2024
Anticoagulation Versus Antiplatelets in Spontaneous Cervical Artery Dissection: A Systematic Review and Meta-Analysis
Yaghi S, Shu L, Fletcher L, Fayad F, Shah A, Herning A, Isho N, Mansour P, Joudi K, Zaidat B, Mahmoud N, Khalek F, Xiao H, Goldstein E, Ghannam M, Siegler J, Omran S, Bakradze E, Nguyen T, Keser Z, Khan M, Shahripour R, de Havenon A, Henninger N, Heldner M, Field T, Aziz Y, Mistry E, Furie K, Engelter S, Markus H. Anticoagulation Versus Antiplatelets in Spontaneous Cervical Artery Dissection: A Systematic Review and Meta-Analysis. Stroke 2024, 55: 1776-1786. PMID: 38847098, DOI: 10.1161/strokeaha.124.047310.Peer-Reviewed Original ResearchConceptsCervical artery dissectionSystematic reviewArtery dissectionMeta-analysisBleeding riskIschemic stroke riskAntiplatelet therapyRandomized trialsSpontaneous cervical artery dissectionRisk of deathIschemic strokeCombination of keywordsTreated with antiplateletSafety of dual antiplatelet therapyReducing ischemic strokeSymptomatic intracranial hemorrhageOptimal antithrombotic strategyMajor traumaDual antiplatelet therapyIndividualized therapeutic approachStudy of patientsInclusion criteriaRandomized clinical trialsMeta-analysesEffect sizePrediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research.
de Havenon A, Ayodele I, Alhanti B, Mac Grory B, Xian Y, Fonarow G, Smith E, Worrall B. Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research. Neurology 2024, 102: e209424. PMID: 38759133, PMCID: PMC11175650, DOI: 10.1212/wnl.0000000000209424.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionNIH Stroke ScaleConsistent with previous studiesAdult acute ischemic stroke patientsCross-sectional cohort analysisAcute ischemic stroke patientsLarge vessel occlusion strokePosterior circulation strokeDiagnosis of ischemic strokeReceiver operating curveNeuroimagingGWTG-StrokeIschemic stroke patientsVascular neuroimagingAdult patientsAtrial fibrillationCirculation strokeCohort analysisClinical covariatesStroke patientsOcclusion strokeVessel occlusionPrevious studiesCut-pointsStroke ScaleGenome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke
Aldridge C, Braun R, Lohse K, de Havenon A, Cole J, Cramer S, Lindgren A, Keene K, Hsu F, Worrall B. Genome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke. Neurology 2024, 102: e208011. PMID: 38181310, PMCID: PMC11023036, DOI: 10.1212/wnl.0000000000208011.Peer-Reviewed Original Research
2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Medical ServicesHospitalsHumansIschemic StrokeSocioeconomic FactorsStrokeUnited StatesConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatientsOnce-weekly glucagon-like peptide-1 receptor agonists vs dipeptidyl peptidase-4 inhibitors: cardiovascular effects in people with diabetes and cardiovascular disease
Tan X, Liang Y, Rajpura J, Yedigarova L, Noone J, Xie L, Inzucchi S, de Havenon A. Once-weekly glucagon-like peptide-1 receptor agonists vs dipeptidyl peptidase-4 inhibitors: cardiovascular effects in people with diabetes and cardiovascular disease. Cardiovascular Diabetology 2023, 22: 319. PMID: 37985992, PMCID: PMC10662529, DOI: 10.1186/s12933-023-02051-8.Peer-Reviewed Original ResearchConceptsHealth care resource utilizationAtherosclerotic cardiovascular diseaseGLP-1 RAsCause health care resource utilizationPeptide-1 receptor agonistsDipeptidyl peptidase-4 inhibitorsDPP-4i usersPeptidase-4 inhibitorsMyocardial infarctionMedical costsDPP-4iIschemic strokeReceptor agonistCardiovascular diseaseGlucagon-like peptide-1 receptor agonistsWeekly glucagon-like peptide-1 receptor agonistWeekly GLP-1 RAsCause ER visitsCause hospitalization costsCause medical costsNew adult usersClinical cardiovascular outcomesObservational cohort studyType 2 diabetesCause outpatient visitsDetection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke
Mazurek M, Parasuram N, Peng T, Beekman R, Yadlapalli V, Sorby-Adams A, Lalwani D, Zabinska J, Gilmore E, Petersen N, Falcone G, Sujijantarat N, Matouk C, Payabvash S, Sze G, Schiff S, Iglesias J, Rosen M, de Havenon A, Kimberly W, Sheth K. Detection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke. Stroke 2023, 54: 2832-2841. PMID: 37795593, PMCID: PMC11103256, DOI: 10.1161/strokeaha.123.043146.Peer-Reviewed Original ResearchRates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort
Zhou L, Lansberg M, de Havenon A. Rates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort. PLOS ONE 2023, 18: e0289640. PMID: 37535655, PMCID: PMC10399731, DOI: 10.1371/journal.pone.0289640.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAcute renal failureHospital readmissionIschemic strokeReadmission ratesRenal failureRisk factorsUS population-based cohortUnplanned hospital readmissionNationwide Readmissions DatabaseRisk of readmissionVascular risk factorsHospital-level characteristicsPopulation-based cohortKaplan-Meyer analysisWorsened patient outcomesState administrative databasesModifiable comorbiditiesRecurrent strokeInitial hospitalizationDisadvantaged patientsLonger initial lengthMedicare insuranceAIS patientsSecondary strokePerioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation
Shu L, Jiang W, Xiao H, Henninger N, Nguyen T, Siegler J, de Havenon A, Goldstein E, Mandel D, Rana M, Al‐Mufti F, Frontera J, Furie K, Yaghi S. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation. Annals Of Neurology 2023, 94: 321-329. PMID: 37183768, DOI: 10.1002/ana.26678.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAtrial FibrillationFemaleHumansIschemic StrokeMaleRisk AssessmentRisk FactorsStrokeConceptsAcute ischemic strokeAtrial fibrillationPerioperative acute ischemic strokeDiagnosis-related groupsRisk factors-VASc scoreActive cancerHigher CHA<sub>2</sub> DS<sub>2</sub> VASc score. TheElective proceduresInternational Classification of DiseasesRisk factors of acute ischemic strokeScoring systemIschemic strokeClassification of DiseasesNeurological surgeryDays of dischargeLogistic regression modelsNationwide Readmissions DatabaseElective surgical proceduresAnticoagulant therapyInternational ClassificationPeriprocedural periodRenal failureSurgical typeAdult patientsRecurrence risk in symptomatic intracranial stenosis treated medically in the real world
Yaghi S, Shu L, Goldstein E, Chang A, Kala N, Stretz C, Burton T, Perelstein E, Furie K, Jayaraman M, Torabi R, Moldovan K, de Havenon A, Khatri P, Gebregziabher M, Liebeskind D, Prabhakaran S. Recurrence risk in symptomatic intracranial stenosis treated medically in the real world. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107086. PMID: 37030126, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107086.Peer-Reviewed Original ResearchConceptsIntracranial atherosclerotic stenosisSymptomatic intracranial atherosclerotic stenosisClinical trialsRecurrence riskRecurrent strokeInclusion criteriaReal-world settingMaximal medical treatmentRecurrent stroke rateDual antiplatelet therapyAcute ischemic strokeReal-world cohortSymptomatic intracranial stenosisPharmacological treatment strategiesCox regression modelMeeting inclusion criteriaLow event ratesAntiplatelet therapyStroke RegistryIschemic eventsIschemic strokeWorld CohortHospitalized patientsEarly recurrenceIntracranial stenosisEffect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample
de Havenon A, Zhou L, Yaghi S, Frontera J, Sheth K. Effect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample. Stroke 2023, 54: e194-e198. PMID: 37021563, PMCID: PMC10121243, DOI: 10.1161/strokeaha.122.041929.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleStroke ScaleStroke severityLowest quartileCOVID-19Acute ischemic stroke outcomesAcute ischemic stroke severityHigher stroke severityHospital stroke mortalityIschemic stroke outcomeHigher National InstitutesNational Inpatient SampleCross-sectional cohortIschemic stroke severityCOVID-19 statusNational InstituteHospital mortalityAdjusted riskHospital dischargeIschemic strokeStroke outcomeStroke mortalityAIS severityInpatient SampleExposure statusComplications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Rose D, Cavalier A, Kam W, Cantrell S, Lusk J, Schrag M, Yaghi S, Stretz C, de Havenon A, Saldanha I, Wu T, Ranta A, Barber P, Marriott E, Feng W, Kosinski A, Laskowitz D, Poli S, Mac Grory B. Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke 2023, 54: 1192-1204. PMID: 36951049, PMCID: PMC10133185, DOI: 10.1161/strokeaha.122.042335.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntracranial hemorrhageIschemic strokeSystematic reviewIntravenous tenecteplaseRelative riskHigh-dose groupRisk of complicationsPrior systematic reviewsTenecteplase-treated patientsFull-text articlesWeb of ScienceGastrointestinal hemorrhageAdult patientsExtracranial hemorrhageNoncomparative studySecondary outcomesPooled riskPrimary outcomeTreatment complicationsAbsolute riskCochrane LibraryInterventional studyMedium doseEffect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity
de Havenon A, Abbasi M, Yaghi S, Delic A, Bangad A, Johnston K, Tirschwell D, Sheth K. Effect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity. Annals Of Neurology 2023, 93: 1106-1116. PMID: 36852919, DOI: 10.1002/ana.26621.Peer-Reviewed Original ResearchConceptsIV-tPAHigher NIHSSIschemic strokeAtrial fibrillationNational Inpatient Sample (NIS) 2016Non-Hispanic white raceOlder ageBaseline National InstitutesDEFUSE-3 trialsHealth Stroke ScalePost-stroke mortalityIschemic stroke mortalityEffect of alteplaseRisk of mortalityLogistic regression modelsAnn NeurolFAST-MAGIMS IIISevere ISHospital mortalityIntravenous alteplaseSevere strokeStroke ScaleStroke severityFunctional outcomeUnderstanding Patterns of Missingness in Acute Ischemic Stroke Trials: A Secondary Analysis of Pooled Participant-Level Follow-Up Data
de Havenon A, Bangad A, Skolarus L, Aldridge C, Braun R, Cole J, Cramer S, Lindgren A, Sunmonu N, Worrall B, Lohse K. Understanding Patterns of Missingness in Acute Ischemic Stroke Trials: A Secondary Analysis of Pooled Participant-Level Follow-Up Data. Stroke 2023, 54: e201-e202. PMID: 36896708, PMCID: PMC10133020, DOI: 10.1161/strokeaha.122.042168.Peer-Reviewed Original ResearchChange in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial
Anadani M, Turan T, Yaghi S, Spiotta A, Gory B, Sharma R, Sheth K, de Havenon A. Change in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial. Stroke 2023, 54: 921-927. PMID: 36876480, PMCID: PMC10050138, DOI: 10.1161/strokeaha.121.038202.Peer-Reviewed Original ResearchMeSH KeywordsHemorrhageHumansIschemic StrokeMyocardial InfarctionRisk FactorsSmokingStrokeTreatment OutcomeConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsAcute ischemic strokeIschemic strokeCardiovascular eventsPersistent smokersPersistent smokingSPS3 trialSmoking statusMyocardial infarctionMajor adverse cardiovascular events outcomesCardiovascular event outcomesMajor cardiovascular outcomesSubsequent cardiovascular eventsHistory of hypertensionRisk of strokeEnd of studyPost Hoc AnalysisPrior smokersRandomization armCardiovascular outcomesFormer smokersMonth 3Primary outcomeTotal cohortSecondary Ischemic Stroke Prevention
Bangad A, Abbasi M, de Havenon A. Secondary Ischemic Stroke Prevention. Neurotherapeutics 2023, 20: 721-731. PMID: 36877331, PMCID: PMC10275832, DOI: 10.1007/s13311-023-01352-w.Peer-Reviewed Original ResearchConceptsSecondary ischemic stroke preventionIschemic stroke preventionRecurrent ischemic strokeStroke preventionIschemic strokeRisk factorsMajor public health concernSecondary stroke preventionLifestyle risk factorsVascular risk factorsRecurrent stroke riskAvailability of treatmentPublic health concernHealth care systemAHA guidelinesStroke riskSurgical treatmentHealth burdenPatient burdenFirst strokeStrokeHealth concernCare systemPreventionTreatmentComposition, Treatment, and Outcomes by Radiologically Defined Thrombus Characteristics in Acute Ischemic Stroke
Das S, Goldstein E, de Havenon A, Abbasi M, Nguyen T, de Sousa D, Yaghi S. Composition, Treatment, and Outcomes by Radiologically Defined Thrombus Characteristics in Acute Ischemic Stroke. Stroke 2023, 54: 1685-1694. PMID: 36661035, DOI: 10.1161/strokeaha.122.038563.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeAdvanced imaging modalitiesStroke treatmentOcclusive thrombusThrombus characteristicsTreatment modalitiesArterial thrombiNeurovascular imagingClot compositionPrevention strategiesTherapy modalitiesThrombusImaging modalitiesPatientsStrokeModalitiesFuture studiesFurther testingTreatmentReview articleClassification systemPathomechanismEpidemiologyImportant clues
2022
Subsequent ischemic stroke and tobacco smoking: A secondary analysis of the POINT trial
Lang A, de Havenon A, Mac Grory B, Henninger N, Shu L, Furie K, Easton J, Kim A, Johnston S, Yaghi S. Subsequent ischemic stroke and tobacco smoking: A secondary analysis of the POINT trial. European Stroke Journal 2022, 8: 328-333. PMID: 37021190, PMCID: PMC10069178, DOI: 10.1177/23969873221148224.Peer-Reviewed Original ResearchConceptsSubsequent ischemic strokeEffect of clopidogrelSubsequent stroke riskIschemic strokeMajor hemorrhagePoint trialStroke riskSmoking statusMinor Ischemic Stroke (POINT) trialSubgroup interaction analysesMultivariable Cox regressionMinor ischemic strokeIschemic stroke trialsEffect of smokingNon-significant trendNew TIACurrent smokersStroke trialsTobacco smokingCox regressionIndex eventSmokersSecondary analysisClopidogrelStrokeA comparison of simultaneous multislice and conventional diffusion tensor imaging techniques for ischemic stroke evaluation at 1.5T
Culleton S, Kolowori S, Roberts J, de Havenon A, DiBella E, McNally J. A comparison of simultaneous multislice and conventional diffusion tensor imaging techniques for ischemic stroke evaluation at 1.5T. British Journal Of Radiology 2022, 96: 20220222. PMID: 36469531, PMCID: PMC10997011, DOI: 10.1259/bjr.20220222.Peer-Reviewed Original ResearchConceptsIschemic stroke evaluationStroke workupStroke evaluationMean diffusivityDiffusion tensorIschemic strokeStroke protocolAcute settingIschemic stroke detectionTreatment windowBlinded neuroradiologistsIRB approvalDiagnostic accuracyFractional anisotropyT MRIObserver 2Observer 1Interrater reliabilityT-testConventional diffusion tensorWorkupDTIAverage image qualityCharacteristic areaCoefficient of variationBorderzone infarction and recurrent stroke in intracranial atherosclerosis
Kvernland A, Torres J, Raz E, Nossek E, de Havenon A, Gebregziabher M, Khatri P, Prabhakaran S, Liebeskind D, Yaghi S. Borderzone infarction and recurrent stroke in intracranial atherosclerosis. Journal Of Stroke And Cerebrovascular Diseases 2022, 32: 106897. PMID: 36402094, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106897.Peer-Reviewed Original ResearchConceptsRecurrent cerebrovascular eventsIntracranial stenosisBorderzone infarctsInfarct patternsIschemic strokeBorderzone infarctionRetrospective single-center studyAcute ischemic strokeRecurrent ischemic strokeSingle-center studySymptomatic intracranial stenosisHigh-risk cohortBinary logistic regression analysisDistal blood flowAlternative treatment strategiesLogistic regression analysisLogistic regression modelsCerebrovascular eventsRecurrent strokeIntracranial atherosclerosisPrimary outcomeCenter studyMean ageSurrogate markerTreatment strategiesDirect cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**
de Havenon A, Orlando C, Delic A, McNally JS, Majersik JJ, Harman T, Alexander M, Reddy V, Lyden S, Anzai Y. Direct cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**. The Neuroradiology Journal 2022, 36: 142-147. PMID: 35701745, PMCID: PMC10034695, DOI: 10.1177/19714009221108681.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHospital lengthIschemic strokeBrain attackRapid MRIAIS patientsEmergency departmentCT perfusionMRI cohortRapid MRI protocolTotal hospital lengthEmergency department evaluationDirect costsNeurologic symptom onsetTotal direct costsDirect cost analysisHospital LOSSequential patientsSymptom onsetDepartment evaluationED LOSPrimary outcomeDischarge diagnosisPatientsMRI protocol