[inventory] selected articles of stroke in January 2020
Last Update: 2020-06-19
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< br / > < br / >Recently, a research article was published in stroke, an authoritative journal in the field of cardiovascular diseasesThe researchers aimed to compare the safety and outcome of PCs and ACS patients after intravenous thrombolysis, and combined the results in a meta-analysis< br / > < br / > the researchers included CT / MRA occlusive data from patients who were safely enrolled in treatment trials at the stroke thrombolysis registry between 2013 and 2017The outcomes were parenchymal hematoma, symptomatic cerebral hemorrhage (Sich) according to SITS-MOST, ECASS II and NINDS, three-month modified Rankin Scale score and deathThe researchers adjusted for Sich risk factors (age, gender, NIH stroke scale, blood pressure, glucose, and atrial fibrillation) and centers using inverse probability treatment weights, and then calculated the mean treatment effect (ATE)The outcomes of PCs and ACS patients after intravenous thrombolysis were compared< br / > < br / > of 5146 patients, 753 (14.6%) had PCsThe median stroke scale of the National Institutes of health in patients with PCs was lower: 7 (interquartile range, 4-13) vs13 (7-18), P < 0.001, with fewer cerebrovascular risk factors%)In patients with PCs and ACS, 3-month outcomes (70% data availability) were death 18.5% and 20.5%, ate 6.0% (0.7% to 11.4%), modified Rankin Scale score 0-1, 45.2% and 37.5%, ate 1.7% (- 6.6% to 3.2%), modified Rankin Scale score 0-2, 61.3% and 49.4%, ate 2.4% (3.1% to 7.9%)The meta-analysis showed that the relative risk of Sich between PCs and ACS was 0.49 (95% CI 0.32-0.75)< br / > < br / > it can be seen that the risk of bleeding complications after PCs intravenous thrombolysis is half of that of ACS, with similar functional outcomes and higher risk of death, and it is recognized that the National Institutes of Health Stroke Scale limits stroke severity or infarct area adjustmenthttps：//article.do ? Id = ddb9186099cc < br / >There was no heart disease in 93627 subjects aged 66 years or older 21 931 subjects with first-time ischemic stroke were matched with 71 696 subjects without stroke < br / > < br / > the first ischemic stroke was associated with an increased risk of adverse cardiovascular events, which was time-dependent < br / > < br / > < br / > < br / > in general, we will think that this connection may be related to common risk factors such as hypertension, diabetes or smoking between heart disease and stroke < br / > < br / > however, the researchers pointed out that seeing this connection in people without heart disease suggests that other mechanisms are also involved < br / > < br / > researchers infer that the heart and brain have deep neural connections Stroke related brain damage will lead to autonomic nervous dysfunction and inflammation, which will lead to heart complications In the future, it is necessary to carry out in-depth research and explore the mechanism of heart problems caused by stroke, which will eventually bring new ideas for how to prevent these problems At the same time, it is emphasized that clinicians should pay more attention to the symptoms of coronary artery disease or hidden heart disease in stroke patients in order to intervene early https：// article.do ? Id = 3fa81861185f < br / >, And to evaluate any possible regulatory factors in patients with hypertension < br / > < br / > this analysis included 11547 hypertension participants who had no stroke history in China's first level stroke prevention trial (csppt) The main outcome was stroke In the 4.4-year median follow-up, 726 stroke patients were identified, including 631 ischemic patients and 90 hemorrhagic patients Each SD increase in mean cIMT was positively correlated with the risk of first stroke (hazard ratio [HR] 1.11 [95%CI 1.03-1.20]) and first ischemic stroke (HR 1.10 [95%CI 1.01 – 1.20]) In addition, participants in the second to fourth quartiles (≥ 0.66 mm) had a higher risk of first stroke (HR 1.31 [95% CI 1.06-1.61]) and first hemorrhagic stroke (HR 2.25 [95% CI 1.11-4.58]) compared to participants in the first quartile (< 0.66 mm) More importantly, the association between CIMT and first stroke was stronger in subjects with higher mean arterial pressure ([quintile 5] ≥ 109.3 and < 109.3 mmHg, P interaction = 0.024) or diastolic pressure ([quintile 5] ≥ 90.7 and < 90.7 mmHg, P interaction = 0.009) There was a significant positive correlation between baseline CIMT and risk of first stroke in patients with hypertension The association was even stronger in patients with higher mean arterial or diastolic blood pressure levels https：// article.do ? Id = 8b3c186512cc < br / > Rao shares the pathophysiological mechanism with AIS, and direct comparison can guide emergency treatment, evaluation and secondary prevention < br / > < br / > recently, a research article was published in stroke, an authoritative journal in the field of cardiovascular disease The national re admission database contains about 50% of the data of hospitalized patients in the United States from 2013 to 2015 Researchers used the ninth edition of the ICD code to identify and compare Rao and AIS admission rates, comorbidities and interventions, and clinical comorbidity software codes to identify the cause of re-entry, using survey weighting where possible The cumulative risk of all-cause readmission after Rao ≤ 1 year was estimated by Kaplan Meier analysis < br / > < br / > in 4871 Rao and 1239963 AIS inpatients, compared with AIS patients, Rao patients had lower possibility of diabetes (P < 0.0001) (RAO was 24.3%, AIS was 36.8%), congestive heart failure (9.1% vs 14.8%), atrial fibrillation (15.5% vs 25.2%) or hypertension (62.2% vs 67.6%), But the risk of valve disease (13.3% vs 10.5%) and smoking (38.6% vs 32.9%) were higher When Rao was admitted to hospital, the incidence of thrombolysis was 2.9% (5.8% in central Rao sub group, and 8.0% in AIS) The incidence of therapeutic anterior chamber puncture was 1.0%, without thrombectomy 1.4% of patients received carotid endarterectomy in hospital, and 1.6% received carotid endarterectomy within 30 days Within 30 days, 10% of Rao patients were readmitted, and twice as likely to be readmitted due to arrhythmia or endocarditis as AIS patients The re admission rate of stroke after Rao was the highest in the first 150 days after admission, and the risk of central Rao was higher than branch Rao < br / > < br / > it can be seen that the prevalence of many stroke risk factors (especially valve disease and smoking) in Rao patients is very high, which can be solved by reducing the risk Although baseline AF is less, Rao patients are more likely to be readmitted for AF / arrhythmia and require a variety of interventions Shortly after Rao, AIS was at the highest risk, and the results of the study highlighted the importance of an urgent and comprehensive neurovascular assessment https：// article.do ? Id = feff18651841 < br / >, The aim of the study was to compare the outcomes of patients with ischemic stroke who started direct oral anticoagulant therapy (doac) early and late after stroke < br / > < br / > This prospective, multicenter, observational study collected data from 1192 patients with nonvalvular atrial fibrillation with acute ischemic stroke or transient ischemic attack These patients started doac treatment during the acute hospitalization, and were divided into two groups according to the median time of starting doac treatment after the onset of the disease Outcomes included stroke or systemic embolism, major bleeding, 3 months, and 2-year-old death < br / > Therefore, 223 patients (median age 74 [quartile range, 68-81] years; 78 women) were assigned to the early treatment group (< 3 days) and 276 patients (median age 75 [quartile range, 69-82] years; 101 women) to the late treatment group (≥ 4 days) The baseline score of stroke scale of NIH in the early treatment group was lower than that in the late treatment group Overall, the 2-year duration of doac treatment was 85.2%, excluding patients who died or lost visits Multivariate Cox shared vulnerability model showed that at 2 years, the risk of stroke or systemic embolism was comparable (hazard ratio 0.86 [95% CI 0.47 – 1.57]), major bleeding (hazard ratio 1.39 [95% CI 0.42 – 4.60]), and death (hazard ratio 0.61 [95% CI 0.28 – 1.33]) There was no significant difference in the 3-month outcome risk between the two groups < br / > < br / > it can be seen that the risk of stroke or systemic embolism, massive hemorrhage and death is similar whether doac treatment is started within 3 days or 4 days or less after non valvular atrial fibrillation related ischemic stroke or transient ischemic attack https：// article.do ? Id = 44a91866995e < br / > Recently, a research article was published in stroke, the authoritative journal of cardiovascular diseases The researchers investigated whether blood pressure variability (BPV), heart rate variability and baroreflex sensitivity can predict the functional prognosis of stroke patients < br / > < br / > BPV and heart rate were calculated from 5-minute blood pressure and heart rate monitoring within 7 days after stroke
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