2023
Association of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke
Stulberg E, Harris B, Zheutlin A, Delic A, Sheibani N, Anadani M, Yaghi S, Petersen N, de Havenon A. Association of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke. Neurology 2023, 101: e1145-e1157. PMID: 37487742, PMCID: PMC10513881, DOI: 10.1212/wnl.0000000000207599.Peer-Reviewed Original ResearchConceptsAverage real variabilityNonstroke patientsDischarge destinationHospital deathIschemic strokeIll patientsIllness severityWorse outcomesAdult intensive care unit patientsMinimum mean arterial pressureIntensive care unit patientsIntensive Care III databaseBlood pressure goalsAcute ischemic strokeMean arterial pressureBlood pressure variabilityCare unit patientsRisk of deathMedical Information MartUnit patientsArterial pressureIntracerebral hemorrhageSubarachnoid hemorrhageRisk factorsEffect modification
2021
Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control
de Havenon A, Muddasani V, Castillo M, Sheth KN, Delic A, Herman A, Conaway M, Johnston KC, Investigators F. Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106065. PMID: 34455151, PMCID: PMC8511272, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106065.Peer-Reviewed Original ResearchConceptsIntensive glucose controlAcute ischemic strokeWorse functional outcomeBlack patientsGlucose controlIschemic strokeWhite patientsExcellent outcomesFunctional outcomeTreatment armsWorse outcomesAcute ischemic stroke patientsStroke Hyperglycemia Insulin Network Effort (SHINE) trialIntensive treatment armStandard treatment armIschemic stroke patientsExcellent functional outcomeMixed effects logistic regression modelsLogistic regression modelsPrimary outcomeStroke patientsPotential confoundersOdds ratioFunctional impairmentPatients
2020
Impact of COVID-19 on Outcomes in Ischemic Stroke Patients in the United States
de Havenon A, Ney JP, Callaghan B, Delic A, Hohmann S, Shippey E, Esper GJ, Stulberg E, Tirschwell D, Frontera J, Yaghi S, Anadani M, Majersik JJ. Impact of COVID-19 on Outcomes in Ischemic Stroke Patients in the United States. Journal Of Stroke And Cerebrovascular Diseases 2020, 30: 105535. PMID: 33310595, PMCID: PMC7832426, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105535.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsIschemic strokeFavorable dischargeStroke patientsPrimary analysisLaboratory-confirmed COVID-19COVID-19Vizient Clinical Data BaseAcute coronary syndromeAcute renal failureCohort of patientsCoronavirus disease 2019Clinical data baseCoronary syndromeHospital deathVenous thromboembolismMechanical thrombectomyRenal failureHispanic patientsDischarge diagnosisSubarachnoid hemorrhageWorse outcomesDisease 2019High riskLower oddsRisk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457)
Nguyen C, Silverman A, Wang A, Kodali S, Strander S, Kimmel A, Peshwe K, de Havenon A, Gilmore E, Sansing L, Schindler J, Matouk C, Sheth K, Petersen N. Risk of Worse Outcome in Stroke Patients with High Blood Pressure Variability After Endovascular Thrombectomy May Be Amplified by Impaired Cerebral Autoregulation (4457). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.4457.Peer-Reviewed Original Research
2019
Subclinical Cerebrovascular Disease: Epidemiology and Treatment
de Havenon A, Meyer C, McNally JS, Alexander M, Chung L. Subclinical Cerebrovascular Disease: Epidemiology and Treatment. Current Atherosclerosis Reports 2019, 21: 39. PMID: 31350593, PMCID: PMC8011954, DOI: 10.1007/s11883-019-0799-1.Peer-Reviewed Original ResearchConceptsMedical managementRisk factorsAggressive medical managementSilent brain infarctsOptimal medical treatmentVascular risk factorsDevelopment of dementiaBest medical managementImportant risk factorLate-life depressionCommon clinical scenariosWhite matter hyperintensitiesT2-weighted MRISusceptibility-weighted MRIEvidence-based approachBrain infarctsCerebral microbleedsCerebrovascular diseaseGait instabilityBrain healthClinical equipoiseWorse outcomesClinical trialsMatter hyperintensitiesEpidemiologic studies
2018
Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage
de Havenon A, Majersik JJ, Stoddard G, Wong KH, McNally JS, Smith AG, Rost NS, Tirschwell DL. Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage. Stroke 2018, 49: 1981-1984. PMID: 30012822, PMCID: PMC6202185, DOI: 10.1161/strokeaha.118.022133.Peer-Reviewed Original ResearchConceptsBlood pressure variabilitySystolic blood pressure variabilitySystolic blood pressureNeurological outcomeRankin ScaleBlood pressureAcute periodIntracerebral hemorrhageWorse outcomesPressure variabilityLong-term neurological outcomeUtility-weighted modified Rankin scaleWorse neurological outcomeAcute ischemic strokeModified Rankin ScaleBlood pressure meansATACH-2 trialProtocol-based approachATACH-2Ischemic strokeSecondary outcomesPrimary outcomeEarly identificationSecondary analysisConsistent associationIncreased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome
Bennett AE, Wilder MJ, McNally JS, Wold JJ, Stoddard GJ, Majersik JJ, Ansari S, de Havenon A. Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome. Journal Of NeuroInterventional Surgery 2018, 10: 823. PMID: 29352059, DOI: 10.1136/neurintsurg-2017-013473.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleBlood pressure variabilityIntra-arterial therapyIntravenous tissue plasminogen activatorPressure variabilityTissue plasminogen activatorLogistic regression modelsOrdinal logistic regression modelsIschemic strokeWorse outcomesMean age 63.2 yearsMedian admission National InstitutesMultivariable ordinal logistic regression modelsSystolic blood pressure variabilityPlasminogen activatorAdmission National InstitutesWorse neurologic outcomeWorse clinical outcomesLogistic regression analysisOrdinal logistic regression analysisIndependent predictive abilitySuccessive variationAcute strokeEndovascular thrombectomyNeurologic outcome