Search results for: ABCD2




Left Atrial Strain Predicts Stroke Recurrence and Death in Patients With Cryptogenic Stroke.
Left atrial strain (LAS) has been widely studied as a predictor of atrial fibrillation (AF) after cryptogenic stroke (CS). However, the evidence about its prognostic role in terms of stroke recurrence and death in this setting remains scarce. A total of 92 consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale ≥4 of unknown etiology were prospectively recruited. Echocardiography, including LAS was performed during admission. The primary outcome measure was the composite of stroke recurrence or death. The mean age was 77.5 ± 7.7, and 58% of patients were female. After a median follow up of 28 months, the primary outcome measure occurred in 15 patients (16%). The primary outcome was more frequent in patients with diabetes (53% vs 21%, p = 0.02), chronic kidney disease (33% vs 10%, p = 0.034), and a history of heart failure (13% vs 0%, p = 0.025). LAS reservoir (LASr) and LAS conduit (LAScd) were lower in patients developing the primary outcome (21% ± 7% vs 28.8% ± 11%, p = 0.017 and 7.7% ± 3.9% vs 13.7% ± 7%, p = 0.007, respectively). On multivariate analysis, LASr (hazard ratio 0.9, 95% confidence interval 0.85 to 0.99, p = 0.048) and diabetes (hazard ratio 3.3, 95% confidence interval 1.03 to 10.4, p = 0.045) were associated with stroke recurrence or all-cause death after CS. On the log-rank test (using the discriminatory cut-off value of LASr <23%), LASr (p = 0.009) was associated with higher risk of the primary outcome. In conclusion, lower values of the LAS reservoir were associated with a higher risk of stroke recurrence or death after CS. LAS may identify patients at higher risk of thromboembolism and stress conditions.Alberto Vera, Alberto Cecconi, Álvaro Ximénez-Carrillo, Carmen Ramos, Pablo Martínez-Vives, Beatriz Lopez-Melgar, Ancor Sanz-García, Guillermo Ortega, Clara Aguirre, Álvaro Montes, José Vivancos, Luis Jesús Jiménez-Borreguero, Fernando Alfonso,
1179 related Products with: Left Atrial Strain Predicts Stroke Recurrence and Death in Patients With Cryptogenic Stroke.
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Multimodal MRI study of the relationship between plaque characteristics and hypoperfusion in patients with transient ischemic attack.
Transient ischemic attack is a significant risk factor for acute cerebral infarction. Previous studies have demonstrated that hypoperfusion in patients with transient ischemic attack was associated with the recurrence of transient ischemic attack, stroke, and persistent worsening of neurological symptoms. Moreover, transient ischemic attack patients classified as high-risk group according to the ABCD score have a higher incidence of stroke. Therefore, the objective of this study was to investigate the plaque characteristics of transient ischemic attack patients with concomitant cerebral hypoperfusion using multimodal MRI, as well as hemodynamic changes in the high-risk group with transient ischemic attack patients.Ying Sui, Jiali Sun, Yue Chen, Wei Wang
1364 related Products with: Multimodal MRI study of the relationship between plaque characteristics and hypoperfusion in patients with transient ischemic attack.
96 tests196 tests96 tests
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Safety and Feasibility of an Emergency Department-to-Outpatient Pathway for Patients With TIA and Nondisabling Stroke.
Evaluation of transient ischemic attack/nondisabling ischemic strokes (TIA/NDS) in the emergency department (ED) contributes to capacity issues and increasing health care expenditures, especially high-cost duplicative imaging.Alexis Roy, Anirudh Sreekrishnan, Erica Camargo Faye, Scott Silverman, Kori S Zachrison, Andrea M Harriott, Marcelo Matiello, Giovanna S Manzano, Mrinalini Prasanna, Simona Nedelcu, Aneesh B Singhal
2458 related Products with: Safety and Feasibility of an Emergency Department-to-Outpatient Pathway for Patients With TIA and Nondisabling Stroke.
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Bedside Testing in Acute Vestibular Syndrome-Evaluating HINTS Plus and Beyond-A Critical Review.
Acute vertigo and dizziness are frequent presenting symptoms in patients in the emergency department. These symptoms, which can be subtle and transient, present diagnostic challenges because they can be caused by a broad range of conditions that cut across many specialties and organ systems. Previous work has emphasized the value of combining structured history taking and a targeted examination focusing on subtle oculomotor signs. In this review, we discuss various diagnostic bedside algorithms proposed for the acutely dizzy patient. We analyzed these different approaches by calculating their area-under-the-curve (ROC) characteristics and sensitivity/specificity. We found that the algorithms that incorporated structured history taking and the use of subtle oculomotor signs had the highest diagnostic accuracy. In fact, both the HINTS+ bedside exam and the STANDING algorithm can more accurately diagnose acute strokes than early (<24 to 48 h after symptom onset) MRI with diffusion-weighted imaging (DWI). An important caveat is that HINTS and STANDING require moderate training to achieve this accuracy. Therefore, for physicians who have not undergone adequate training, other approaches are needed. These other approaches (e.g., ABCD2 score, PCI score, and TriAGe+ score) rely on vascular risk factors, clinical symptoms, and focal neurologic findings. While these other scores are easier for frontline providers to use, their diagnostic accuracy is far lower than HINTS+ or STANDING. Therefore, a focus on providing dedicated training in HINTS+ or STANDING techniques to frontline clinicians will be key to improving diagnostic accuracy and avoiding unnecessary brain imaging.Alexander A Tarnutzer, Jonathan A Edlow
2350 related Products with: Bedside Testing in Acute Vestibular Syndrome-Evaluating HINTS Plus and Beyond-A Critical Review.
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Soluble C-type lectin-like receptor 2 in stroke (CLECSTRO) study: protocol of a multicentre, prospective cohort of a novel platelet activation marker in acute ischaemic stroke and transient ischaemic attack.
Soluble C-type lectin-like receptor 2 (sCLEC-2) is a new biomarker for platelet activation, which can be easily measured by usual blood collection. We conducted the CLECSTRO, a prospective, observational cohort study, to evaluate the clinical implications of sCLEC-2 in patients with acute ischaemic stroke (AIS) and transient ischaemic attack (TIA).Shinichiro Uchiyama, Katsue Suzuki-Inoue, Hideo Wada, Yasushi Okada, Teruyuki Hirano, Takehiko Nagao, Hiroyuki Kinouchi, Ryo Itabashi, Haruhiko Hoshino, Koichi Oki, Yutaka Honma, Nobuo Ito, Hiroshi Sugimori, Masahide Kawamura
2926 related Products with: Soluble C-type lectin-like receptor 2 in stroke (CLECSTRO) study: protocol of a multicentre, prospective cohort of a novel platelet activation marker in acute ischaemic stroke and transient ischaemic attack.
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ABCD2 score has equivalent stroke risk prediction for anterior circulation TIA and posterior circulation TIA.
Transient ischemic attack (TIA) was clinically divided into anterior circulation (AC) or posterior circulation (PC). Previous study reported that ABCD2 score could predict the stroke risk after AC-TIA but might have limitation for PC-TIA. We aimed to classify TIA depending on neuroimaging and assess the value of ABCD2 score for predicting stroke risk in different territories. Research data was from TIA database of the First Affiliated Hospital of Zhengzhou University. TIA patients with acute infarction on diffuse weighted imaging [that is, transient symptoms with infarction (TSI)] were divided into anterior and posterior circulation groups according to the location of infarction. The outcome was recurrent stroke within 7 and 90 days. The predictive power of ABCD2 score was determined using area under receiver operator characteristic curve (AUC) analyses. Overall, 382 AC-TSI and 112 PC-TSI patients were included. There were 38 (9.9%) AC-TSI patients and 11(9.8%) PC-TSI patients who had recurrent stroke at 7 days, and 66 (17.3%) AC-TSI patients and 19 (17.0%) PC-TSI patients who had recurrent stroke within 90 days. At 7 days, the AUC for ABCD2 score was 0.637 (95% confidence interval CI 0.554-0.720) in anterior circulation and 0.683 (95% CI 0.522-0.845) in posterior circulation. The C statistics for ABCD2 score in the two groups were not statistically significant (Z = - 0.499; P = 0.62). Similar result was found when the outcome time-point was set at 90 days. ABCD2 score could predict the short-term risk of recurrent stroke after AC-TSI and PC-TSI, and had similar predictive abilities for AC-TSI and PC-TSI.Shuang Cao, Lu Zhao, Lulu Pei, Yuan Gao, Hui Fang, Kai Liu, Hao Liu, Shuxiang Yang, Shilei Sun, Jun Wu, Bo Song, Yuming Xu
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Evaluating the use of the ABCD2 score as a clinical decision aid in the emergency department: Retrospective observational study.
Clinical decision aids (CDAs) can help clinicians with patient risk assessment. However, there is little data on CDA calculation, interpretation and documentation in real-world ED settings. The ABCD2 score (range 0-7) is a CDA used for patients with transient ischaemic attack (TIA) and assesses risk of stroke, with a score of 0-3 being low risk. The aim of this study was to describe ABCD2 score documentation in patients with an ED diagnosis of TIA.Siddhant Wahi, Zoe A Michaleff, Paige Lomax, Adam Brand, Madeleen van der Merwe, Mark Jones, Paul Glasziou, Gerben Keijzers
2900 related Products with: Evaluating the use of the ABCD2 score as a clinical decision aid in the emergency department: Retrospective observational study.
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Transcriptome-wide profile of 1α,25 dihydroxyvitamin D in HTR-8/SVneo cells.
Vitamin D has been implicated in multiple reproductive events, whereas the effect of its bioactive metabolite 1α, 25 dihydroxyvitamin D3 (1,25(OH) D ) on transcriptome profile of the placenta is unclear. The aim of this article is to determine transcriptome-wide profile caused by 1,25(OH) D in human placental trophoblast cells.Jiahuan Luo, Li Tang, Ruopeng Zhang, Mengxin Lv, Dingyun You, Qian Yuan
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Development of a model to predict the risk of cerebral infarction in acute vestibular syndrome.
This study aimed to develop a model to predict the risk of cerebral infarction in acute vestibular syndrome and assist emergency physicians in quickly identifying patients with cerebral infarction.Guiming Lin, Fangfang Liu, Hengshi Xu, Guanshui Bao
2146 related Products with: Development of a model to predict the risk of cerebral infarction in acute vestibular syndrome.
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Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3): Rationale and design of a multicenter randomized placebo-controlled trial.
Anti-inflammatory therapy using colchicine has reduced recurrent vascular events in patients with coronary heart disease.Yongjun Wang, Jiejie Li, S Claiborne Johnston, Graeme J Hankey, J Donald Easton, Xia Meng, Fu-Dong Shi, Yilong Wang, Xingquan Zhao, Zixiao Li, Liping Liu, Hongqiu Gu, Yong Jiang, Anxin Wang, Yuesong Pan, Jing Jing, Siying Niu, Hao Li
1051 related Products with: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3): Rationale and design of a multicenter randomized placebo-controlled trial.
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