, Vera, Zateyshchikov, Dmitry, Gorbachev, Vladimir, Chefranova, Zhanna, Dudarev, Mikhail, Nilk, Rostislav, Rozhdestvenskiy, Alexey, Gurcik, Ladislav, Dvorak, Miloslav, Krastev, Georgi, Kurca, Egon, Vyletelka, Juraj, Kim, Jong Sung, Bae, Hee-Joon, Kim, Yong-Won, Kim, Joon-Tae, Cha, Jae-Kwan, Nam, Hyo Suk, Chang, Dae-Il, Lee, Yong-Seok, Oh, Kyungmi, Yu, Sung-Wook, Sohn, Sung-Il, Lee, Jun, Cho, Han Jin, Kim, Eung-Gyu, Rha, Joung-Ho, Kim, Seo Hyun, Cateriano, Carlos Molina, Leal, Joaquín Serena, Mora, José Vivancos, Yañez, Manuel Rodríguez, González, Jaume Roquer, García, Francisco Purroy, Cortina, Meritxell Gomis, Vallejo, Jaime Masjuan, Lara, Juan Arenillas, Martín, Tomás Segura, Herrero, José Antonio Egido, Ferrairó, Jose Ignacio Tembl, Culleré, Jaime Gállego, Álvarez, Francisco Moniche, Steinberg, Anna, Callander, Margarita, Laska, Ann Charlotte, Bokemark, Lena, Mooe, Thomas, Käll, Tor-Björn, Welin, Lennart, Sjöblom, Lars, Hambraeus, Joakim, Teichert, Jörg, Wannberg, Hans, Sanner, Johan, Ramströmer, Bo, Ziedén, Bo, Hau, Stefan Olsson, Gustafsson, Claes, Kahles, Timo, Lyrer, Philippe, Arnold, Marcel, Liesch, Martin, Medlin, Friedrich, Cereda, Carlo, Kägi, Georg, Luft, Andreas, Carrera, Emmanuel, Lee, Tsong-Hai, Po, Helen L, Chern, Chang-Ming, Lien, Li-Ming, Chan, Lung, Liu, Chung-Hsiang, Wu, Shey-Lin, Lee, Jiann-Der, Chen, Chih-Hung, Lin, Huey-Juan, Lin, Ruey-Tay, Chen, Wei-Hsi, Sun, Yu, Tantirittisak, Tasanee, Muengtaweepongsa, Sombat, Nilanont, Yongchai, Tiamkao, Somsak, Udommongkol, Chesda, Watcharasaksilp, Kanokwan, Jantararotai, Witoon, Sirin, Hadiye, Ince, Birsen, Asil, Talip, Arsava, Murat, Incesu, Tulay Kurt, Tireli, Hulya, Kucukoglu, Hayriye, Ak, Fikri, Unal, Ali, Ozturk, Serefnur, Uzuner, Nevzat, Chmyr, Galyna, Lebedynets, Volodymyr, Nikonov, Vadym, Shulga, Lyudmyla, Smolanka, Volodymyr, Khavunka, Marta, Yavorska, Valentyna, Tomakh, Nataliya, Kozyolkin, Olexandr, Litovaltseva, Galyna, Lansberg, Maarten, Bernstein, Richard, Brown, David, Dissin, Jonathan, Graffagnino, Carmelo, Harris, Jonathan, Hicks, William, Katzan, Irene, Kramer, Jeffrey, Willey, Joshua, Silliman, Scott, Starkman, Sidney, Thaler, David, Tremwel, Margaret, Concha, Mauricio, Rajamani, Kumar, Dandapani, Bhuvaneswari, Silver, Brian, Deal, Nathan, Chang, Ira, Hassan, Ameer, Rudolph, Steven, Fischer, Kenneth, Kirshner, Howard, Logan, William, Mallenbaum, Sidney, Hefzy, Hebah, Latorre, Julius, Levine, Steven, Ciabarra, Anthony, Dafer, Rima, Anyanwu, Benjamin, Cherian, Laurel, Panezai, Spozhmy, Khanna, Anna, Dodds, Jodi, Torbey, Michel, Gebel, James, Woo, Henry, Chiu, David, Androulakis, Xiao, Burgin, William, Pineda, Maria, Yilmaz, Engin, Altafullah, Irfan, Boutwell, Christine, Cruz-Flores, Salvador, Sapkota, Biggya, Fayad, Pierre, Jacoby, Michael, Rafiq, Shahid, Salgado, Efrain, Lafranchise, Eugene, Felton, Warren, Madhavan, Ramesh, Zaidat, Osama, Pieper, Connie, Riviello, Ralph, Burnett, Aaron, Fischer, Michelle, Gentile, Nina, Calder, Christopher, Dietrich, Dennis, Cross, Jonathan, Blankenship, Larry, Montoya, Liliana, Grogan, Wendell, Young, Mark, Khan, Farrukh, Campbell, Duane, Daboul, Nizar, Espinoza, Andrey, Cullis, Paul, Concepcion, Gilberto, Wulff, John, Afzal, Haider, Jaffrani, Naseem, Reiter, William, Arshad, Tamjeed, Lukovits, Timothy, Welker, James, Chang, Fen Lei, Badruddin, Aamir, Babikian, Viken, Menon, Ravi, Sander, James, Springer, Mellanie, Nanda, Ashish, Mas, Luis, Rajan, Raj, Silverman, Bruce, Huang, David, Carpenter, David, Clark, Joni, Ching, Marilou, Santhakumar, Sunitha, Gould, Jeffrey, Bansal, Vibhav, Vidal, Gabriel, Mikesell, Timothy, Brick, John, French, William, Shah, Qaisar, Holmstedt, Christine, Ishag-Osman, Nadir, Kostis, John, Shehadeh, Abbas, Sethi, Pramodkumak, Imam, Asher, Mccomas, Carl, Tran, Duc, Gebreyohanns, Mehari, Wiseman, Brian, Malik, Maheen, Schwarcz, Aron, Altschul, Dorothea, Castaldo, John, Alshekhlee, Amer, Gancher, Stephen, Krish, Nagesh, Nguyen-Huynh, Mai, Tremwell, Margaret, Sharma, Jitendra, Lee, Lance, Neil, William, Siddiqui, Fazeel, Malek, Ali, Romero, Charles, Huy, Thang Nguyen, Hoang, Hoa, Nguyen, Thang, Nguyen, Anh, Nguyen, Hung, Dean's Office (DO - AUSTIN), University of Texas at Austin [Austin], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Bichat - Claude Bernard, Stanford Stroke Center, Stanford University Medical Center, AstraZeneca, Harvard T.H. Chan School of Public Health, National Cerebral and Cardiovascular Center (NCCC - OSAKA), Osaka University [Osaka], Stroke Unit (SU - BARCELONE), Vall d'Hebron University Hospital [Barcelona], Department of Neurology (Dep Neuro - BEIJING), Tiantan Hospital, Department of Medicine and Therapeutics [Hong Kong], The Chinese University of Hong Kong [Hong Kong], Murdoch University, Service de Neurologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Ticagrelor, Adenosine, Medizin, Aged, Aspirin, Double-Blind Method, Female, Hemorrhage, Humans, Ischemic Attack, Transient, Kaplan-Meier Estimate, Middle Aged, Platelet Aggregation Inhibitors, Purinergic P2Y Receptor Antagonists, Stroke, Medicine (all), 030204 cardiovascular system & hematology, Stringa autori originale: Johnston SC, Easton JD, 0302 clinical medicine, Myocardial infarction, Ischemic Attack, Transient, General Medicine, Clopidogrel, Denison H, 3. Good health, Minematsu K, Wang Y, SOCRATES Steering Committee and Investigators. - Free full-text sul sito dell'editore, Anesthesia, Platelet aggregation inhibitor, Evans SR, medicine.drug, Stringa autori originale: Johnston SC, Amarenco P, Albers GW, Denison H, Easton JD, Evans SR, Held P, Jonasson J, Minematsu K, Molina CA, Wang Y, Wong KS, Ischemia, Loading dose, Molina CA, 03 medical and health sciences, medicine, business.industry, Jonasson J, medicine.disease, Albers GW, Amarenco P, Held P, Wong KS, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia.; We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90). The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days.; During the 90 days of treatment, a primary end-point event occurred in 442 of the 6589 patients (6.7%) treated with ticagrelor, versus 497 of the 6610 patients (7.5%) treated with aspirin (hazard ratio, 0.89; 95% confidence interval [CI], 0.78 to 1.01; P=0.07). Ischemic stroke occurred in 385 patients (5.8%) treated with ticagrelor and in 441 patients (6.7%) treated with aspirin (hazard ratio, 0.87; 95% CI, 0.76 to 1.00). Major bleeding occurred in 0.5% of patients treated with ticagrelor and in 0.6% of patients treated with aspirin, intracranial hemorrhage in 0.2% and 0.3%, respectively, and fatal bleeding in 0.1% and 0.1%.; In our trial involving patients with acute ischemic stroke or transient ischemic attack, ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death at 90 days. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01994720.).
Published: 2016
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23. Impact of heart rate on admission on mortality and morbidity in acute ischaemic stroke patients - results from VISTA

Author: Nolte, C H, Erdur, H, Grittner, U, Schneider, A, Piper, S K, Scheitz, J F, Wellwood, I, Bath, P M W, Diener, Hans Christoph, Lees, K R, Endres, M, Alexandrov, A, Bluhmki, E, Bornstein, N, Chen, C, Claesson, L, Davis, S M, Donnan, G, Fisher, M, Ginsberg, M, Gregson, B, Grotta, J, Hacke, W, Hennerici, M G, Hommel, M, Kaste, M, Lyden, P, Marler, J, Muir, K, Sacco, R, Shuaib, A, Teal, P, Venketasubramanian, N, Wahlgren, N G, Warach, S, and Weimar, Christian
Subjects: Male, medicine.medical_specialty, Heart disease, acute stroke, recurrent stroke, Medizin, heart failure, 030204 cardiovascular system & hematology, Brain Ischemia, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Patient Admission, Modified Rankin Scale, Heart Rate, Internal medicine, Atrial Fibrillation, medicine, Humans, cardiovascular diseases, Myocardial infarction, Stroke, Aged, Aged, 80 and over, business.industry, Hazard ratio, Atrial fibrillation, Middle Aged, medicine.disease, mortality, Neurology, Heart failure, Cardiology, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: BACKGROUND AND PURPOSE: Elevated heart rate (HR) is associated with worse outcomes in patients with cardiovascular disease. Its predictive value in acute stroke patients is less well established. We investigated the effects of HR on admission in acute ischaemic stroke patients. METHODS: Using the Virtual International Stroke Trials Archive (VISTA) database, the association between HR in acute stroke patients without atrial fibrillation and the pre-defined composite end-point of (recurrent) ischaemic stroke, transient ischaemic attack (TIA), myocardial infarction (MI) and vascular death within 90 days was analysed. Pre-defined secondary outcomes were the composite end-point components and any death, decompensated heart failure and degree of functional dependence according to the modified Rankin Scale after 90 days. HR was analysed as a categorical variable (quartiles). RESULTS: In all, 5606 patients were available for analysis (mean National Institutes of Health Stroke Scale 13; mean age 67 years; mean HR 77 bpm; 44% female) amongst whom the composite end-point occurred in 620 patients (11.1%). Higher HR was not associated with the composite end-point. The frequencies of secondary outcomes were 3.2% recurrent stroke (n = 179), 0.6% TIA (n = 35), 1.8% MI (n = 100), 6.8% vascular death (n = 384), 15.0% any death (n = 841) and 2.2% decompensated heart failure (n = 124). Patients in the highest quartile (HR> 86 bpm) were at increased risk for any death [adjusted hazard ratio (95% confidence interval) 1.40 (1.11-1.75)], decompensated heart failure [adjusted hazard ratio 2.20 (1.11-4.37)] and worse modified Rankin Scale [adjusted odds ratio 1.29 (1.14-1.52)]. CONCLUSIONS: In acute stroke patients, higher HR (>86 bpm) is linked to mortality, heart failure and higher degree of dependence after 90 days but not to recurrent stroke, TIA or MI.
Published: 2016

24. Development, Expansion, and Use of a Stroke Clinical Trials Resource for Novel Exploratory Analyses

Author: Ali, Myzoon, Bath, Philip, Brady, Marian, Davis, Stephen, Diener, Hans Christoph, Donnan, Geoffrey, Fisher, Marc, Hacke, Werner, Hanley, Daniel F., Luby, Marie, Tsivgoulis, G., Wahlgren, Nils, Steven Warach, Steven, Lees, Kennedy R., Lees, K. R., Alexandrov, A., Bath, P. W., Bluhmki, E., Claesson, L., Davis, S. M., Gregson, B., Grotta, J., Hennerici, M. G., Hommel, M., Kaste, M., Lyden, P., Marler, J., Muir, K., Sacco, R., Shuaib, A., Teal, P., Wahlgren, N. G., Warach, S., Weimar, Christian, Ashburn, A., Barer, D., Bowen, A., Brodie, E., Corr, S., Drummond, A., Edmans, J., English, C., Gladman, J., Kalra, L., Langhorne, P., Lincoln, N., Logan, P., Mead, G., Patchick, E., Pollock, A., Pomeroy, V., Rodgers, H., Sackley, C., Shaw, L., Sunnerhagen, K. S., Tyson, S., Vliet, P. van, Whiteley, M., Albers, G., Furlan, T., Kidwell, C., Koroshetz, W., Lev, M., Sorensen, G., Wardlaw, J., Wintermark, M., Hanley, D. F., Steiner, T., Mayer, S., Molina, C., and Numminen, H.
Subjects: Diagnostic Imaging, medicine.medical_specialty, Databases, Factual, education, Medizin, MEDLINE, Physical medicine and rehabilitation, Resource (project management), medicine, Humans, Registries, cardiovascular diseases, Clinical care, Stroke, health care economics and organizations, Cerebral Hemorrhage, Clinical Trials as Topic, Data collection, business.industry, Communication, Data Collection, Stroke Rehabilitation, medicine.disease, Test (assessment), Clinical trial, Treatment Outcome, Neurology, Physical therapy, Registry data, business
Abstract: Introduction Analysis of reliable registry data can direct future research to influence clinical care. Data from the Virtual International Stroke Trials Archive have been used to test hypotheses and inform trial design. We sought to expand Virtual International Stroke Trials Archive into a broader stroke resource with new opportunities for research and international collaboration. Methods Using procedures initially developed for an acute stroke trial archive, we invited trialists to lodge data on rehabilitation, secondary prevention, intracerebral haemorrhage, imaging, and observational stroke studies. Results We have extended Virtual International Stroke Trials Archive into six subsections: Virtual International Stroke Trials Archive-Acute ( n = 28 190 patients’ data), Virtual International Stroke Trials Archive-Rehab ( n = 10 194), Virtual International Stroke Trials Archive-intracerebral haemorrhage ( n = 1829), Virtual International Stroke Trials Archive-Prevention, Virtual International Stroke Trials Archive-Imaging ( n = 1300), and Virtual International Stroke Trials Archive-Plus ( n = 6573). Enrollment continues, with commitments for the contribution of six further trials to Virtual International Stroke Trials Archive-Prevention, 13 trials to Virtual International Stroke Trials Archive-Rehab, and one registry to Virtual International Stroke Trials Archive-Plus. Data on age, type of stroke, medical history, outcomes by modified Rankin scale and Barthel Index (BI), mortality, and adverse events are available for analyses. The Virtual International Stroke Trials Archive network encourages the development of young investigators and provides opportunities for international peer review and collaboration. Conclusions Application of the original Virtual International Stroke Trials Archive concepts beyond acute stroke trials can extend the value of clinical research at low cost, without threatening commercial or intellectual property interests. This delivers valuable research output to inform the efficiency of future stroke research. We invite stroke researchers to participate actively in Virtual International Stroke Trials Archive and encourage the extension of Virtual International Stroke Trials Archive principles to other disease areas.
Published: 2012
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25. Long-term air pollution and traffic noise exposures and mild cognitive impairment in older adults : a cross-sectional analysis of the Heinz Nixdorf recall study

Author: Tzivian, Lilian, Dlugaj, Martha, Winkler, Angela, Weinmayr, Gudrun, Hennig, Frauke, Fuks, Kateryna B., Vossoughi, Mohammad, Schikowski, Tamara, Weimar, Christian, Erbel, Raimund, Jöckel, Karl-Heinz, Moebus, Susanne, Hoffmann, Barbara, and Heinz Nixdorf Recall study Investigative Group
Subjects: Male, Gerontology, Time Factors, Cross-sectional study, Health, Toxicology and Mutagenesis, Medizin, 010501 environmental sciences, 01 natural sciences, behavioral disciplines and activities, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Air Pollution, Germany, mental disorders, medicine, Humans, Dementia, Cognitive Dysfunction, Cognitive impairment, Aged, 0105 earth and related environmental sciences, Aged, 80 and over, Air Pollutants, Recall, business.industry, Research, Traffic noise, Public Health, Environmental and Occupational Health, Cognition, Environmental Exposure, Environmental exposure, Middle Aged, medicine.disease, Cross-Sectional Studies, Noise, Transportation, Female, Nitrogen Oxides, Particulate Matter, business, 030217 neurology & neurosurgery, Cohort study
Abstract: Background: Mild cognitive impairment (MCI) describes the intermediate state between normal cognitive aging and dementia. Adverse effects of air pollution (AP) on cognitive functions have been proposed, but investigations of simultaneous exposure to noise are scarce. Objectives: We analyzed the cross-sectional associations of long-term exposure to AP and traffic noise with overall MCI and amnestic (aMCI) and nonamnestic (naMCI) MCI. Methods: At the second examination of the population-based Heinz Nixdorf Recall study, cognitive assessment was completed in 4,086 participants who were 50–80 years old. Of these, 592 participants were diagnosed as having MCI (aMCI, n = 309; naMCI, n = 283) according to previously published criteria using five neuropsychological subtests. We assessed long-term residential concentrations for size-fractioned particulate matter (PM) and nitrogen oxides with land use regression, and for traffic noise [weighted 24-hr (LDEN) and night-time (LNIGHT) means]. Logistic regression models adjusted for individual risk factors were calculated to estimate the association of environmental exposures with MCI in single- and two-exposure models. Results: Most air pollutants and traffic noise were associated with overall MCI and aMCI. For example, an interquartile range increase in PM2.5 and a 10 A-weighted decibel [dB(A)] increase in LDEN were associated with overall MCI as follows [odds ratio (95% confidence interval)]: 1.16 (1.05, 1.27) and 1.40 (1.03, 1.91), respectively, and with aMCI as follows: 1.22 (1.08, 1.38) and 1.53 (1.05, 2.24), respectively. In two-exposure models, AP and noise associations were attenuated [e.g., for aMCI, PM2.5 1.13 (0.98, 1.30) and LDEN 1.46 (1.11, 1.92)]. Conclusions: Long-term exposures to air pollution and traffic noise were positively associated with MCI, mainly with the amnestic subtype. Citation: Tzivian L, Dlugaj M, Winkler A, Weinmayr G, Hennig F, Fuks KB, Vossoughi M, Schikowski T, Weimar C, Erbel R, Jöckel KH, Moebus S, Hoffmann B, on behalf of the Heinz Nixdorf Recall study Investigative Group. 2016. Long-term air pollution and traffic noise exposures and mild cognitive impairment in older adults: a cross-sectional analysis of the Heinz Nixdorf Recall Study. Environ Health Perspect 124:1361–1368; http://dx.doi.org/10.1289/ehp.1509824
Published: 2016
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26. Intracluster correlation coefficients and reliability of randomized multicenter stroke trials within VISTA

Author: Frank, Benedikt, Fulton, Rachael L., Goldie, Fraser C., Hacke, Werner, Weimar, Christian, Lees, Kennedy R., Alexandrov, Bath, Bluhmki, Claesson, Curram, Davis, Donnan, Diener, Hans Christoph, Fisher, Gregson, Grotta, Hacke, Hennerici, Hommel, Kaste, Lees, Lyden, Marler, Muir, Sacco, Shuaib, Teal, Wahlgren, and Warach
Subjects: medicine.medical_specialty, Internationality, Databases, Factual, Intraclass correlation, Medizin, Disease cluster, law.invention, Brain Ischemia, Design effect, Randomized controlled trial, Modified Rankin Scale, law, medicine, Cluster Analysis, Humans, Multicenter Studies as Topic, Cluster randomised controlled trial, Stroke, Randomized Controlled Trials as Topic, Internet, Models, Statistical, business.industry, Reproducibility of Results, medicine.disease, Treatment Outcome, Neurology, Sample size determination, Physical therapy, business, Follow-Up Studies
Abstract: Background Reliable estimates of intracluster correlation coefficients (ICCs) for specific outcome measures are crucial for sample size calculations of future cluster randomized trials. ICCs indicate the proportion of data variability that is explained by defined levels of clustering. Aims In this manuscript, we present potentially valuable and reliable estimates of ICCs for specific baseline and follow-up data. Method ICCs were estimated from linear and generalized linear mixed models using maximum likelihood estimation for common measures used in stroke research, including modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI). Results Data were available for 11 841 patients with ischemic stroke from 11 randomized trials. After adjusting for age, thrombolysis, and baseline NIHSS, the median ICC for follow-up data, using center as the level of clustering, ranged from 0·007 to 0·041. The ICCs using trial, continent or year of enrollment as level of clustering were distinctly lower. Less than 1% of the variability of mRS, NIHSS, and BI was explained by any of these three cluster levels. Conclusion This compendium of relevant ICC estimates should assist trial planning. For example, the sample size for a cluster trial with 150 patients per center using ordinal analysis of mRS should be inflated by 2·0 due to the ICC of 0·007; whereas the ICC of 0·031 using mRS dichotomized above mRS 0–1, requires inflation by 5·6. The low contribution of trials, year or continent of enrollment to overall variation in outcome offers reassurance that analyses using pooled data from multiple trials in VISTA are unlikely to suffer from bias from these sources.
Published: 2012

27. One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke

Author: Amarenco, Pierre, Lavallée, Philippa C, Labreuche, Julien, Albers, Gregory W, Bornstein, Natan M, Canhão, Patrícia, Caplan, Louis R, Donnan, Geoffrey A, Ferro, José M, Hennerici, Michael G, Molina, Carlos, Rothwell, Peter M, Sissani, Leila, Skoloudík, David, Steg, Philippe Gabriel, Touboul, Pierre-Jean, Uchiyama, Shinichiro, Vicaut, Éric, Wong, Lawrence K S, Ameriso, Sebastian, Gandolfo, Claudia Nora, Povedano, Guillermo, Saggesse, Javier, Gandolfo, Claudia, Pavon, Heman, Cancino, Jorge, Toledo, Walter, Huang, Yinin, Gong, Xiping, Ma, Yetao, Mi, Donghu, Song, Tian, Wang, Yilong, Wang, Yongjun, Chandgfend, Fran, Congtao, Guo, Hongyun, Jiao, Intao, He, Jixing, Wu, Linlin, Liu, Liquing, Song, Liwen, Tai, Ran, Liu, Shujuan, Tian, Wenhong, Liu, Tsoi, Tak Hong, Wong, Lawrence, Liu, Roxanna, Flasar, Roman, Zítková, Bed?i?ka, Reif, Michal, Goldemund, David, Neumann, Ji?í, Svá?ková, Dagmar, a?ák, Daniel, Král, Michal, koloudík, David, Václavík, Daniel, Kuliha, Martin, Cabrejo, Lucie, Guidoux, Céline, Hobeanu, Cristina Maria, Lavallée, Philippa, Meseguer, Elena, Audebert, Henrich, Menger, Daniel, Heide, Wolfgang, Lipp, Saskia, Ozalp, Huriye, Sctzmann, Christine, Weimar, Christian, Platzbecker, Katharina, Ringleb, Peter, Hennerici, Michel G, Griebe, Martin, Willmann, Katrin Knoll Olaf, Faiss, Juergen harmut, Dillan, Susan, Kobersteein, Anja, Krimmer, Katharina, Tietz, Sandra, Wienecke, Peter, Hamann, Gerhard, Burkhardt, Nico, Liebetrau, Martin, Mueller, Nadine, Wagner, Michaela, Strivastava, Kelly, Peter, Merwick, Aline, Tanne, David, Cavazzuti, Milena, Anticoli, Sabrina, Toni, Danilo, Nagata, Ken, Okada, Yasushi, Yamagami, Hiroshi, Minematsu, Kazuo, Nakagawara, Jojo, Lee, Byung Chui, Yoon, Byung Woo, Hoe, Ji Hoe, Park, Jong Moo, Abboud, Halim, Koussa, Salam, Awada, Adnan, Tan, Kay Sin, Arauz, Antonio, Gongora, Fernando, Valenzuela, Adrian Infante, Escamilla, Juan M, Canhao, Patrica, Ferro, Jose, Fonseca, Ana Catarina, Correia, Manuel, Tuna, Assuncao, Sternic, Nada, Mijajlovic, Aleksandra Pavlovic Milija, Dupejova, Beata, Szedelyová, Jana, Smirkova, Renata, Segura, Tomas, Rodgriguez, Ana, Silva, Yolanda, Tejada, Javier, Purroy, Francisco, Masjuan, Jaime, Vivancos, Jose, Palomeras, Ernest, Gamemro, Miguel Angel, Arenillas, J F, Calleja, Anna, Rojo, Esther, Buchan, Alastair, Rothwell, Peter, Lee, Tsong Hai, Chang, Ku chou, Huang, Yu-Ching, Lin, Ruey-Tay, Tiamkao, Somsak, and the TIAregistry.org Investigators
Subjects: Male, ABCD(2) SCORE, Medizin, Infarction, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, Randomized controlled trial, law, Recurrence, Risk Factors, Stroke, biology, TIAregistry.org Investigators, Ischemic Attack, Transient, Medicine (all), Composite outcomes, Minor stroke, General Medicine, 11 Medical And Health Sciences, Middle Aged, TIME, Cardiovascular Diseases, Ischemic Attack, Transient, Female, INFARCTION, Life Sciences & Biomedicine, Healthcare system, Risk, Acute coronary syndrome, medicine.medical_specialty, Aged, Humans, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, ABCD2, medicine, cardiovascular diseases, Science & Technology, business.industry, TIA, medicine.disease, RANDOMIZED-TRIAL, INDIVIDUALS, Emergency medicine, biology.protein, Physical therapy, business, 030217 neurology & neurosurgery
Abstract: BACKGROUND Previous studies conducted between 1997 and 2003 estimated that the risk of stroke or an acute coronary syndrome was 12 to 20% during the first 3 months after a transient ischemic attack (TIA) or minor stroke. The TIAregistry.org project was designed to describe the contemporary profile, etiologic factors, and outcomes in patients with a TIA or minor ischemic stroke who receive care in health systems that now offer urgent evaluation by stroke specialists. METHODS We recruited patients who had had a TIA or minor stroke within the previous 7 days. Sites were selected if they had systems dedicated to urgent evaluation of patients with TIA. We estimated the 1-year risk of stroke and of the composite outcome of stroke, an acute coronary syndrome, or death from cardiovascular causes. We also examined the association of the ABCD2 score for the risk of stroke (range, 0 [lowest risk] to 7 [highest risk]), findings on brain imaging, and cause of TIA or minor stroke with the risk of recurrent stroke over a period of 1 year. RESULTS From 2009 through 2011, we enrolled 4789 patients at 61 sites in 21 countries. A total of 78.4% of the patients were evaluated by stroke specialists within 24 hours after symptom onset. A total of 33.4% of the patients had an acute brain infarction, 23.2% had at least one extracranial or intracranial stenosis of 50% or more, and 10.4% had atrial fibrillation. The Kaplan–Meier estimate of the 1-year event rate of the composite cardiovascular outcome was 6.2% (95% confidence interval, 5.5 to 7.0). Kaplan–Meier estimates of the stroke rate at days 2, 7, 30, 90, and 365 were 1.5%, 2.1%, 2.8%, 3.7%, and 5.1%, respectively. In multivariable analyses, multiple infarctions on brain imaging, large-artery atherosclerosis, and an ABCD2 score of 6 or 7 were each associated with more than a doubling of the risk of stroke. CONCLUSIONS We observed a lower risk of cardiovascular events after TIA than previously reported. The ABCD2 score, findings on brain imaging, and status with respect to large-artery atherosclerosis helped stratify the risk of recurrent stroke within 1 year after a TIA or minor stroke. (Funded by Sanofi and Bristol-Myers Squibb.) Supported by an unrestricted grant from Sanofi and Bristol-Myers Squibb.

28. Risk Factors for Intracranial Hemorrhage in Cerebral Venous Thrombosis

Author: Afifi, Khaled, Bellanger, Guillaume, Zuurbier, Yvonne, Esperon, Garcia Carlos, Barboza, Miguel, Buyck, Pieter-Jan, Costa, Paolo, Irene Escudero-Martínez, Renard, Dimitri, Lemmens, Robin, Hinteregger, Nicole, Fazekas, Franz, Jimenez Conde, Jordi, Giralt-Steinhauer, Eva, Hiltunen, Sini, Pezzini, Alessandro, Montaner, Joan, Weimar, Christian, Churilov, Leonid, Gattringer, Thomas, Asadi, Hamed, Tatlisumak, Turgut, Coutinho, Jonathan, Demaerel, Philippe, and Thijs, Vincent

29. Long-term exposure to ambient air pollution and incidence of cerebrovascular events : results from 11 European cohorts within the ESCAPE project

Author: Stafoggia, Massimo, Cesaroni, Giulia, Peters, Annette, Andersen, Zorana J., Badaloni, Chiara, Beelen, Rob, Caracciolo, Barbara, Cyrys, Josef, de Faire, Ulf, de Hoogh, Kees, Eriksen, Kirsten T., Fratiglioni, Laura, Galassi, Claudia, Gigante, Bruna, Havulinna, Aki S., Hennig, Frauke, Hilding, Agneta, Hoek, Gerard, Hoffmann, Barbara, Houthuijs, Danny, Korek, Michal, Lanki, Timo, Leander, Karin, Magnusson, Patrik K., Meisinger, Christa, Migliore, Enrica, Overvad, Kim, Ostenson, Claes-Göran, Pedersen, Nancy L., Pekkanen, Juha, Penell, Johanna, Pershagen, Goran, Pundt, Noreen, Pyko, Andrei, Raaschou-Nielsen, Ole, Ranzi, Andrea, Ricceri, Fulvio, Sacerdote, Carlotta, Swart, Wim J. R., Turunen, Anu W., Vineis, Paolo, Weimar, Christian, Weinmayr, Gudrun, Wolf, Kathrin, Brunekreef, Bert, and Forastiere, Francesco
Subjects: 13. Climate action

30. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA

Author: SUNDAY CLARK, Emil Ylikallio, MARIAN MUCHADA, Cristina Hobeanu, Saima Bashir Viturro, David Tirschwell, Amy Ying Xin Yu, Matthew Vibbert, Jiaying Zhang, Javier Sotoca, Ricardo Rigual, Gerrit M. Grosse, Laurent Derex, Daniel Guisado-Alonso, Angel Ois, Naresh Mullaguri, Fernanda Bellolio, Laurie Gutmann, Sudeepta Dandapat, Joseph Carrera, POL CAMPS-RENOM, Patricia Martínez-Sánchez, Hayrapet Kalashyan, Brent Becker, Elena Meseguer, Shubhabrata Das, Alejandro Martinez-Domeño, Michelle Leppert, Paulina Sergot, Amie Hsia, Marc Malkoff, Sami Curtze, Roland Faigle, X. Michelle Androulakis, Freimuth Brunner, Ashish Kulhari, Alexandra Reynolds, Neal Parikh, Ivan Marinkovic, Marion Buckwalter, Nicholas Morris, Justin Mazzillo, Philippa Lavallée, Vincent Thijs, Joan Martí-Fàbregas, Jason Mathew, Jaume Roquer Gonzalez, Thalia Field, Tissa Wijeratne, Theodore Wein, Starane Shepherd, and Weimar, Christian (Beitragende*r)
Subjects: Male, Myocardial Infarction, Medizin, 030204 cardiovascular system & hematology, Medical and Health Sciences, Brain Ischemia, 0302 clinical medicine, Ischemia, Neurological Emergencies Treatment Trials Network, Secondary Prevention, Myocardial infarction, and the POINT Investigators, Stroke, Aspirin, education.field_of_study, Ischemic Attack, Transient, General Medicine, Middle Aged, Clopidogrel, Ischemic Attack, Transient, 6.1 Pharmaceuticals, Combination, Cardiology, Female, Drug Therapy, Combination, Patient Safety, Ticagrelor, medicine.drug, Risk, medicine.medical_specialty, Ticlopidine, Clinical Trials and Supportive Activities, Population, Hemorrhage, Loading dose, Article, 03 medical and health sciences, Drug Therapy, Double-Blind Method, Clinical Research, General & Internal Medicine, Internal medicine, medicine, Humans, cardiovascular diseases, education, Aged, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, medicine.disease, Brain Disorders, Clinical Research Collaboration, business, Platelet Aggregation Inhibitors, 030217 neurology & neurosurgery
Abstract: BackgroundCombination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population.MethodsIn a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone. The dose of aspirin in each group was selected by the site investigator. The primary efficacy outcome in a time-to-event analysis was the risk of a composite of major ischemic events, which was defined as ischemic stroke, myocardial infarction, or death from an ischemic vascular event, at 90 days.ResultsA total of 4881 patients were enrolled at 269 international sites. The trial was halted after 84% of the anticipated number of patients had been enrolled because the data and safety monitoring board had determined that the combination of clopidogrel and aspirin was associated with both a lower risk of major ischemic events and a higher risk of major hemorrhage than aspirin alone at 90 days. Major ischemic events occurred in 121 of 2432 patients (5.0%) receiving clopidogrel plus aspirin and in 160 of 2449 patients (6.5%) receiving aspirin plus placebo (hazard ratio, 0.75; 95% confidence interval [CI], 0.59 to 0.95; P=0.02), with most events occurring during the first week after the initial event. Major hemorrhage occurred in 23 patients (0.9%) receiving clopidogrel plus aspirin and in 10 patients (0.4%) receiving aspirin plus placebo (hazard ratio, 2.32; 95% CI, 1.10 to 4.87; P=0.02).ConclusionsIn patients with minor ischemic stroke or high-risk TIA, those who received a combination of clopidogrel and aspirin had a lower risk of major ischemic events but a higher risk of major hemorrhage at 90 days than those who received aspirin alone. (Funded by the National Institute of Neurological Disorders and Stroke; POINT ClinicalTrials.gov number, NCT00991029 .).
Published: 2018
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31. Validating and comparing stroke prognosis scales

Author: Terence J, Quinn, Sarjit, Singh, Kennedy R, Lees, Philip M, Bath, Phyo K, Myint, M, Ginsberg, and Weimar, Christian (Beitragende*r)
Subjects: Male, medicine.medical_specialty, Medizin, MEDLINE, Datasets as Topic, 030204 cardiovascular system & hematology, Brain Ischemia, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Level of consciousness, Modified Rankin Scale, Internal medicine, medicine, Humans, Stroke, Aged, Clinical Trials as Topic, Receiver operating characteristic, business.industry, Prognosis, Missing data, medicine.disease, Confidence interval, Clinical trial, ROC Curve, Area Under Curve, Female, Neurology (clinical), business, Intracranial Hemorrhages, 030217 neurology & neurosurgery
Abstract: Objective:To compare the prognostic accuracy of various acute stroke prognostic scales using a large, independent, clinical trials dataset.Methods:We directly compared 8 stroke prognostic scales, chosen based on focused literature review (Acute Stroke Registry and Analysis of Lausanne [ASTRAL]; iSCORE; iSCORE-revised; preadmission comorbidities, level of consciousness, age, and neurologic deficit [PLAN]; stroke subtype, Oxfordshire Community Stroke Project, age, and prestroke modified Rankin Scale [mRS] [SOAR]; modified SOAR; Stroke Prognosis Instrument 2 [SPI2]; and Totaled Health Risks in Vascular Events [THRIVE]) using individual patient-level data from a clinical trials archive (Virtual International Stroke Trials Archive [VISTA]). We calculated area under receiver operating characteristic curves (AUROC) for each scale against 90-day outcomes of mRS (dichotomized at mRS >2), Barthel Index (>85), and mortality. We performed 2 complementary analyses: the first limited to patients with complete data for all components of all scales (simultaneous) and the second using as many patients as possible for each individual scale (separate). We compared AUROCs and performed sensitivity analyses substituting extreme outcome values for missing data.Results:In total, 10,777 patients contributed to the analyses. Our simultaneous analyses suggested that ASTRAL had greatest prognostic accuracy for mRS, AUROC 0.78 (95% confidence interval [CI] 0.75–0.82), and SPI2 had poorest AUROC, 0.61 (95% CI 0.57–0.66). Our separate analyses confirmed these results: ASTRAL AUROC 0.79 (95% CI 0.78–0.80 and SPI2 AUROC 0.60 (95% CI 0.59–0.61). On formal comparative testing, there was a significant difference in modified Rankin Scale AUROC between ASTRAL and all other scales. Sensitivity analysis identified no evidence of systematic bias from missing data.Conclusions:Our comparative analyses confirm differences in the prognostic accuracy of stroke scales. However, even the best performing scale had prognostic accuracy that may not be sufficient as a basis for clinical decision-making.
Published: 2017
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32. Stroke aetiological classification reliability and effect on trial sample size: systematic review, meta-analysis and statistical modelling

Author: David Alexander Dickie, Philip Bath, James Grotta, Stephen Davis, Markku Kaste, Azmil H Abdul-Rahim, and Weimar, Christian (Beitragende*r)
Subjects: Time Factors, Heart Diseases, Embolism, Medizin, Medicine (miscellaneous), 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Terminology as Topic, Statistics, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Aetiology, Stroke, Bootstrapping (statistics), Protocol (science), Observer Variation, lcsh:R5-920, Clinical Trials as Topic, Models, Statistical, business.industry, Research, Anticoagulants, medicine.disease, Classification, 3. Good health, Clinical trial, Inter-rater reliability, Treatment Outcome, Sample size determination, Meta-analysis, Data Interpretation, Statistical, Sample Size, Platelet aggregation inhibitor, lcsh:Medicine (General), business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors
Abstract: Background Inter-observer variability in stroke aetiological classification may have an effect on trial power and estimation of treatment effect. We modelled the effect of misclassification on required sample size in a hypothetical cardioembolic (CE) stroke trial. Methods We performed a systematic review to quantify the reliability (inter-observer variability) of various stroke aetiological classification systems. We then modelled the effect of this misclassification in a hypothetical trial of anticoagulant in CE stroke contaminated by patients with non-cardioembolic (non-CE) stroke aetiology. Rates of misclassification were based on the summary reliability estimates from our systematic review. We randomly sampled data from previous acute trials in CE and non-CE participants, using the Virtual International Stroke Trials Archive. We used bootstrapping to model the effect of varying misclassification rates on sample size required to detect a between-group treatment effect across 5000 permutations. We described outcomes in terms of survival and stroke recurrence censored at 90 days. Results From 4655 titles, we found 14 articles describing three stroke classification systems. The inter-observer reliability of the classification systems varied from ‘fair’ to ‘very good’ and suggested misclassification rates of 5% and 20% for our modelling. The hypothetical trial, with 80% power and alpha 0.05, was able to show a difference in survival between anticoagulant and antiplatelet in CE with a sample size of 198 in both trial arms. Contamination of both arms with 5% misclassified participants inflated the required sample size to 237 and with 20% misclassification inflated the required sample size to 352, for equivalent trial power. For an outcome of stroke recurrence using the same data, base-case estimated sample size for 80% power and alpha 0.05 was n = 502 in each arm, increasing to 605 at 5% contamination and 973 at 20% contamination. Conclusions Stroke aetiological classification systems suffer from inter-observer variability, and the resulting misclassification may limit trial power. Trial registration Protocol available at reviewregistry540. Electronic supplementary material The online version of this article (10.1186/s13063-019-3222-x) contains supplementary material, which is available to authorized users.
Published: 2018

33. Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Author: Bruce C V Campbell, Wim H van Zwam, Mayank Goyal, Bijoy K Menon, Diederik W J Dippel, Andrew M Demchuk, Serge Bracard, Philip White, Antoni Dávalos, Charles B L M Majoie, Aad van der Lugt, Gary A Ford, Natalia Pérez de la Ossa, Michael Kelly, Romain Bourcier, Geoffrey A Donnan, Yvo B W E M Roos, Oh Young Bang, Raul G Nogueira, Thomas G Devlin, Lucie A van den Berg, Frédéric Clarençon, Paul Burns, Jeffrey Carpenter, Olvert A Berkhemer, Dileep R Yavagal, Vitor Mendes Pereira, Xavier Ducrocq, Anand Dixit, Helena Quesada, Jonathan Epstein, Stephen M Davis, Olav Jansen, Marta Rubiera, Xabier Urra, Emilien Micard, Hester F Lingsma, Olivier Naggara, Scott Brown, Francis Guillemin, Keith W Muir, Robert J van Oostenbrugge, Jeffrey L Saver, Tudor G Jovin, Michael D Hill, Peter J Mitchell, Puck SS Fransen, Debbie Beumer, Albert J Yoo, Wouter J Schonewille, Jan Albert Vos, Paul J Nederkoorn, Marieke JH Wermer, Marianne AA van Walderveen, Julie Staals, Jeannette Hofmeijer, Jacques A. van Oostayen, Geert J. Lycklama à Nijeholt, Jelis Boiten, Patrick A. Brouwer, Bart J. Emmer, Sebastiaan F. de Bruijn, Lukas C. van Dijk, Jaap Kappelle, Rob H Lo, Ewoud J. van Dijk, Joost de Vries, Paul L.M. de Kort, Willem Jan J. van Rooij, Jan S.P. van den Berg, Boudewijn A.A.M. van Hasselt, Leo A.M. Aerden, René J. Dallinga, Marieke C. Visser, Joseph C.J. Bot, Patrick C. Vroomen, Omid Eshghi, Tobien H.C.M.L. Schreuder, Roel J.J. Heijboer, Koos Keizer, Alexander V. Tielbeek, Heleen M. den Hertog, Dick G. Gerrits, Renske M. van den Berg-Vos, Giorgos B. Karas, Ewout W. Steyerberg, Zwenneke Flach, Henk A. Marquering, Marieke E.S. Sprengers, Sjoerd F.M. Jenniskens, Ludo F.M. Beenen, René van den Berg, Peter J. Koudstaal, Wim H. van Zwam, Yvo B.W.E.M. Roos, Robert J. van Oostenbrugge, Charles B.L.M. Majoie, Diederik W.J. Dippel, Martin M. Brown, Thomas Liebig, Theo Stijnen, Tommy Andersson, Heinrich Mattle, Nils Wahlgren, Esther van der Heijden, Naziha Ghannouti, Nadine Fleitour, Imke Hooijenga, Corina Puppels, Wilma Pellikaan, Annet Geerling, Annemieke Lindl-Velema, Gina van Vemde, Ans de Ridder, Paut Greebe, José de Bont-Stikkelbroeck, Joke de Meris, Kirsten Janssen, Willy Struijk, Silvan Licher, Nikki Boodt, Adriaan Ros, Esmee Venema, Ilse Slokkers, Raymie-Jayce Ganpat, Maxim Mulder, Nawid Saiedie, Alis Heshmatollah, Stefanie Schipperen, Stefan Vinken, Tiemen van Boxtel, Jeroen Koets, Merel Boers, Emilie Santos, Jordi Borst, Ivo Jansen, Manon Kappelhof, Marit Lucas, Ralph Geuskens, Renan Sales Barros, Roeland Dobbe, Marloes Csizmadia, MD Hill, M Goyal, AM Demchuk, BK Menon, M Eesa, KJ Ryckborst, MR Wright, NR Kamal, L Andersen, PA Randhawa, T Stewart, S Patil, P Minhas, M Almekhlafi, S Mishra, F Clement, T Sajobi, A Shuaib, WJ Montanera, D Roy, FL Silver, TG Jovin, DF Frei, B Sapkota, JL Rempel, J Thornton, D Williams, D Tampieri, AY Poppe, D Dowlatshahi, JH Wong, AP Mitha, S Subramaniam, G Hull, MW Lowerison, M Salluzzi, M Maxwell, S Lacusta, E Drupals, K Armitage, PA Barber, EE Smith, WF Morrish, SB Coutts, C Derdeyn, B Demaerschalk, D Yavagal, R Martin, R Brant, Y Yu, RA Willinsky, A Weill, C Kenney, H Aram, PK Stys, TW Watson, G Klein, D Pearson, P Couillard, A Trivedi, D Singh, E Klourfeld, O Imoukhuede, D Nikneshan, S Blayney, R Reddy, P Choi, M Horton, T Musuka, V Dubuc, TS Field, J Desai, S Adatia, A Alseraya, V Nambiar, R van Dijk, NJ Newcommon, B Schwindt, KS Butcher, T Jeerakathil, B Buck, K Khan, SS Naik, DJ Emery, RJ Owen, TB Kotylak, RA Ashforth, TA Yeo, D McNally, M Siddiqui, M Saqqur, D Hussain, H Kalashyan, A Manosalva, M Kate, L Gioia, S Hasan, A Mohammad, M Muratoglu, A Cullen, P Brennan, A O'Hare, S Looby, D Hyland, S Duff, M McCusker, B Hallinan, S Lee, J McCormack, A Moore, M O'Connor, C Donegan, L Brewer, A Martin, S Murphy, K O'Rourke, S Smyth, P Kelly, T Lynch, T Daly, P O'Brien, A O'Driscoll, M Martin, R Collins, T Coughlan, D McCabe, D O'Neill, M Mulroy, O Lynch, T Walsh, M O'Donnell, T Galvin, J Harbison, P McElwaine, K Mulpeter, C McLoughlin, M Reardon, E Harkin, E Dolan, M Watts, N Cunningham, C Fallon, S Gallagher, P Cotter, M Crowe, R Doyle, I Noone, M Lapierre, VA Coté, S Lanthier, C Odier, A Durocher, J Raymond, N Daneault, Y Deschaintre, B Jankowitz, L Baxendell, L Massaro, C Jackson-Graves, S Decesare, P Porter, K Armbruster, A Adams, J Billigan, J Oakley, A Ducruet, A Jadhav, D-V Giurgiutiu, A Aghaebrahim, V Reddy, M Hammer, M Starr, V Totoraitis, L Wechsler, S Streib, S Rangaraju, D Campbell, M Rocha, D Gulati, T Krings, L Kalman, A Cayley, J Williams, R Wiegner, LK Casaubon, C Jaigobin, JM del Campo, E Elamin, JD Schaafsma, R Agid, R Farb, K ter Brugge, BL Sapkoda, BW Baxter, K Barton, A Knox, A Porter, A Sirelkhatim, T Devlin, C Dellinger, N Pitiyanuvath, J Patterson, J Nichols, S Quarfordt, J Calvert, H Hawk, C Fanale, A Bitner, A Novak, D Huddle, R Bellon, D Loy, J Wagner, I Chang, E Lampe, B Spencer, R Pratt, R Bartt, S Shine, G Dooley, T Nguyen, M Whaley, K McCarthy, J Teitelbaum, W Poon, N Campbell, M Cortes, C Lum, R Shamloul, S Robert, G Stotts, M Shamy, N Steffenhagen, D Blacquiere, M Hogan, M AlHazzaa, G Basir, H Lesiuk, D Iancu, M Santos, H Choe, DC Weisman, K Jonczak, A Blue-Schaller, Q Shah, L MacKenzie, B Klein, K Kulandaivel, O Kozak, DJ Gzesh, LJ Harris, JS Khoury, J Mandzia, D Pelz, S Crann, L Fleming, K Hesser, B Beauchamp, B Amato-Marzialli, M Boulton, P Lopez- Ojeda, M Sharma, S Lownie, R Chan, R Swartz, P Howard, D Golob, D Gladstone, K Boyle, M Boulos, J Hopyan, V Yang, L Da Costa, CA Holmstedt, AS Turk, R Navarro, E Jauch, S Ozark, R Turner, S Phillips, J Shankar, J Jarrett, G Gubitz, W Maloney, R Vandorpe, M Schmidt, J Heidenreich, G Hunter, M Kelly, R Whelan, L Peeling, PA Burns, A Hunter, I Wiggam, E Kerr, M Watt, A Fulton, P Gordon, I Rennie, P Flynn, G Smyth, S O'Leary, N Gentile, G Linares, P McNelis, K Erkmen, P Katz, A Azizi, M Weaver, C Jungreis, S Faro, P Shah, H Reimer, V Kalugdan, G Saposnik, A Bharatha, Y Li, P Kostyrko, T Marotta, W Montanera, D Sarma, D Selchen, J Spears, JH Heo, K Jeong, DJ Kim, BM Kim, YD Kim, D Song, K-J Lee, J Yoo, OY Bang, S Rho, J Lee, P Jeon, KH Kim, J Cha, SJ Kim, S Ryoo, MJ Lee, S-I Sohn, C-H Kim, H-G Ryu, J-H Hong, H-W Chang, C-Y Lee, J Rha, Bruce CV Campbell, Leonid Churilov, Bernard Yan, Richard Dowling, Nawaf Yassi, Thomas J Oxley, Teddy Y Wu, Gabriel Silver, Amy McDonald, Rachael McCoy, Timothy J Kleinig, Rebecca Scroop, Helen M Dewey, Marion Simpson, Mark Brooks, Bronwyn Coulton, Martin Krause, Timothy J Harrington, Brendan Steinfort, Kenneth Faulder, Miriam Priglinger, Susan Day, Thanh Phan, Winston Chong, Michael Holt, Ronil V Chandra, Henry Ma, Dennis Young, Kitty Wong, Tissa Wijeratne, Hans Tu, Elizabeth Mackay, Sherisse Celestino, Christopher F Bladin, Poh Sien Loh, Amanda Gilligan, Zofia Ross, Skye Coote, Tanya Frost, Mark W Parsons, Ferdinand Miteff, Christopher R Levi, Timothy Ang, Neil Spratt, Lara Kaauwai, Monica Badve, Henry Rice, Laetitia de Villiers, P. Alan Barber, Ben McGuinness, Ayton Hope, Maurice Moriarty, Patricia Bennett, Andrew Wong, Alan Coulthard, Andrew Lee, Jim Jannes, Deborah Field, Gagan Sharma, Simon Salinas, Elise Cowley, Barry Snow, John Kolbe, Richard Stark, John King, Richard Macdonnell, John Attia, Cate D'Este, Hans-Christoph Diener, Elad I. Levy, Alain Bonafé, Reza Jahan, Gregory W. Albers, Christophe Cognard, David J. Cohen, Werner Hacke, Tudor G. Jovin, Heinrich P. Mattle, Raul G. Nogueira, Adnan H. Siddiqui, Dileep R. Yavagal, Rüdiger von Kummer, Wade Smith, Francis Turjman, Scott Hamilton, Richard Chiacchierini, Arun Amar, Nerses Sanossian, Yince Loh, B Baxter, VK Reddy, A Horev, M Star, A Siddiqui, LN Hopkins, K Snyder, R Sawyer, S Hall, V Costalat, C Riquelme, P Machi, E Omer, C Arquizan, I Mourand, M Charif, X Ayrignac, N Menjot de Champfleur, N Leboucq, G Gascou, M Moynier, R du Mesnil de Rochemont, O Singer, J Berkefeld, C Foerch, M Lorenz, W Pfeilschifer, E Hattingen, M Wagner, SJ You, S Lescher, H Braun, S Dehkharghani, SR Belagaje, A Anderson, A Lima, M Obideen, D Haussen, R Dharia, M Frankel, V Patel, K Owada, A Saad, L Amerson, C Horn, S Doppelheuer, K Schindler, DK Lopes, M Chen, R Moftakhar, C Anton, M Smreczak, JS Carpenter, S Boo, A Rai, T Roberts, A Tarabishy, L Gutmann, C Brooks, J Brick, J Domico, G Reimann, K Hinrichs, M Becker, E Heiss, C Selle, A Witteler, S Al-Boutros, M-J Danch, A Ranft, S Rohde, K Burg, C Weimar, V Zegarac, C Hartmann, M Schlamann, S Göricke, A Ringlestein, I Wanke, C Mönninghoff, M Dietzold, R Budzik, T Davis, G Eubank, WJ Hicks, P Pema, N Vora, J Mejilla, M Taylor, W Clark, A Rontal, J Fields, B Peterson, G Nesbit, H Lutsep, H Bozorgchami, R Priest, O Ologuntoye, S Barnwell, A Dogan, K Herrick, C Takahasi, N Beadell, B Brown, S Jamieson, MS Hussain, A Russman, F Hui, D Wisco, K Uchino, Z Khawaja, I Katzan, G Toth, E Cheng-Ching, M Bain, S Man, A Farrag, P George, S John, L Shankar, A Drofa, R Dahlgren, A Bauer, A Itreat, A Taqui, R Cerejo, A Richmond, P Ringleb, M Bendszus, M Möhlenbruch, T Reiff, H Amiri, J Purrucker, C Herweh, M Pham, O Menn, I Ludwig, I Acosta, C Villar, W Morgan, C Sombutmai, F Hellinger, E Allen, M Bellew, R Gandhi, E Bonwit, J Aly, RD Ecker, D Seder, J Morris, M Skaletsky, J Belden, C Baker, LS Connolly, P Papanagiotou, C Roth, A Kastrup, M Politi, F Brunner, M Alexandrou, H Merdivan, C Ramsey, C Given II, S Renfrow, V Deshmukh, K Sasadeusz, F Vincent, JT Thiesing, J Putnam, A Bhatt, A Kansara, D Caceves, T Lowenkopf, L Yanase, J Zurasky, S Dancer, B Freeman, T Scheibe-Mirek, J Robison, J Roll, D Clark, M Rodriguez, B-FM Fitzsimmons, O Zaidat, JR Lynch, M Lazzaro, T Larson, L Padmore, E Das, A Farrow-Schmidt, A Hassan, W Tekle, C Cate, O Jansen, C Cnyrim, F Wodarg, C Wiese, A Binder, C Riedel, A Rohr, N Lang, H Laufs, S Krieter, L Remonda, M Diepers, J Añon, K Nedeltchev, T Kahles, S Biethahn, M Lindner, V Chang, C Gächter, C Esperon, M Guglielmetti, JF Arenillas Lara, M Martínez Galdámez, AI Calleja Sanz, E Cortijo Garcia, P Garcia Bermejo, S Perez, P Mulero Carrillo, E Crespo Vallejo, M Ruiz Piñero, L Lopez Mesonero, FJ Reyes Muñoz, C Brekenfeld, J-H Buhk, A Krützelmann, G Thomalla, B Cheng, C Beck, J Hoppe, E Goebell, B Holst, U Grzyska, G Wortmann, S Starkman, G Duckwiler, R Jahan, N Rao, S Sheth, K Ng, A Noorian, V Szeder, M Nour, M McManus, J Huang, J Tarpley, S Tateshima, N Gonzalez, L Ali, D Liebeskind, J Hinman, M Calderon-Arnulphi, C Liang, J Guzy, S Koch, K DeSousa, G Gordon-Perue, M Elhammady, E Peterson, V Pandey, S Dharmadhikari, P Khandelwal, A Malik, R Pafford, P Gonzalez, K Ramdas, G Andersen, D Damgaard, P Von Weitzel-Mudersbach, C Simonsen, N Ruiz de Morales Ayudarte, M Poulsen, L Sørensen, S Karabegovich, M Hjørringgaard, N Hjort, T Harbo, K Sørensen, E Deshaies, D Padalino, A Swarnkar, JG Latorre, E Elnour, Z El-Zammar, M Villwock, H Farid, A Balgude, L Cross, K Hansen, M Holtmannspötter, D Kondziella, J Hoejgaard, S Taudorf, H Soendergaard, A Wagner, M Cronquist, T Stavngaard, M Cortsen, LH Krarup, T Hyldal, H-P Haring, S Guggenberger, M Hamberger, J Trenkler, M Sonnberger, K Nussbaumer, C Dominger, E Bach, BD Jagadeesan, R Taylor, J Kim, K Shea, R Tummala, H Zacharatos, D Sandhu, M Ezzeddine, A Grande, D Hildebrandt, K Miller, J Scherber, A Hendrickson, M Jumaa, S Zaidi, T Hendrickson, V Snyder, M Killer-Oberpfalzer, J Mutzenbach, F Weymayr, E Broussalis, K Stadler, A Jedlitschka, A Malek, N Mueller-Kronast, P Beck, C Martin, D Summers, J Day, I Bettinger, W Holloway, K Olds, S Arkin, N Akhtar, C Boutwell, S Crandall, M Schwartzman, C Weinstein, B Brion, S Prothmann, J Kleine, K Kreiser, T Boeckh-Behrens, H Poppert, S Wunderlich, ML Koch, V Biberacher, A Huberle, G Gora-Stahlberg, B Knier, T Meindl, D Utpadel-Fischler, M Zech, M Kowarik, C Seifert, B Schwaiger, A Puri, S Hou, A Wakhloo, M Moonis, N Henninger, R Goddeau, F Massari, A Minaeian, JD Lozano, M Ramzan, C Stout, A Patel, A Tunguturi, S Onteddu, R Carandang, M Howk, M Ribó, E Sanjuan, M Rubiera, J Pagola, A Flores, M Muchada, P Meler, E Huerga, S Gelabert, P Coscojuela, A Tomasello, D Rodriguez, E Santamarina, O Maisterra, S Boned, L Seró, A Rovira, CA Molina, M Millán, L Muñoz, N Pérez de la Ossa, M Gomis, L Dorado, E López-Cancio, E Palomeras, J Munuera, P García Bermejo, S Remollo, C Castaño, R García-Sort, P Cuadras, P Puyalto, M Hernández-Pérez, M Jiménez, A Martínez-Piñeiro, G Lucente, A Dávalos, A Chamorro, X Urra, V Obach, A Cervera, S Amaro, L Llull, J Codas, M Balasa, J Navarro, H Ariño, A Aceituno, S Rudilosso, A Renu, JM Macho, L San Roman, J Blasco, A López, N Macías, P Cardona, H Quesada, F Rubio, L Cano, B Lara, MA de Miquel, L Aja, J Serena, E Cobo, Gregory W Albers, Kennedy R Lees, J Arenillas, R Roberts, F Al-Ajlan, L Zimmel, S Patel, J Martí-Fàbregas, M Salvat-Plana, S Bracard, René Anxionnat, Pierre-Alexandre Baillot, Charlotte Barbier, Anne-Laure Derelle, Jean-Christophe Lacour, Sébastien Richard, Yves Samson, Nader Sourour, Flore Baronnet-Chauvet, Frédéric Clarencon, Sophie Crozier, Sandrine Deltour, Federico Di Maria, Raphael Le Bouc, Anne Leger, Gurkan Mutlu, Charlotte Rosso, Zoltan Szatmary, Marion Yger, Chiara Zavanone, Serge Bakchine, Laurent Pierot, Nathalie Caucheteux, Laurent Estrade, Krzysztof Kadziolka, Alexandre Leautaud, Céline Renkes, Isabelle Serre, Hubert Desal, Benoît Guillon, Claire Boutoleau-Bretonniere, Benjamin Daumas-Duport, Solène De Gaalon, Pascal Derkinderen, Sarah Evain, Fanny Herisson, David-Axel Laplaud, Thibaud Lebouvier, Alina Lintia-Gaultier, Hélène Pouclet-Courtemanche, Tiphaine Rouaud, Violaine Rouaud Jaffrenou, Aurélia Schunck, Mathieu Sevin-Allouet, Frederique Toulgoat, Sandrine Wiertlewski, Jean-Yves Gauvrit, Thomas Ronziere, Vincent Cahagne, Jean-Christophe Ferre, Jean-François Pinel, Hélène Raoult, Jean-Louis Mas, Jean-François Meder, Amen-Adam Al Najjar-Carpentier, Julia Birchenall, Eric Bodiguel, David Calvet, Valérie Domigo, Sylvie Godon-Hardy, Vincent Guiraud, Catherine Lamy, Loubna Majhadi, Ludovic Morin, Denis Trystram, Guillaume Turc, Jérôme Berge, Igor Sibon, Patrice Menegon, Xavier Barreau, François Rouanet, Sabrina Debruxelles, Annabelle Kazadi, Pauline Renou, Olivier Fleury, Anne Pasco-Papon, Frédéric Dubas, Jildaz Caroff, Sophie Godard Ducceschi, Marie-Aurélie Hamon, Alderic Lecluse, Guillaume Marc, Maurice Giroud, Frédéric Ricolfi, Yannick Bejot, Adrien Chavent, Arnaud Gentil, Apolline Kazemi, Guy-Victor Osseby, Charlotte Voguet, Marie-Hélène Mahagne, Jacques Sedat, Yves Chau, Laurent Suissa, Sylvain Lachaud, Emmanuel Houdart, Christian Stapf, Frédérique Buffon Porcher, Hugues Chabriat, Pierre Guedin, Dominique Herve, Eric Jouvent, Jérôme Mawet, Jean-Pierre Saint-Maurice, Hans-Martin Schneble, Norbert Nighoghossian, Nadia-Nawel Berhoune, Françoise Bouhour, Tae-Hee Cho, Laurent Derex, Sandra Felix, Hélène Gervais-Bernard, Benjamin Gory, Luis Manera, Laura Mechtouff, Thomas Ritzenthaler, Roberto Riva, Fabrizio Salaris Silvio, Caroline Tilikete, Raphael Blanc, Michaël Obadia, Mario Bruno Bartolini, Antoine Gueguen, Michel Piotin, Silvia Pistocchi, Hocine Redjem, Jacques Drouineau, Jean-Philippe Neau, Gaelle Godeneche, Matthias Lamy, Emilia Marsac, Stephane Velasco, Pierre Clavelou, Emmanuel Chabert, Nathalie Bourgois, Catherine Cornut-Chauvinc, Anna Ferrier, Jean Gabrillargues, Betty Jean, Anna-Raquel Marques, Nicolas Vitello, Olivier Detante, Marianne Barbieux, Kamel Boubagra, Isabelle Favre Wiki, Katia Garambois, Florence Tahon, Vasdev Ashok, Oguzhan Coskun, Georges Rodesch, Bertrand Lapergue, Frédéric Bourdain, Serge Evrard, Philippe Graveleau, Jean Pierre Decroix, Adrien Wang, François Sellal, Guido Ahle, Gabriela Carelli, Marie-Hélène Dugay, Claude Gaultier, Ariel Pablo Lebedinsky, Lavinia Lita, Raul Mariano Musacchio, Catherine Renglewicz-Destuynder, Alain Tournade, Françis Vuillemet, Francisco Macian Montoro, Charbel Mounayer, Frederic Faugeras, Laetitia Gimenez, Catherine Labach, Géraldine Lautrette, Christian Denier, Guillaume Saliou, Olivier Chassin, Claire Dussaule, Elsa Melki, Augustin Ozanne, Francesco Puccinelli, Marina Sachet, Mariana Sarov, Jean-François Bonneville, Thierry Moulin, Alessandra Biondi, Elisabeth De Bustos Medeiros, Fabrice Vuillier, Patrick Courtheoux, Fausto Viader, Marion Apoil-Brissard, Mathieu Bataille, Anne-Laure Bonnet, Julien Cogez, Emmanuel Touze, Xavier Leclerc, Didier Leys, Mohamed Aggour, Pierre Aguettaz, Marie Bodenant, Charlotte Cordonnier, Dominique Deplanque, Marie Girot, Hilde Henon, Erwah Kalsoum, Christian Lucas, Jean-Pierre Pruvo, Paolo Zuniga, Caroline Arquizan, Vincent Costalat, Paolo Machi, Isabelle Mourand, Carlos Riquelme, Pierre Bounolleau, Charles Arteaga, Anthony Faivre, Marc Bintner, Patrice Tournebize, Cyril Charlin, Françoise Darcel, Pascale Gauthier-Lasalarie, Marcia Jeremenko, Servane Mouton, Jean-Baptiste Zerlauth, Chantal Lamy, Deramond Hervé, Hosseini Hassan, André Gaston, Francis-Guy Barral, Pierre Garnier, Rémy Beaujeux, Valérie Wolff, Denis Herbreteau, Séverine Debiais, Alicia Murray, Gary Ford, Martin M Brown, Andy Clifton, Janet Freeman, Ian Ford, Hugh Markus, Joanna Wardlaw, Andy Molyneux, Thompson Robinson, Steff Lewis, John Norrie, Fergus Robertson, Richard Perry, Geoffrey Cloud, Andrew Clifton, Jeremy Madigan, Christine Roffe, Sanjeev Nayak, Kyriakos Lobotesis, Craig Smith, Amit Herwadkar, Naga Kandasamy, Tony Goddard, John Bamford, Ganesh Subramanian, Rob Lenthall, Edward Littleton, Sal Lamin, Kelley Storey, Rita Ghatala, Azra Banaras, John Aeron-Thomas, Bath Hazel, Holly Maguire, Emelda Veraque, Louise Harrison, Rekha Keshvara, James Cunningham, University of Melbourne, University of Calgary, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), University of Amsterdam [Amsterdam] (UvA), Universitat Autònoma de Barcelona (UAB), Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, Neurology, Graduate School, Other Research, APH - Personalized Medicine, APH - Quality of Care, Biomedical Engineering and Physics, ARD - Amsterdam Reproduction and Development, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Microcirculation, ACS - Atherosclerosis & ischemic syndromes, ACS - Pulmonary hypertension & thrombosis, Radiology & Nuclear Medicine, Public Health, Weimar, Christian (Beitragende*r), Molecular cell biology and Immunology, Pathology, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, Rheumatology, Beeldvorming, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: CARIM - R3.11 - Imaging, MUMC+: DA BV Medisch Specialisten Radiologie (9), Klinische Neurowetenschappen, and MUMC+: MA Neurologie (3)
Subjects: Male, medicine.medical_specialty, Sedation, Medizin, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, Anesthesia, General, CONTROLLED-TRIAL, THERAPY, law.invention, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, Randomized controlled trial, law, Modified Rankin Scale, Journal Article, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Medicine, Humans, General anaesthesia, Stroke, Aged, Randomized Controlled Trials as Topic, Thrombectomy, Aged, 80 and over, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, MR, Middle Aged, Outcome and Process Assessment (Health Care), medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], 3. Good health, Surgery, Outcome and Process Assessment, Health Care, Meta-analysis, Observational study, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Meta-Analysis
Abstract: BACKGROUND: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care.METHODS: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered.FINDINGS: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09-2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75-3·10, pINTERPRETATION: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons.FUNDING: Medtronic.
Published: 2018
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34. Sex and Stroke in Thrombolyzed Patients and Controls

Author: Christian Hametner, Rachael L. MacIsaac, Lars Kellert, Azmil H. Abdul-Rahim, Peter A. Ringleb, Kennedy R. Lees, A. Alexandrov, P.M. Bath, E. Bluhmki, N. Bornstein, C. Chen, L. Claesson, S.M. Davis, G. Donnan, H.C. Diener, M. Fisher, M. Ginsberg, B. Gregson, J. Grotta, W. Hacke, M.G. Hennerici, M. Hommel, M. Kaste, P. Lyden, J. Marler, K. Muir, N. Venketasubramanian, R. Sacco, A. Shuaib, P. Teal, N.G. Wahlgren, S. Warach, C. Weimar, and Weimar, Christian (Beitragende*r)
Subjects: Male, medicine.medical_specialty, Medizin, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Fibrinolytic Agents, Risk Factors, Internal medicine, medicine, Humans, Thrombolytic Therapy, Stroke, Aged, Randomized Controlled Trials as Topic, Advanced and Specialized Nursing, Aged, 80 and over, business.industry, Middle Aged, medicine.disease, Confidence interval, Tissue Plasminogen Activator, Administration, Intravenous, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract: Background and Purpose— We hypothesized that any sex-related difference in outcome poststroke is explained by other prognostic factors and that the response to intravenous recombinant tissue-type plasminogen activator (r-tPA) is equal in males and females after adjustment for such factors. Methods— We accessed an independent collection of randomized clinical trials—the VISTA (Virtual International Stroke Trials Archive). Data were preprocessed by selecting complete cases (n=8028) and matching females to males (coarsened exact matching, n=4575, 24.3% r-tPA). Outcome was assessed by the 7-point modified Rankin Scale (mRS) measured at 90 days after ischemic stroke. Relationship among variables was estimated by adjusted regression analysis. Results— In nonthrombolyzed patients, ordinal analysis of mRS adjusting for stroke- and sex-related prognostic factors suggested comparable outcomes for females and males (odds ratio, 0.96; 95% confidence interval, 0.85–1.06). Females responded comparably to r-tPA as did males, irrespective of the outcome definition of mRS (ordinal: P Interaction =0.46, relative excess risk because of interaction=0). The number needed to treat was 6.8 and 11.2 for 1 female to achieve mRS score of 0 to 2 and 0 to 1, which was highly congruent with males. Analysis for a nonlinear variation of age-by-sex revealed a good outcome for females P Interaction =0.004). No relationship between sex, r-tPA, and bleeding complications was evident. Conclusions— Functional outcome (mRS) without r-tPA was overall similar between the sexes, as was the response to r-tPA. Nonlinear sex-by-age interaction improved estimates of functional independence; this should be considered in sex-related studies in stroke.
Published: 2016

35. Fall-Kontroll-Studie zu konventionellen und neuen Risikofaktoren für Schlaganfall

Author: Platzbecker, Katharina and Weimar, Christian (Akademische Betreuung)
Subjects: Medizin
Abstract: Duisburg, Essen, Univ., Diss., 2014
Published: 2014

36. Zuweisung und stationäre Akutversorgung von Schlaganfallpatienten in neurologischen Kliniken, Stroke Units und internistischen Kliniken : eine Auswertung der Schlaganfall-Datenbank der Stiftung Deutsche Schlaganfall-Hilfe

Author: Schymanietz, Peter Andreas and Weimar, Christian (Akademische Betreuung)
Subjects: Medizin
Abstract: Duisburg, Essen, Univ., Diss., 2007
Published: 2007

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