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310 results on '"Eskandari, Ashraf"'

2. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Kahles, Timo, Nedeltchev, Krassen, Altersberger, Valerian, Bonati, Leo H, Brehm, Alex, Bruni, Nicole, De Marchis, Gian Marco, Engelter, Stefan T, Fabbro, Thomas, Fisch, Urs, Fladt, Joachim, Gensicke, Henrik, Hert, Lisa, Lyrer, Philippe A, Maurer, Marina, Peters, Nils, Polymeris, Alexandros, Psychogios, Marios-Nikos, Schaedelin, Sabine, Stippich, Christoph, Thilemann, Sebastian, Traenka, Christopher, Wagner, Benjamin, Arnold, Marcel, Fischer, Urs, Goeggel Simonetti, Barbara, Gralla, Jan, Heldner, Mirjam, Jung, Simon, Leib, Stephen L, Seiffge, David J, Mueller, Hubertus, Sveikata, Lukas, Sztajzel, Roman, Correia, Pamela, Eskandari, Ashraf, Meyer, Ivo, Michel, Patrik, Nannoni, Stefania, Remillard, Suzette, Sirimarco, Gaia, Zachariadis, Alexandros, Kaegi, Georg, Mueller, Anna, Vehoff, Jochen, Hamann, Janne, Luft, Andreas R, Steiner, Levke, Wegener, Susanne, Erdur, Hebun J, Nolte, Christian H, von Rennenberg, Regina, Scheitz, Jan F, Feil, Katharina, Kellert, Lars, Christensen, Hanne, Rosenbaum, Sverre, Schaedelin, Sabine A, Simonetti, Barbara Goeggel, Kägi, Georg, Seiffge, David, Polymeris, Alexandros A, and Lyrer, Philippe

Published
2021
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3. Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2)

Author

Lyden, Patrick, Hemmen, Thomas, Grotta, James, Rapp, Karen, Ernstrom, Karin, Rzesiewicz, Teresa, Parker, Stephanie, Concha, Mauricio, Hussain, Syed, Agarwal, Sachin, Meyer, Brett, Jurf, Julie, Altafullah, Irfan, Raman, Rema, Hess, Mary Jane, Mullin, Anthony, Jane Hess, Mary, Muranevici, Gabriela, Piantadosi, Bonnie, Jimenez-Maggiora, Gustavo, So, Jia-Shing, Jain, Sonia, Diringer, Michael, Derdeyn, Colin, Stern, Barney, Hamilton, Scott, Dietrich, Dalton, Becker, Kyra, Yenari, Midori, Dirnagl, Ulrich, Wijman, Christine, Chamorro, Ángel, Janis, Scott, Moy, Claudia, Lin, Felice, Song, Shlee, Schlick, Konrad, Khanolkar, Pooja, Edwards, Nancy J, Roldan, Ana, Wilson, Jeanette, Little, Amy, Lewis, Pam, Neil, William, Bruce, Nhu, Guzik, Amy, Sohdi, Ajeet, Herial, Nabeel, Ovbiagele, Bruce, Meyer, Dawn, Modir, Royya, Chavez, Ronelyn, Velazquez, Angela, Mayer, Stephan, Claassen, Jan, Falo, Cristina, Tafreshi, Gilda, Kelly, Nancy, Shell, Erin, Dugan, Guy, Kim, Elizabeth, Tanner, Amy, Michel, Patrik, Eskandari, Ashraf, Oddo, Mauro, Suys, Tamarah, Remillard, Suzette, Cordier, Maria, Brown, Robert, Jasak, Sara, McCullough, Louise, Brautigam, Robert, Alexandrov, Andrei, Sisson, April, Albright, Karen, Broessner, Gregor, Schmutzhard, Erich, Escioglou, Elissanet, Jones, William, Poisson, Sharon, Simpson, Jennifer, Shah, Qaisar, Jonczak, Karin, Bussinger, Patricia, Lewandowski, Christopher, Berry, Shannen, Lundell, AnneMarie, Miller, Joseph B, Cruz-Flores, Salvador, Holzer, Eve, Torretta, Susan, Brown, David, Heim, Laura, and Smith, Carlos

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Stroke, Clinical Trials and Supportive Activities, Lung, Brain Disorders, Clinical Research, Neurosciences, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Hypothermia, Induced, Male, Middle Aged, Outcome Assessment, Health Care, Single-Blind Method, hypothermia, intention to treat analysis, ischemic stroke, neuroprotection, pneumonia, stroke, therapeutics, Collaborators, Cardiorespiratory Medicine and Haematology, Neurology & Neurosurgery, Clinical sciences, Allied health and rehabilitation science
Abstract

Background and purposeTherapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients.MethodsSafety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol. A femoral venous intravascular cooling catheter after intravenous recombinant tissue-type plasminogen activator in eligible patients provided 24 hours cooling followed by a 12-hour rewarm. Serial safety assessments and imaging were performed. The primary end point was 3-month modified Rankin score 0,1.ResultsOf the intended 1600 subjects, 120 were enrolled before the study was stopped. Randomly, 63 were to receive hypothermia plus antishivering treatment and 57 normothermia. Compared with previous studies, cooling rates were improved with a cold saline bolus, without fluid overload. The intention-to-treat primary outcome of 90-day modified Rankin Score 0,1 occurred in 33% hypothermia and 38% normothermia subjects, odds ratio (95% confidence interval) of 0.81 (0.36-1.85). Serious adverse events occurred equally. Mortality was 15.9% hypothermia and 8.8% normothermia subjects, odds ratio (95% confidence interval) of 1.95 (0.56-7.79). Pneumonia occurred in 19% hypothermia versus 10.5% in normothermia subjects, odds ratio (95% confidence interval) of 1.99 (0.63-6.98).ConclusionsIntravascular therapeutic hypothermia was confirmed to be safe and feasible in recombinant tissue-type plasminogen activator-treated acute ischemic stroke patients. Protocol changes designed to reduce pneumonia risk appeared to fail, although the sample is small.Clinical trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01123161.

Published
2016

10. Undiagnosed major risk factors in acute ischaemic stroke patients: frequency, profile, stroke mechanisms and outcome.

Author

Rêgo, André, Nannoni, Stefania, Scherz, Ali, Eskandari, Ashraf, Salerno, Alexander, Pereira, Miguel, Strambo, Davide, and Michel, Patrik

Subjects
ISCHEMIC stroke, STROKE, STROKE patients, LOGISTIC regression analysis, ATRIAL fibrillation
Abstract

Background and purpose: There is scarce clinical information about the clinical profile of patients with acute ischaemic stroke with previously undiagnosed major vascular risk factors (UMRFs). Methods: This was a retrospective analysis of data from the Acute Stroke Registry and Analysis of Lausanne registry between 2003 and 2018 with univariate and multivariate logistic regression analyses comparing clinical profiles of patients with UMRFs to patients with at least one previously diagnosed MRF (DMRF). Results: In all, 4354 patients (median age 70 years [interquartile range 15.2], 44.7% female) were included after excluding 763 (14.9%) for lack of consent and three for missing information. Amongst 1125 (25.8%) UMRF patients, 69.7% (n = 784) had at least one newly diagnosed MRF and the others none. The newly detected MRFs were dyslipidaemia (61.4%), hypertension (23.7%), atrial fibrillation (10.2%), diabetes mellitus (5.2%), ejection fraction <35% (2.0%) and coronary disease (1.0%). Comparing UMRF patients to DMRF patients, multivariate analysis showed a positive association with lower age, non‐Caucasian ethnicity, contraceptive use (<55 years old), smoking (≥55 years old) and patent‐foramen‐ovale‐related stroke mechanism. A negative association was found with pre‐stroke antiplatelet use and higher body mass index. Functional outcome did not differ. Cerebrovascular recurrences were similar between groups. Conclusions: In this large single‐centre cohort, 69.7% of patients with acute ischaemic stroke and UMRF were newly diagnosed with at least one new MRF, the most common being dyslipidaemia, hypertension or atrial fibrillation. Patients of the UMRF group were younger, more often smokers and on contraceptives, and had more patent‐foramen‐ovale‐related strokes. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Association of prestroke metformin use, stroke severity, and thrombolysis outcome

Author

Westphal, Laura P., Widmer, Roni, Held, Ulrike, Steigmiller, Klaus, Hametner, Christian, Ringleb, Peter, Curtze, Sami, Martinez-Majander, Nicolas, Tiainen, Marjaana, Nolte, Christian H., Scheitz, Jan F., Erdur, Hebun, Polymeris, Alexandros A., Traenka, Christopher, Eskandari, Ashraf, Michel, Patrik, Heldner, Mirjam R., Arnold, Marcel, Zini, Andrea, Vandelli, Laura, Coutinho, Jonathan M., Groot, Adrien E., Padjen, Visnja, Jovanovic, Dejana R., Bejot, Yannick, Brenière, Céline, Turc, Guillaume, Seners, Pierre, Pezzini, Alessandro, Magoni, Mauro, Leys, Didier, Gilliot, Sixtine, Scherrer, Michael J., Kägi, Georg, Luft, Andreas R., Gensicke, Henrik, Nederkoorn, Paul, Tatlisumak, Turgut, Engelter, Stefan T., and Wegener, Susanne

Published
2020
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16. A tool to identify patients with embolic stroke of undetermined source at high recurrence risk

Author

Ntaios, George, Georgiopoulos, Georgios, Perlepe, Kalliopi, Sirimarco, Gaia, Strambo, Davide, Eskandari, Ashraf, Nannoni, Stefania, Vemmou, Anastasia, Koroboki, Eleni, Manios, Efstathios, Rodríguez-Campello, Ana, Cuadrado-Godia, Elisa, Roquer, Jaume, Arnao, Valentina, Caso, Valeria, Paciaroni, Maurizio, Diez-Tejedor, Exuperio, Fuentes, Blanca, Rodríguez Pardo, Jorge, Sánchez-Velasco, Sara, Arauz, Antonio, Ameriso, Sebastian F., Pertierra, Lucía, Gómez-Schneider, Maia, Hawkes, Maximiliano A., Barboza, Miguel A., Chavarria Cano, Beatriz, Iglesias Mohedano, Ana Maria, García Pastor, Andrés, Gil-Núñez, Antonio, Putaala, Jukka, Tatlisumak, Turgut, Karagkiozi, Efstathia, Papavasileiou, Vasileios, Makaritsis, Konstantinos, Bandini, Fabio, Vemmos, Konstantinos, and Michel, Patrik

Published
2019
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20. Causes and Risk Factors of Cerebral Ischemic Events in Patients With Atrial Fibrillation Treated With Non–Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention: The RENo Study

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Caso, Valeria, Silvestrelli, Giorgio, Seiffge, David Julian, Engelter, Stefan, De Marchis, Gian Marco, Polymeris, Alexandros, Zedde, Maria Luisa, Yaghi, Shadi, Michel, Patrik, Eskandari, Ashraf, Antonenko, Kateryna, Sohn, Sung-Il, Cappellari, Manuel, Tassinari, Tiziana, Tassi, Rossana, Masotti, Luca, Katsanos, Aristeidis H., Giannopoulos, Sotirios, Acciarresi, Monica, Alberti, Andrea, Venti, Michele, Mosconi, Maria Giulia, Vedovati, Maria Cristina, Pierini, Patrizia, Giustozzi, Michela, Lotti, Enrico Maria, Ntaios, George, Kargiotis, Odysseas, Monaco, Serena, Lochner, Piergiorgio, Bandini, Fabio, Liantinioti, Chrysoula, Palaiodimou, Lina, Abdul-Rahim, Azmil H., Lees, Kennedy, Mancuso, Michelangelo, Pantoni, Leonardo, Rosa, Silvia, Bertora, Pierluigi, Galliazzo, Silvia, Ageno, Walter, Toso, Elisabetta, Angelini, Filippo, Chiti, Alberto, Orlandi, Giovanni, Denti, Licia, Flomin, Yuriy, Marcheselli, Simona, Mumoli, Nicola, Rimoldi, Alexandra, Verrengia, Elena, Schirinzi, Erika, Del Sette, Massimo, Papamichalis, Panagiotis, Komnos, Apostolos, Popovic, Nemanja, Zarkov, Marija, Rocco, Alessandro, Diomedi, Marina, Giorli, Elisa, Ciccone, Alfonso, Mac Grory, Brian C., Furie, Karen L., Bonetti, Bruno, Saia, Valentina, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Grifoni, Elisa, Padroni, Marina, Karagkiozi, Efstathia, Perlepe, Kalliopi, Makaritsis, Konstantinos, Mannino, Marina, Maccarrone, Miriam, Ulivi, Leonardo, Giannini, Nicola, Ferrari, Elena, Pezzini, Alessandro, Doronin, Boris, Volodina, Vera, Baldi, Antonio, D’Amore, Cataldo, Deleu, Dirk, Corea, Francesco, Putaala, Jukka, Santalucia, Paola, Nardi, Katiuscia, Risitano, Angela, Toni, Danilo, and Tsivgoulis, Georgios

Published
2019
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22. The risk of stroke recurrence in patients with atrial fibrillation and reduced ejection fraction

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Caso, Valeria, Becattini, Cecilia, Mosconi, Maria Giulia, Giustozzi, Michela, Tsivgoulis, Georgios, Seiffge, David Julian, Engelter, Stefan T., Lyrer, Philippe, Polymeris, Alexandros A., Dittrich, Tolga, Zietz, Annaelle, Putaala, Jukka, Strbian, Daniel, Tomppo, Liisa, Michel, Patrik, Strambo, Davide, Salerno, Alexander, Remillard, Suzette, Buehrer, Manuela, Bavaud, Odessa, Vanacker, Peter, Zuurbier, Susanna M., Yperzeele, Laetitia, Loos, Caroline M.J., Cappellari, Manuel, Emiliani, Andrea, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Dawson, Jesse, Cronshaw, Robert, Schirinzi, Erika, Del Sette, Massimo, Stretz, Christoph, Kala, Narendra, Reznik, Michael, Schomer, Ashley, Mac Grory, Brian, Jayaraman, Mahesh, Yaghi, Shadi, Furie, Karen L., Masotti, Luca, Grifoni, Elisa, Toni, Danilo, Risitano, Angela, Falcou, Anne, Petraglia, Luca, Lotti, Enrico Maria, Padroni, Marina, Pavolucci, Lucia, Lochner, Piergiorgio, Silvestrelli, Giorgio, Ciccone, Alfonso, Alberti, Andrea, Venti, Michele, De Magistris, Ilaria Leone, Cancelloni, Virginia, Kargiotis, Odysseas, Rocco, Alessandro, Diomedi, Marina, Marcheselli, Simona, Caliandro, Pietro, Zauli, Aurelia, Reale, Giuseppe, Moci, Marco, Antonenko, Kateryna, Rota, Eugenia, Tassinari, Tiziana, Saia, Valentina, Palmerini, Francesco, Aridon, Paolo, Arnao, Valentina, Monaco, Serena, Cottone, Salvatore, Baldi, Antonio, D’Amore, Cataldo, Ageno, Walter, Pegoraro, Samuela, Ntaios, George, Sagris, Dimitrios, Giannopoulos, Sotirios, Kosmidou, Maria, Ntais, Evangelos, Romoli, Michele, Pantoni, Leonardo, Rosa, Silvia, Bertora, Pierluigi, Chiti, Alberto, Canavero, Isabella, Saggese, Carlo Emanuele, Plocco, Maurizio, Giorli, Elisa, Palaiodimou, Lina, Bakola, Eleni, Bandini, Fabio, Gasparro, Antonio, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Morotti, Andrea, Magoni, Mauro, Ornello, Raffaele, Sacco, Simona, Popovic, Nemanja, Scoditti, Umberto, Genovese, Antonio, Denti, Licia, Flomin, Yuriy, Mancuso, Michelangelo, Ferrari, Elena, Caselli, Maria Chiara, Ulivi, Leonardo, Giannini, Nicola, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Carletti, Monica, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Lanari, Alessia, Tatlisumak, Turgut, Acciarresi, Monica, Vannucchi, Vieri, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Sohn, Sung-Il, Mumoli, Nicola, Tadi, Prasanna, Letteri, Federica, Maccarrone, Miriam, Galati, Franco, Tiseo, Cindy, Gourbali, Vanessa, Halvatsiotis, Panagiotis, Orlandi, Giovanni, Giuntini, Martina, Corea, Francesco, Bellesini, Marta, Baronello, Mario Maimone, Karapanayiotides, Theodore, Rueckert, Christina, Csiba, Laszló, Szabó, Lilla, Rigatelli, Alberto, Imberti, Davide, Zabzuni, Dorjan, Pieroni, Alessio, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Doronin, Boris, Volodina, Vera, Deleu, Dirk, Bonetti, Bruno, Porta, Cesare, Gentile, Luana, Eskandari, Ashraf, and De Marchis, Gian Marco

Abstract

Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF.Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding).Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77).Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.

Published
2023
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23. Risk of recurrent stroke in patients with atrial fibrillation treated with oral anticoagulants alone or in combination with anti-platelet therapy

Author

Caliandro, Pietro, Cancelloni, Virginia, Marco, Moci, Reale, Giuseppe, Zauli, Aurelia, Agnelli, Giancarlo, Caso, Valeria, Becattini, Cecilia, Calabresi, Paolo, Giulia Mosconi, Maria, Giustozzi, Michela, Tsivgoulis, Georgios, Julian Seiffge, David, Engelter, Stefan T., Lyrer, Philippe, Polymeris, Alexandros A., Dittrich, Tolga, Zietz, Annaelle, Marco De Marchis, Gian, Putaala, Jukka, Strbian, Daniel, Tomppo, Liisa, Michel, Patrik, Strambo, Davide, Salerno, Alexander, Remillard, Suzette, Buehrer, Manuela, Bavaud, Odessa, Vanacker, Peter, Zuurbier, Susanna, Yperzeele, Laetitia, Loos, Caroline M.J., Cappellari, Manuel, Emiliani, Andrea, Zedde, Marialuisa, Abdul-Rahim, Azmil, Dawson, Jesse, Cronshaw, Robert, Schirinzi, Erika, Del Sette, Massimo, Stretz, Christoph, Kala, Narendra, Reznik, Michael, Schomer, Ashley, Mac Grory, Brian, Jayaraman, Mahesh, McTaggart, Ryan, Yaghi, Shadi, Furie, Karen L., Masotti, Luca, Grifoni, Elisa, Toni, Danilo, Risitano, Angela, Falcou, Anne, Petraglia, Luca, Maria Lotti, Enrico, Padroni, Marina, Pavolucci, Lucia, Lochner, Piergiorgio, Silvestrelli, Giorgio, Ciccone, Alfonso, Alberti, Andrea, Venti, Michele, Leone De Magistris, Ilaria, Kargiotis, Odysseas, Rocco, Alessandro, Diomedi, Marina, Marcheselli, Simona, Antonenko, Kateryna, Rota, Eugenia, Tassinari, Tiziana, Saia, Valentina, Palmerini, Francesco, Aridon, Paolo, Arnao, Valentina, Monaco, Serena, Cottone, Salvatore, Baldi, Antonio, D’Amore, Cataldo, Ageno, Walter, Pegoraro, Samuela, Ntaios, George, Sagris, Dimitrios, Giannopoulos, Sotirios, Kosmidou, Maria, Ntais, Evangelos, Romoli, Michele, Pantoni, Leonardo, Rosa, Silvia, Bertora, Pierluigi, Chiti, Alberto, Canavero, Isabella, Emanuele Saggese, Carlo, Plocco, Maurizio, Giorli, Elisa, Palaiodimou, Lina, Bakola, Eleni, Bandini, Fabio, Gasparro, Antonio, Terruso, Valeria, Mannino, Marina, Pezzini, Alessandro, Ornello, Raffaele, Sacco, Simona, Popovic, Nemanja, Scoditti, Umberto, Genovese, Antonio, Denti, Licia, Flomin, Yuriy, Mancuso, Michelangelo, Ferrari, Elena, Chiara Caselli, Maria, Ulivi, Leonardo, Giannini, Nicola, Vadikolias, Kostantinos, Liantinioti, Chrysoula, Chondrogianni, Maria, Halvatsiotis, Panagiotis, Carletti, Monica, Karagkiozi, Efstathia, Athanasakis, George, Makaritsis, Kostantinos, Lanari, Alessia, Tatlisumak, Turgut, Acciarresi, Monica, Vannucchi, Vieri, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Sohn, Sung-Il, Mumoli, Nicola, Tadi, Prasanna, Letteri, Federica, Maccarrone, Miriam, Poli, Loris, Magoni, Mauro, Galati, Franco, Tiseo, Cindy, Gourbali, Vanessa, Orlandi, Giovanni, Giuntini, Martina, Corea, Francesco, Bellesini, Marta, Girardi, Laura, Maimone Baronello, Mario, Karapanayiotides, Theodore, Rueckert, Christina, Csiba, Laszló, Szabó, Lilla, Rigatelli, Alberto, Imberti, Davide, Zabzuni, Dorjan, Pieroni, Alessio, Barlinn, Kristian, Pallesen, Lars-Peder, Barlinn, Jessica, Doronin, Boris, Volodina, Vera, Deleu, Dirk, Bonetti, Bruno, Porta, Cesare, Gentile, Luana, Eskandari, Ashraf, and Paciaroni, Maurizio

Abstract

Introduction: Ischaemic stroke patients with atrial fibrillation (AF) are at high risk of stroke recurrence despite oral anticoagulation therapy. Patients with cardiovascular comorbidities may take both antiplatelet and oral anticoagulation therapy (OAC/AP). Our study aims to evaluate the safety and efficacy of OAC/AP therapy as secondary prevention in people with AF and ischaemic stroke.Patients and methods: We performed a post-hoc analysis of pooled individual data from multicenter prospective cohort studies and compared outcomes in the OAC/AP cohort and patients on DOAC/VKA anticoagulation alone (OAC cohort). Primary outcome was a composite of ischaemic stroke, systemic embolism, intracranial bleeding, and major extracranial bleeding, while secondary outcomes were ischaemic and haemorrhagic events considered separately. A multivariable logistic regression analysis was performed to identify independent predictors for outcome events. To compare the risk of outcome events between the two cohorts, the relation between the survival function and the set of explanatory variables were calculated by Cox proportional hazard models and the results were reported as adjusted hazard ratios (HR). Finally another analysis was performed to compare the overall risk of outcome events in both OAC/AP and OAC cohorts after propensity score matching (PSM).Results: During a mean follow-up time of 7.5 ± 9.1 months (median follow-up time 3.5 months, interquartile range ±3), 2284 stroke patients were on oral anticoagulants and 215 were on combined therapy. The multivariable model demonstrated that the composite outcome is associated with age (OR: 1.03, 95% CI: 1.01–1.04 for each year increase) and concomitant antiplatelet therapy (OR: 2.2, 95% CI: 1.48–3.27), the ischaemic outcome with congestive heart failure (OR: 1.55, 95% CI: 1.02–2.36) and concomitant antiplatelet therapy (OR: 1.93, 95% CI: 1.19–3.13) and the haemorrhagic outcome with age (OR: 1.03, 95% CI: 1.01–1.06 for each year increase), alcoholism (OR: 2.15, 95% CI: 1.06–4.39) and concomitant antiplatelet therapy (OR: 2.22, 95% CI: 1.23–4.02). Cox regression demonstrated a higher rate of the composite outcome (hazard ratio of 1.93 [95% CI, 1.35–2.76]), ischaemic events (HR: 2.05 [95% CI: 1.45–2.87]) and bleeding outcomes (HR: 1.90 [95% CI, 1.06–3.40]) in OAC/AP cohort. After PSM analysis, the composite outcome remained more frequent in people treated with OAC + AP (RR: 1.70 [95% CI, 1.05–2.74]).Discussion: Secondary prevention with combination of oral anticoagulant and antiplatelet therapy after ischaemic stroke was associated with worse outcomes in our cohort.Conclusion: Further research is needed to improve secondary prevention by investigating the mechanisms of recurrent ischaemic stroke in patients with atrial fibrillation.

Published
2023
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24. Predicting Penumbra Salvage and Infarct Growth in Acute Ischemic Stroke: A Multifactor Survival Game.

Author

Sirimarco, Gaia, Strambo, Davide, Nannoni, Stefania, Labreuche, Julien, Cereda, Carlo, Dunet, Vincent, Puccinelli, Francesco, Saliou, Guillaume, Meuli, Reto, Eskandari, Ashraf, Wintermark, Max, and Michel, Patrik

Subjects
ISCHEMIC stroke, STROKE, CEREBRAL arteries, BRAIN damage, STROKE patients, HYPERGLYCEMIA
Abstract

Background. Effective treatment of acute ischemic stroke requires reperfusion of salvageable tissue. We investigated the predictors of penumbra salvage (PS) and infarct growth (IG) in a large cohort of stroke patients. Methods. In the ASTRAL registry from 2003 to 2016, we selected middle cerebral artery strokes <24 h with a high-quality CT angiography and CT perfusion. PS and IG were correlated in multivariate analyses with clinical, biochemical and radiological variables, and with clinical outcomes. Results. Among 4090 patients, 551 were included in the study, 50.8% male, mean age (±SD) 66.3 ± 14.7 years, mean admission NIHSS (±SD 13.3 ± 7.1) and median onset-to-imaging-time (IQR) 170 (102 to 385) minutes. Increased PS was associated with the following: higher BMI and lower WBC; neglect; larger penumbra; absence of early ischemic changes, leukoaraiosis and other territory involvement; and higher clot burden score. Reduced IG was associated with the following: non-smokers; lower glycemia; larger infarct core; absence of early ischemic changes, chronic vascular brain lesions, other territory involvement, extracranial arterial pathology and hyperdense middle cerebral artery sign; and higher clot burden score. When adding subacute variables, recanalization was associated with increased PS and reduced IG, and the absence of haemorrhage with reduced IG. Collateral status was not significantly associated with IG nor with PS. Increased PS and reduced IG correlated with better 3- and 12-month outcomes. Conclusion. In our comprehensive analysis, multiple factors were found to be responsible for PS or IG, the strongest being radiological features. These findings may help to better select patients, particularly for more aggressive or late acute stroke treatment. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Renal Function and Risk Stratification of Patients With Embolic Stroke of Undetermined Source

Author

Ntaios, George, Lip, Gregory Y.H., Lambrou, Dimitris, Michel, Patrik, Perlepe, Kalliopi, Eskandari, Ashraf, Nannoni, Stefania, Sirimarco, Gaia, Strambo, Davide, Vemmos, Konstantinos, Koroboki, Eleni, Manios, Efstathios, Vemmou, Anastasia, Rodríguez-Campello, Ana, Cuadrado-Godia, Elisa, Roquer, Jaume, Arnao, Valentina, Caso, Valeria, Paciaroni, Maurizio, Diez-Tejedor, Exuperio, Fuentes, Blanca, Rodríguez Pardo, Jorge, Arauz, Antonio, Ameriso, Sebastian F., Pertierra, Lucía, Gómez-Schneider, Maia, Hawkes, Maximiliano A., Bandini, Fabio, Chavarria Cano, Beatriz, Mohedano, Ana Maria Iglesias, García Pastor, Andrés, Gil-Núñez, Antonio, Putaala, Jukka, Tatlisumak, Turgut, Barboza, Miguel A., Karagkiozi, Efstathia, Makaritsis, Konstantinos, and Papavasileiou, Vasileios

Published
2018
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31. Endovascular Treatment for Acute Ischemic Stroke With or Without General Anesthesia: A Matched Comparison

Author

Wagner, Benjamin, primary, Lorscheider, Johannes, additional, Wiencierz, Andrea, additional, Blackham, Kristine, additional, Psychogios, Marios, additional, Bolliger, Daniel, additional, De Marchis, Gian Marco, additional, Engelter, Stefan T., additional, Lyrer, Philippe, additional, Wright, Patrick R., additional, Fischer, Urs, additional, Mordasini, Pasquale, additional, Nannoni, Stefania, additional, Puccinelli, Francesco, additional, Kahles, Timo, additional, Bianco, Giovanni, additional, Carrera, Emmanuel, additional, Luft, Andreas R., additional, Cereda, Carlo W., additional, Kägi, Georg, additional, Weber, Johannes, additional, Nedeltchev, Krassen, additional, Michel, Patrik, additional, Gralla, Jan, additional, Arnold, Marcel, additional, Bonati, Leo H., additional, Anon, Javier, additional, Clarke, Sandra, additional, Diepers, Michael, additional, Gruber, Philipp, additional, Martin, Eileen, additional, Remonda, Luca, additional, Schweikert, Andreas, additional, Zupa., Vedrana, additional, Altersberger, Valerian, additional, Brehm, Alex, additional, Dittrich, Tolga, additional, El Mekabaty, Amgad, additional, Fladt, Joachim, additional, Fisch, Urs, additional, Gensicke, Henrik, additional, Hert, Lisa, additional, Manuzzi, Sabrina, additional, Maurer, Marina, additional, Meya, Louisa, additional, Peters, Nils, additional, Polymeris, Alexandros, additional, Thilemann, Sebastian, additional, Traenka, Christopher, additional, Tsogkas, Ioannes, additional, Zietz, Anaelle, additional, Goeldlin, Martina, additional, Heldner, Mirjam, additional, Jung, Simon, additional, Kaesmacher, Johannes, additional, Mamaari, Basel, additional, Meinel, Thomas, additional, Mueller, Madlaine, additional, Sarykaya, Hakan, additional, Seiffge, David, additional, Siepen, Bernhard, additional, Vynkier, Jan, additional, Eskandari, Ashraf, additional, Pantazou, Vasiliki, additional, Strambo, Davide, additional, Frangi, Jane, additional, Sihabdeen, Shairin, additional, Vehoff, Jochen, additional, Katan, Mira, additional, Mueller, Achim, additional, and Wegener, Susanne, additional

Published
2022
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34. Delay-sensitive and delay-insensitive deconvolution perfusion-CT: similar ischemic core and penumbra volumes if appropriate threshold selected for each

Author

Man, Fengyuan, Patrie, James, Xin, Wenjun, Zhu, Guangming, Hou, Qinghua, Michel, Patrik, Eskandari, Ashraf, Jovin, Tudor, Xian, Junfang, Wang, Zhenchang, and Wintermark, Max

Abstract

Introduction: Perfusion-CT (PCT) processing involves deconvolution, a mathematical operation that computes the perfusion parameters from the PCT time density curves and an arterial curve. Delay-sensitive deconvolution does not correct for arrival delay of contrast, whereas delay-insensitive deconvolution does. The goal of this study was to compare delay-sensitive and delay-insensitive deconvolution PCT in terms of delineation of the ischemic core and penumbra. Methods: We retrospectively identified 100 patients with acute ischemic stroke who underwent admission PCT and CT angiography (CTA), a follow-up vascular study to determine recanalization status, and a follow-up noncontrast head CT (NCT) or MRI to calculate final infarct volume. PCT datasets were processed twice, once using delay-sensitive deconvolution and once using delay-insensitive deconvolution. Regions of interest (ROIs) were drawn, and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) in these ROIs were recorded and compared. Volume and geographic distribution of ischemic core and penumbra using both deconvolution methods were also recorded and compared. Results: MTT and CBF values are affected by the deconvolution method used (p

Published
2021

37. EndoVAscular treatment and ThRombolysis for Ischemic Stroke Patients (EVA-TRISP) registry: basis and methodology of a pan-European prospective ischaemic stroke revascularisation treatment registry

Author

Nordanstig, Annika, primary, Curtze, Sami, additional, Gensicke, Henrik, additional, Zinkstok, Sanne M, additional, Erdur, Hebun, additional, Karlsson, Camilla, additional, Karlsson, Jan-Erik, additional, Martinez-Majander, Nicolas, additional, Sibolt, Gerli, additional, Lyrer, Philippe, additional, Traenka, Christopher, additional, Baharoglu, Merih I, additional, Scheitz, Jan F, additional, Bricout, Nicolas, additional, Hénon, Hilde, additional, Leys, Didier, additional, Eskandari, Ashraf, additional, Michel, Patrik, additional, Hametner, Christian, additional, Ringleb, Peter Arthur, additional, Arnold, Marcel, additional, Fischer, Urs, additional, Sarikaya, Hakan, additional, Seiffge, David J, additional, Pezzini, Alessandro, additional, Zini, Andrea, additional, Padjen, Visnja, additional, Jovanovic, Dejana R, additional, Luft, Andreas, additional, Wegener, Susanne, additional, Kellert, Lars, additional, Feil, Katharina, additional, Kägi, Georg, additional, Rentzos, Alexandros, additional, Lappalainen, Kimmo, additional, Leker, Ronen R, additional, Cohen, Jose E, additional, Gomori, John, additional, Brehm, Alex, additional, Liman, Jan, additional, Psychogios, Marios, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Gralla, Jan, additional, Magoni, Mauro, additional, Majoie, Charles B L M, additional, Bohner, Georg, additional, Vukasinovic, Ivan, additional, Cvetic, Vladimir, additional, Weber, Johannes, additional, Kulcsar, Zsolt, additional, Bendszus, Martin, additional, Möhlenbruch, Markus, additional, Ntaios, George, additional, Kapsalaki, Eftychia, additional, Jood, Katarina, additional, Nolte, Christian H, additional, Nederkoorn, Paul J J, additional, Engelter, Stefan, additional, Strbian, Daniel, additional, and Tatlisumak, Turgut, additional

Published
2021
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40. Data?driven machine?learning analysis of potential embolic sources in embolic stroke of undetermined source

Author

Ntaios, George, Weng, Stephen F., Perlepe, Kalliopi, Akyea, Ralph, Condon, Laura, Lambrou, Dimitrios, Sirimarco, Gaia, Strambo, Davide, Eskandari, Ashraf, Karagkiozi, Efstathia, Vemmou, Anastasia, Korompoki, Eleni, Manios, Efstathios, Makaritsis, Konstantinos, Vemmos, Konstantinos, and Michel, Patrik

Subjects
machine learning, potential embolic source, embolic stroke of undetermined source, stroke, hierarchical clustering
Abstract

Background: Hierarchical clustering, a common “unsupervised” machine‐learning algorithm, is advantageous for exploring potential underlying aetiology in particularly heterogeneous diseases. We investigated potential embolic sources in ESUS using a data‐driven, machine‐learning method, and explored variation in stroke recurrence between clusters.Methods: We used hierarchical k‐means clustering algorithm on patients’ baseline data, which assigned each individual into a unique clustering group, using a minimum‐variance method to calculate the similarity between ESUS patients based on all baseline features. Potential embolic sources were categorised into atrial cardiopathy, atrial fibrillation, arterial disease, left ventricular disease, cardiac valvulopathy, patent foramen ovale (PFO) and cancer.Results: Among 800 consecutive ESUS patients (43.3% women, median age 67years), the optimal number of clusters was 4. Left ventricular disease was most prevalent in cluster 1 (present in all patients) and perfectly associated with cluster 1. PFO was most prevalent in cluster 2 (38.9% of patients) and associated significantly with increased likelihood of cluster 2 (adjusted odds‐ratio:2.69, 95%CI:1.64‐4.41). Arterial disease was most prevalent in cluster 3 (57.7%) and associated with increased likelihood of cluster 3 (adjusted odds‐ratio:2.21, 95%CI:1.43‐3.13). Atrial cardiopathy was most prevalent in cluster 4 (100%) and perfectly associated with cluster 4. Cluster 3 was the largest cluster involving 53.7% of patients. Atrial fibrillation was not significantly associated with any cluster.Conclusions: This data‐driven machine‐learning analysis identified 4 clusters of ESUS which were strongly associated with arterial disease, atrial cardiopathy, PFO and left ventricular disease respectively. More than half of patients were assigned to the cluster associated with arterial disease.

Published
2021

41. Timing of initiation of oral anticoagulants in patients with acute ischemic stroke and atrial\ud fibrillation comparing posterior and anterior circulation strokes

Author

Paciaroni, Maurizio, Agnelli, Giancarlo, Giustozzi, Michela, Tsivgoulis, Georgios, Yaghi, Shadi, MacGrory, Brian, Furie, Karen L., Tadi, Prasanna, Zedde, Marialuisa, Abdul-Rahim, Azmil H., Dawson, Jesse, Lees, Kennedy R., Alberti, Andrea, Venti, Michele, Acciarresi, Monica, D'Amore, Cataldo, Mosconi, Maria Guilia, Bognini, Valentina, Cappellari, Manuel, Rigatelli, Alberto, Bonetti, Bruno, Putaala, Jukka, Tomppo, Liisa, Tatlisumak, Turgut, Bandini, Fabio, Marcheselli, Simona, Pezzini, Alessandro, Poli, Loris, Padovani, Alessandro, Masotti, Luca, Grifoni, Elisa, Vannucchi, Vieri, Sohn, Sung-Il, Lorenzini, Gianni, Tassi, Rossana, Guideri, Francesca, Acampa, Maurizio, Martini, Giuseppe, Ntaios, George, Athanasakis, George, Makaritsis, Konstantinos, Karagkiozi, Efstathia, Vadikolias, Konstantinos, Liantinioti, Chrissoula, Palaiodimou, Lina, Mumoli, Nicola, Porta, Cesare, Galati, Franco, Sacco, Simona, Tiseo, Cindy, Corea, Francesco, Ageno, Walter, Bellesini, Marta, Silvestrelli, Giorgio, Ciccone, Alfonso, Scoditti, Umberto, Denti, Licia, Mancuso, Michelangelo, Caselli, Maria Chiara, Maccarrone, Miriam, Ulivi, Leonardo, Orlandi, Giovanni, Giannini, Nicola, Tassinari, Tiziana, De Lodovici, Maria Luisa, Rueckert, Christina, Baldi, Antonio, Toni, Danilo, Gentile, Luana, Letteri, Federica, Giuntini, Martina, Lotti, Enrico Maria, Flomin, Yuriy, Pieroni, Alessio, Kargiotis, Odysseas, Karapanayiotides, Theodore, Monaco, Serena, Mannino, Marina, Maimone Baronello, Mario, Csiba, Laszló, Szabó, Lilla, Chiti, Alberto, Giorli, Elisa, Del Sette, Massimo, Schirinzi, Erika, Imberti, Davide, Zabzuni, Dorjan, Doronin, Boris, Volodina, Vera, Michel, Patrik, Eskandari, Ashraf, Vanacker, Peter, Barlinn, Kristian, Barlinn, Jessica, Deleu, Dirk, Gourbali, Vanessa, and Caso, Valeria

Abstract

Background: The aim of this study in patients with acute posterior ischemic stroke (PS) and atrial fibrillation (AF) were to evaluate the risks of recurrent ischemic event and severe bleeding and these risks in relation with oral anticoagulant therapy (OAT) and its timing.\ud \ud Methods: Patients with PS were prospectively included; the outcome events of these patients were compared with those of patients with anterior stroke (AS) which were taken from previous registries. The primary outcome was the composite of: stroke recurrence, TIA, symptomatic systemic embolism, symptomatic cerebral bleeding and major extracranial bleeding occurring within 90 days from acute stroke.\ud \ud Results: A total of 2,470 patients were available for the analysis: 473 (19.1%) with PS and 1,997 (80.9%) AS. Over 90 days, 213 (8.6%) primary outcome events were recorded: 175 (8.7%) in patients with AS and 38 (8.0%) in those with PS. In patients who initiated OAT within 2 days, the primary outcome occurred in 5 out of 95 patients (5.3%) with PS compared to 21 out of 373 patients (4.3%) with AS (OR 1.07; 95% CI 0.39-2.94). In patients who initiated OAT between days 3 and 7, the primary outcome occurred in 3 out of 103 patients (2.9%) with PS compared to 26 out of 490 patients (5.3%) with AS (OR 0.54; 95% CI 0.16-1.80).\ud \ud Conclusions: Patients with posterior or anterior stroke and AF appear to have similar risks of\ud ischemic or hemorrhagic events at 90 days with no difference concerning the timing of initiation of OAT.

Published
2020

42. Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial

Author

Engelter, Stefan T, primary, Traenka, Christopher, additional, Gensicke, Henrik, additional, Schaedelin, Sabine A, additional, Luft, Andreas R, additional, Simonetti, Barbara Goeggel, additional, Fischer, Urs, additional, Michel, Patrik, additional, Sirimarco, Gaia, additional, Kägi, Georg, additional, Vehoff, Jochen, additional, Nedeltchev, Krassen, additional, Kahles, Timo, additional, Kellert, Lars, additional, Rosenbaum, Sverre, additional, von Rennenberg, Regina, additional, Sztajzel, Roman, additional, Leib, Stephen L, additional, Jung, Simon, additional, Gralla, Jan, additional, Bruni, Nicole, additional, Seiffge, David, additional, Feil, Katharina, additional, Polymeris, Alexandros A, additional, Steiner, Levke, additional, Hamann, Janne, additional, Bonati, Leo H, additional, Brehm, Alex, additional, De Marchis, Gian Marco, additional, Peters, Nils, additional, Stippich, Christoph, additional, Nolte, Christian H, additional, Christensen, Hanne, additional, Wegener, Susanne, additional, Psychogios, Marios-Nikos, additional, Arnold, Marcel, additional, Lyrer, Philippe, additional, Altersberger, Valerian, additional, Engelter, Stefan T, additional, Fabbro, Thomas, additional, Fisch, Urs, additional, Fladt, Joachim, additional, Hert, Lisa, additional, Lyrer, Philippe A, additional, Maurer, Marina, additional, Polymeris, Alexandros, additional, Schaedelin, Sabine, additional, Thilemann, Sebastian, additional, Wagner, Benjamin, additional, Goeggel Simonetti, Barbara, additional, Heldner, Mirjam, additional, Seiffge, David J, additional, Mueller, Hubertus, additional, Sveikata, Lukas, additional, Correia, Pamela, additional, Eskandari, Ashraf, additional, Meyer, Ivo, additional, Nannoni, Stefania, additional, Remillard, Suzette, additional, Zachariadis, Alexandros, additional, Kaegi, Georg, additional, Mueller, Anna, additional, Erdur, Hebun J, additional, and Scheitz, Jan F, additional

Published
2021
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49. Relationship Between Onset-to-Door Time and Door-to-Thrombolysis Time: A Pooled Analysis of 10 Dedicated Stroke Centers

Author

Strbian, Daniel, Michel, Patrik, Ringleb, Peter, Numminen, Heikki, Breuer, Lorenz, Bodenant, Marie, Seiffge, David J., Jung, Simon, Obach, Victor, Weder, Bruno, Tiainen, Marjaana, Eskandari, Ashraf, Gumbinger, Christoph, Gensicke, Henrik, Chamorro, Angel, Mattle, Heinrich P., Engelter, Stefan T., Leys, Didier, Köhrmann, Martin, Parkkila, Anna-Kaisa, Hacke, Werner, and Tatlisumak, Turgut

Published
2013
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50. Validation of the DRAGON Score in 12 Stroke Centers in Anterior and Posterior Circulation

Author

Strbian, Daniel, Seiffge, David J., Breuer, Lorenz, Numminen, Heikki, Michel, Patrik, Meretoja, Atte, Coote, Skye, Bordet, Régis, Obach, Victor, Weder, Bruno, Jung, Simon, Caso, Valeria, Curtze, Sami, Ollikainen, Jyrki, Lyrer, Philippe A., Eskandari, Ashraf, Mattle, Heinrich P., Chamorro, Angel, Leys, Didier, Bladin, Christopher, Davis, Stephen M., Köhrmann, Martin, Engelter, Stefan T., and Tatlisumak, Turgut

Published
2013
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