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Acute ischemic lesions of varying ages predict risk of ischemic events in stroke/TIA patients.

https://arctichealth.org/en/permalink/ahliterature165277
Source
Neurology. 2007 Feb 6;68(6):415-9
Publication Type
Article
Date
Feb-6-2007
Author
P N Sylaja
S B Coutts
S. Subramaniam
M D Hill
M. Eliasziw
A M Demchuk
Author Affiliation
Calgary Stroke Program, University of Calgary, Calgary, Alberta, Canada T2N 2T9.
Source
Neurology. 2007 Feb 6;68(6):415-9
Date
Feb-6-2007
Language
English
Publication Type
Article
Keywords
Aged
Alberta - epidemiology
Brain - pathology
Comorbidity
Diffusion Magnetic Resonance Imaging - statistics & numerical data
Female
Humans
Incidence
Ischemic Attack, Transient - diagnosis - epidemiology
Male
Middle Aged
Risk Assessment - methods
Risk factors
Stroke - diagnosis - epidemiology
Abstract
Multiple ischemic lesions identified by diffusion-weighted imaging (DWI) have been shown to predict high risk of future ischemic events. However, the importance of lesion age has not been factored into this risk. Our goal was to evaluate whether the presence of ischemic lesions of varying ages identified by DWI and apparent diffusion coefficient (ADC) suggests a higher risk of future ischemic events.
Patients with acute stroke and TIA presenting within 12 hours of symptom onset who had a baseline and 1-month follow-up MRI were enrolled in the study. Acute ischemic lesions were divided into DWI positive with ADC low lesions and DWI positive with ADC normalized lesions. The baseline MRI and the presence of new lesions on the follow-up MRI were analyzed.
A total of 360 patients were prospectively enrolled, and all had appropriate imaging. Two hundred twenty-three were excluded as there were no DWI lesions, they received recombinant tissue plasminogen activator, or they did not have the 30-day follow-up MRI. One hundred seventeen patients had DWI lesions of one age (DWI positive with either ADC low lesions or ADC normalized lesions alone) and 20 had lesions of varying ages (DWI positive lesions with reduced and normalized ADC) on the baseline MRI. Patients with multiple DWI lesions of varying ages were at more risk of having new lesions on the 30-day MRI compared with those having lesions of the same age (relative risk = 3.6; 95% CI 1.9 to 6.8). Multiple DWI lesions of varying ages (odds ratio [OR] 6.6; 95% CI 2.3 to 19.1) and cardioembolic stroke subtype (OR 3.2; 95% CI 1.1 to 8.7) were independently associated with new lesion recurrence by multiple logistic regression analysis.
The presence of multiple diffusion-weighted imaging lesions of varying ages suggests very active early recurrence over time and portends a higher early risk of future ischemic events.
Notes
Comment In: Neurology. 2007 Feb 6;68(6):398-917283310
PubMed ID
17283315 View in PubMed
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Adherence to statin therapy and the incidence of ischemic stroke in patients with diabetes.

https://arctichealth.org/en/permalink/ahliterature277321
Source
Pharmacoepidemiol Drug Saf. 2016 Feb;25(2):161-9
Publication Type
Article
Date
Feb-2016
Author
Maarit Jaana Korhonen
Päivi Ruokoniemi
Jenni Ilomäki
Atte Meretoja
Arja Helin-Salmivaara
Risto Huupponen
Source
Pharmacoepidemiol Drug Saf. 2016 Feb;25(2):161-9
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Aged
Brain Ischemia - diagnosis - epidemiology - prevention & control
Case-Control Studies
Cohort Studies
Diabetes Mellitus - drug therapy - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Incidence
Male
Medication Adherence
Middle Aged
Population Surveillance - methods
Risk factors
Stroke - diagnosis - epidemiology - prevention & control
Abstract
We aimed to quantify for the first time the relationship between statin adherence and ischemic stroke (IS) in patients with diabetes.
Using Finnish health registers, we assembled a cohort of 52?868 statin initiators with diabetes in 1995-2006. We conducted a nested case-control analysis matching cases with IS with up to four controls for age, sex, date of statin initiation and follow-up duration. Adjusted rate ratios for IS were estimated with conditional logistic regression. Additional potential confounders were considered with inverse probability weighting and the role of unmeasured confounding using external adjustment. Statin adherence was measured as the proportion of days covered (PDC).
Among 1703 cases and 6799 controls, good adherence to statins (PDC?=?80%) was associated with a 23% decreased incidence of IS (95%CI 14-32%) compared with poor adherence (PDC?
PubMed ID
26687512 View in PubMed
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Age trajectories of stroke case fatality: leveling off at the highest ages.

https://arctichealth.org/en/permalink/ahliterature136759
Source
Epidemiology. 2011 May;22(3):432-6
Publication Type
Article
Date
May-2011
Author
Tom Skyhøj Olsen
Zorana Jovanovic Andersen
Klaus Kaae Andersen
Author Affiliation
The Stroke Unit, Frederiksberg Hospital, Frederiksberg, Denmark. tso@dadlnet.dk
Source
Epidemiology. 2011 May;22(3):432-6
Date
May-2011
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Cardiovascular Diseases - diagnosis - epidemiology
Cause of Death
Comorbidity
Confidence Intervals
Denmark - epidemiology
Female
Hospital Mortality - trends
Hospitalization - statistics & numerical data
Humans
Hypertension - diagnosis - epidemiology
Logistic Models
Male
Middle Aged
Registries
Risk assessment
Severity of Illness Index
Sex Distribution
Stroke - diagnosis - epidemiology - therapy
Time Factors
Abstract
Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages.
A registry of all hospitalized stroke patients in Denmark included 40,155 patients with evaluations of stroke severity, computed tomography, and cardiovascular risk factors. Data on mortality were used to construct age trajectories of 3-day, 1-week, 1-month, and 1-year case-fatality rates in men and women.
Of the 40,155 patients, 19,301 (48%) were women (mean age, 74.5 years) and 20,854 (52%) were men (mean age, 69.7 years). In both women and men, 3-day case-fatality rates leveled off, beginning in the patients' mid-70s. In women, 1-week case-fatality rates leveled off further in their early 80s, whereas in men, 1-week case-fatality rates accelerated with age. One-month and 1-year case-fatality rates accelerated with age for both sexes.
It is an apparent paradox that case-fatality rates in the acute state of stroke level off at the highest ages. Heterogeneity, innate or acquired, in regard to survival capacity may explain the phenomenon.
PubMed ID
21346579 View in PubMed
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Alcohol-related hospitalization is associated with increased risk of ischaemic stroke among low-risk patients with atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature296234
Source
Europace. 2018 01 01; 20(1):19-24
Publication Type
Journal Article
Date
01-01-2018
Author
Faris Al-Khalili
Lina Benson
Leif Friberg
Author Affiliation
Department of Clinical Sciences, Karolinska Institutet, Danderyds Hospital, s-182 88 Stockholm, Sweden.
Source
Europace. 2018 01 01; 20(1):19-24
Date
01-01-2018
Language
English
Publication Type
Journal Article
Keywords
Administration, Oral
Adolescent
Adult
Alcohol-Related Disorders - diagnosis - epidemiology - therapy
Anticoagulants - administration & dosage
Atrial Fibrillation - diagnosis - drug therapy - epidemiology
Brain Ischemia - diagnosis - epidemiology - prevention & control
Cerebral Hemorrhage - epidemiology
Female
Hospitalization
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk assessment
Risk factors
Stroke - diagnosis - epidemiology - prevention & control
Sweden - epidemiology
Time Factors
Young Adult
Abstract
Patients with atrial fibrillation (AF) under the age of 65 and CHA2DS2-VASc risk score of 0 in men or 1 in women are considered to be at low risk for ischaemic stroke, and therefore without benefit of oral anticoagulation therapy. The objective of this study is to assess the incidence and predictors of ischaemic stroke among low-risk patients with AF identified from a National Patient Register.
A retrospective study of 25 252 low-risk AF patients (age 18-64) out of total 345 123?AF patients identified from the Swedish Nationwide Patient Register for the period 1 January 2006 to 31 December 2012. During a median follow-up of 5.0 (interquartile range 2.9-6.8) years, ischaemic stroke occurred at an annual rate of 0.34 per 100 patient-years [95% confidence interval (CI) 0.31-0.38]. Significant predictors of stroke were age, hazard ratio (HR) 1.06 (CI 1.05-1.08) per incremental year, and previous alcohol-related hospitalization HR 2.01 (CI 1.45-2.79). Intracerebral bleeding events were rare and not statistically different HR 2.05 (CI 0.76-5.56) between patients with and without alcohol-related hospitalizations. Use of oral anticoagulants was associated with lower risk for ischaemic stroke, HR 0.78 (CI 0.63-0.97).
The presence of a previous hospitalization with an alcohol-related disease was associated with a small but significant increase in the risk of stroke among low-risk AF patients. More research about relation between alcohol use and ischaemic stroke in AF patients is warranted.
PubMed ID
28339885 View in PubMed
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Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry.

https://arctichealth.org/en/permalink/ahliterature152380
Source
Stroke. 2009 Apr;40(4):1195-203
Publication Type
Article
Date
Apr-2009
Author
Jukka Putaala
Antti J Metso
Tiina M Metso
Nina Konkola
Yvonn Kraemer
Elena Haapaniemi
Markku Kaste
Turgut Tatlisumak
Author Affiliation
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. jukka.putaala@hus.fi
Source
Stroke. 2009 Apr;40(4):1195-203
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Age of Onset
Brain Ischemia - diagnosis - epidemiology - etiology
Female
Finland - epidemiology
Humans
Male
Middle Aged
Registries - statistics & numerical data
Retrospective Studies
Risk factors
Sex Distribution
Stroke - diagnosis - epidemiology - etiology
Young Adult
Abstract
To analyze trends in occurrence, risk factors, etiology, and neuroimaging features of ischemic stroke in young adults in a large cohort.
We evaluated all 1008 consecutive ischemic stroke patients aged 15 to 49 admitted to Helsinki University Central Hospital, 1994 to 2007. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria. Comparisons were done between groups stratified by gender and age.
Estimated annual occurrence was 10.8/100,000 (range 8.4 to 13.0), increasing exponentially with aging. Of our 628 male and 380 female (ratio 1.7:1) patients, females were preponderant among those 44 clearly had more risk factors. Cardioembolism (20%) and cervicocerebral artery dissection (15%) were the most frequent etiologic subgroups. Proportions of large-artery atherosclerosis (8%) and small-vessel disease (14%) began to enlarge at age 35, whereas frequency of undetermined etiology (33%) decreased along aging. Posterior circulation infarcts were more common among patients
Notes
Comment In: Stroke. 2009 Jul;40(7):e491; author reply e49219498177
PubMed ID
19246709 View in PubMed
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An update on the treatment and management of stroke.

https://arctichealth.org/en/permalink/ahliterature169776
Source
CANNT J. 2006 Jan-Mar;16(1):30-3, 36-9; quiz 34-5, 40-1
Publication Type
Article
Author
Séadna Ledger
Author Affiliation
London Health Sciences Centre, Ontario. Seadna.Ledger@lhsc.on.ca
Source
CANNT J. 2006 Jan-Mar;16(1):30-3, 36-9; quiz 34-5, 40-1
Language
English
French
Publication Type
Article
Keywords
Anticoagulants - therapeutic use
Canada - epidemiology
Endarterectomy, Carotid
Fibrinolytic Agents - therapeutic use
Humans
Hypertension - complications - prevention & control
Kidney Failure, Chronic - complications - therapy
Primary Prevention
Renal Dialysis - adverse effects
Risk factors
Smoking - adverse effects - prevention & control
Stroke - diagnosis - epidemiology - etiology - therapy
Tissue Plasminogen Activator - therapeutic use
Abstract
There have been huge advancements in the prophylaxis and treatment of stroke. The majority of patients who have a stroke are asymptomatic prior to the event. This makes it extremely important to identify high-risk patients and administer prophylaxis where appropriate. However, risk factors, prophylaxis and treatment strategies are less clear in dialysis patients due to the lack of studies. Patients with chronic kidney disease have a higher risk of experiencing a stroke and dying from it. More studies need to be done in this area. For now, modifiable risk factors such as blood pressure and nutrition, should be promoted and prophylaxis and treatment administered with extra vigilance due to these patients' increased bleeding risk.
PubMed ID
16615704 View in PubMed
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Assessment of CHADS2 and CHA 2DS 2-VASc scores in obstructive sleep apnea patients with atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature271612
Source
Sleep Breath. 2015 May;19(2):531-7
Publication Type
Article
Date
May-2015
Author
Filip M Szymanski
Krzysztof J Filipiak
Anna E Platek
Anna Hrynkiewicz-Szymanska
Grzegorz Karpinski
Grzegorz Opolski
Source
Sleep Breath. 2015 May;19(2):531-7
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Atrial Fibrillation - complications - drug therapy - epidemiology
Comorbidity
Cross-Sectional Studies
Female
Fibrinolytic Agents - adverse effects - therapeutic use
Finland
Humans
Male
Middle Aged
Polysomnography
Risk
Sleep Apnea, Obstructive - complications - drug therapy - epidemiology
Stroke - diagnosis - epidemiology - prevention & control
Abstract
Assessment of stroke risk and implementation of appropriate antithrombotic therapy is an important issue in atrial fibrillation patients. Current risk scores do not take into consideration the comorbidities associated with elevated thromboembolic like obstructive sleep apnea (OSA). The aim of the study was to establish whether atrial fibrillation patients with coexisting OSA have higher stroke risk according to CHADS2 and CHA2DS2-VASc scores.
Two hundred fifty-four consecutive patients hospitalized with a primary diagnosis of atrial fibrillation participated in the study. All patients underwent whole night polygraphy and were scored in both CHADS2 and CHA2DS2-VASc according to their medical records or de novo diagnosis.
The study population was predominantly male (65.4%; mean age, 57.5?±?10.0 years) with a high prevalence of hypertension (73.6%), dyslipidemia (63.4%), and obesity (42.9%). OSA was present in 47.6% of patients, who more often had history of stroke (p?=?0.0007). Stroke risk profile assessed by both CHADS2 and CHA2DS2-VASc scores was higher in patients with OSA (1.2?±?0.9 vs. 0.8?±?0.6; p?
Notes
Cites: Pol Arch Med Wewn. 2013;123(12):701-724104459
Cites: Atherosclerosis. 2013 Aug;229(2):489-9523684511
Cites: Kardiol Pol. 2013;71(11):1135-924297711
Cites: JAMA. 2000 Dec 20;284(23):3015-2111122588
Cites: JAMA. 2001 May 9;285(18):2370-511343485
Cites: JAMA. 2001 Jun 13;285(22):2864-7011401607
Cites: Stroke. 1999 Jun;30(6):1223-910356104
Cites: Heart. 2001 Nov;86(5):516-2111602543
Cites: Eur Heart J. 2005 Nov;26(22):2422-3416204266
Cites: N Engl J Med. 2005 Nov 10;353(19):2034-4116282178
Cites: Europace. 2009 Apr;11(4):423-3419153087
Cites: J Clin Sleep Med. 2009 Jun 15;5(3):263-7619960649
Cites: Chest. 2010 Feb;137(2):263-7219762550
Cites: Eur Heart J. 2010 Oct;31(19):2369-42920802247
Cites: Stroke. 2010 Dec;41(12):2731-820966417
Cites: Int J Cardiol. 2011 Jan 21;146(2):131-321094542
Cites: Thyroid. 2011 Jun;21(6):593-64621510801
Cites: Am Heart J. 2011 Sep;162(3):555-6121884876
Cites: Sleep Breath. 2011 Sep;15(3):607-920496114
Cites: Eur Heart J. 2012 Nov;33(21):2719-4722922413
Cites: Thyroid. 2012 Dec;22(12):1200-3522954017
Cites: Eur Heart J. 2013 Jan;34(3):170-623018151
Cites: Eur Respir J. 2013 Mar;41(3):523-3823397300
Cites: Am J Med. 2014 Jan;127(1):45-5224384101
Cites: J Clin Sleep Med. 2014 Jan 15;10(1):103-824426829
Cites: Europace. 2014 Mar;16(3):308-1924351881
Cites: Am J Cardiol. 2014 Mar 15;113(6):950-624444782
Cites: Int J Cardiol. 2014 Mar 15;172(2):466-924452224
Cites: Int J Cardiol. 2014 Mar 15;172(2):297-824467973
Cites: Eur Heart J. 2007 Nov;28(22):2803-1717897924
PubMed ID
25084983 View in PubMed
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The association between depression, suicidal ideation, and stroke in a population-based sample.

https://arctichealth.org/en/permalink/ahliterature127793
Source
Int J Stroke. 2012 Apr;7(3):188-94
Publication Type
Article
Date
Apr-2012
Author
Esme Fuller-Thomson
Maressa J Tulipano
Michael Song
Author Affiliation
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada. esme.fuller.thomson@utoronto.ca
Source
Int J Stroke. 2012 Apr;7(3):188-94
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada - epidemiology
Cross-Sectional Studies
Depression - diagnosis - epidemiology - psychology
Female
Health Surveys - methods
Humans
Male
Middle Aged
Population Surveillance - methods
Stroke - diagnosis - epidemiology - psychology
Suicidal ideation
Abstract
Stroke survivors often experience poststroke depression and suicidal ideation.
to determine the frequency and odds ratio of depression and suicidal ideation among stroke survivors, in comparison to those without stroke, and to identify demographic factors associated with elevated odds of depression and suicidal ideation among stroke survivors.
Secondary analysis of the Canadian Community Health Survey, a population-based sample. Logistic regressions of depression and suicidal ideation were conducted.
Among those with stroke, 7·4% were depressed, in comparison to 5·2% of those without stroke (P?=?0·01). The cumulative lifetime frequency of suicidal ideation was 15·2% among stroke survivors in comparison to 9·4% of those without stroke (P?
PubMed ID
22264390 View in PubMed
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Atrial fibrillation in ischemic stroke: predicting response to thrombolysis and clinical outcomes.

https://arctichealth.org/en/permalink/ahliterature118791
Source
Stroke. 2013 Jan;44(1):99-104
Publication Type
Article
Date
Jan-2013
Author
Gustavo Saposnik
David Gladstone
Roula Raptis
Limei Zhou
Robert G Hart
Author Affiliation
MSc, FAHA, FRCPC, Stroke Outcomes Research Center, Department of Medicine, St. Michael's Hospital, University of Toronto, 55 Queen St E, Toronto, Ontario, M5C 1R6, Canada. saposnikg@smh.ca
Source
Stroke. 2013 Jan;44(1):99-104
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Atrial Fibrillation - diagnosis - epidemiology - therapy
Brain Ischemia - diagnosis - epidemiology - therapy
Canada - epidemiology
Female
Humans
Male
Middle Aged
Predictive value of tests
Registries
Stroke - diagnosis - epidemiology - therapy
Thrombolytic Therapy - trends
Treatment Outcome
Abstract
Atrial fibrillation (AF) increases the risk of stroke and is associated with poor stroke outcomes. Limited tools are available to evaluate clinical outcomes and response to thrombolysis in stroke patients with AF.
We applied the iScore (http://www.sorcan.ca/iscore), a validated risk score, to consecutive patients with an acute ischemic stroke admitted to stroke centers in the Registry of the Canadian Stroke Network. The main outcome considered was a favorable outcome (defined as a modified Rankin scale 0-2) at discharge after thrombolysis. Secondary outcomes included intracerebral hemorrhage, death at 30 days, and at 1 year stratified by terciles of the iScore.
Among 12 686 patients with an acute ischemic stroke, 2185 (17.2%) had AF. Overall, AF patients had higher risk of death at 30 days (22.3% versus 10.2%; P
PubMed ID
23168456 View in PubMed
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Atrial fibrillation in patients with ischaemic stroke in the Swedish national patient registers: how much do we miss?

https://arctichealth.org/en/permalink/ahliterature264905
Source
Europace. 2014 Dec;16(12):1714-9
Publication Type
Article
Date
Dec-2014
Author
Maria A Baturova
Arne Lindgren
Jonas Carlson
Yuri V Shubik
S. Bertil Olsson
Pyotr G Platonov
Source
Europace. 2014 Dec;16(12):1714-9
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Atrial Fibrillation - diagnosis - epidemiology
Brain Ischemia - diagnosis - epidemiology
Causality
Comorbidity
Electrocardiography - statistics & numerical data
False Negative Reactions
Female
Humans
Incidence
Male
Registries
Reproducibility of Results
Risk assessment
Sensitivity and specificity
Stroke - diagnosis - epidemiology
Sweden - epidemiology
Abstract
Data from national discharge registers are commonly used to estimate prevalence and incidence of atrial fibrillation (AF) in epidemiology studies. However, sensitivity and specificity of register-based AF diagnosis have not been evaluated. We sought to assess the validity of AF diagnosis in the Swedish Patient Register against electrocardiography (ECG) documentation of AF.
The study sample comprised of 336 patients [median age 76 (interquartile range (IQR) 67-82 years, 136 female] with first-ever ischaemic stroke, enroled in the Lund Stroke Register from March 2001 to February 2002 and 1 : 1 age- and gender-matched control subjects without stroke from the population register. Data was exported from the patient register in October 2011 (the end of follow-up). Atrial fibrillation documentation by ECG was assessed using an electronic archive containing all ECGs taken in the hospital catchment area starting in 1988. A total of 7247 ECGs were reviewed, with the median number of ECGs per person being 7.5 (IQR 3-15). Atrial fibrillation was detected by ECG in 190 patients; and in 188 patients by linkage with patient register. In most patients, AF was documented first by ECG data, with median time to register diagnosis being 16 days (IQR 3-859). Specificity of AF diagnosis in the Swedish Patient Register was 93%, sensitivity was 80%.
Despite the high specificity, AF diagnosis in the Swedish Patient Register assessed in the population of ischaemic stroke patients and age- and gender-matched control subjects has modest sensitivity, which may result in underestimating prevalent and incident AF cases if only register data are used for identification of subjects with AF in epidemiology studies.
Notes
Comment In: Europace. 2014 Dec;16(12):1701-225013012
PubMed ID
25013011 View in PubMed
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83 records – page 1 of 9.