2022
Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion
Joundi R, Sun J, Xian Y, Alhanti B, Nogueira R, Bhatt D, Fonarow G, Saver J, Schwamm L, Smith E. Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion. Circulation 2022, 145: 896-905. PMID: 35050693, DOI: 10.1161/circulationaha.121.056554.Peer-Reviewed Original ResearchConceptsBasilar artery occlusionSymptomatic intracranial hemorrhageEndovascular therapySymptom onsetEVT timesHospital mortalityArtery occlusionMedian onsetIntracranial hemorrhageBetter outcomesHealth Stroke Scale scoreIndividual-level patient dataMedian National InstitutesStroke Scale scoreHospital-level factorsProportion of patientsLogistic regression modelsSubstantial reperfusionAnterior circulationPrimary outcomeUS registryMean ageDevastating conditionImproved outcomesTherapy time
2021
Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage
Leifer D, Fonarow G, Hellkamp A, Baker D, Hoh B, Prabhakaran S, Schoeberl M, Suter R, Washington C, Williams S, Xian Y, Schwamm L. Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage. Journal Of The American Heart Association 2021, 10: e018373. PMID: 34325522, PMCID: PMC8475679, DOI: 10.1161/jaha.120.018373.Peer-Reviewed Original ResearchConceptsAnnual case volumeComprehensive Stroke Center (CSC) certificationStroke center certificationNational Inpatient SampleSubarachnoid hemorrhageNontraumatic subarachnoid hemorrhageCase volumeHospital mortalityClinical outcomesPoor outcomeCenter certificationSAH casesBetter outcomesVolume thresholdHospital annual case volumeHospital case volumeCases/yearBackground Previous studiesLogistic regression modelsSAH hospitalizationsHospital volumeAneurysm obliterationInpatient SampleOdds ratioImproved outcomes
2019
Thrombolysis in young adults with stroke: Findings from Get With The Guidelines-Stroke.
Dodds J, Xian Y, Sheng S, Fonarow G, Bhatt D, Matsouaka R, Schwamm L, Peterson E, Smith E. Thrombolysis in young adults with stroke: Findings from Get With The Guidelines-Stroke. Neurology 2019, 92: e2784-e2792. PMID: 31092622, DOI: 10.1212/wnl.0000000000007653.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTissue plasminogen activatorIschemic strokeOlder patientsYounger patientsYears of ageSymptomatic intracranial hemorrhage rateYoung adultsGuidelines-Stroke registryIntracranial hemorrhage rateGuidelines-StrokeHospital mortalityHospital arrivalHemorrhage rateIntracranial hemorrhageMultivariable modelPatientsBetter outcomesStrokePlasminogen activatorTPA treatmentTreatmentAdultsAgeOutcomes
2016
Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population
Kim J, Fonarow G, Smith E, Reeves M, Navalkele D, Grotta J, Grau-Sepulveda M, Hernandez A, Peterson E, Schwamm L, Saver J. Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population. Circulation 2016, 135: 128-139. PMID: 27815374, DOI: 10.1161/circulationaha.116.023336.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTissue plasminogen activatorIschemic strokeHospital mortalityIndependent ambulationPlasminogen activatorTissue plasminogen activator-treated patientsIntravenous tissue plasminogen activatorTissue plasminogen activator treatmentIschemic stroke outcomeHours of onsetOdds of dischargePlasminogen activator treatmentMinutes of onsetNational United StatesHemorrhagic complicationsStroke outcomeMedian onsetThrombolytic therapyStroke systemsBetter outcomesPatientsActivator treatmentGolden hourTreatment timePrior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke
Myint P, Hellkamp A, Fonarow G, Reeves M, Schwamm L, Schulte P, Xian Y, Suter R, Bhatt D, Saver J, Peterson E, Smith E. Prior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke. Stroke 2016, 47: 2066-2074. PMID: 27435402, DOI: 10.1161/strokeaha.115.012414.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeAntithrombotic useClinical outcomesVascular indicationsBetter outcomesPrevious antithrombotic therapyUse of antithromboticsMainstay of treatmentRankin Scale scoreImproved clinical outcomesAppropriate patient populationIndependent ambulatory statusGuidelines-StrokeHospital mortalityAmbulatory statusAntithrombotic therapyStroke preventionDischarge destinationHospital factorsSecondary preventionFavorable mortalityStroke patientsAcute eventFunctional outcome
2013
Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis
Ji R, Schwamm L, Pervez M, Singhal A. Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis. JAMA Neurology 2013, 70: 51-57. PMID: 23108720, DOI: 10.1001/jamaneurol.2013.575.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTertiary stroke centerIschemic strokeYoung adultsIschemic attackHospital dischargeStroke centersStroke etiologyRisk factorsIschemic stroke/transient ischemic attackBetter outcomesStroke/transient ischemic attackHealth Stroke Scale scoreTraditional vascular risk factorsDiagnostic testsGuidelines-Stroke databaseMedian National InstitutesSymptomatic brain hemorrhageUndetermined stroke etiologyStroke Scale scoreVascular risk factorsMiddle cerebral arteryShort-term outcomesAge 35 yearsInternal carotid artery
2012
Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy
Chandra R, Leslie-Mazwi T, Oh D, Chaudhry Z, Mehta B, Rost N, Rabinov J, Hirsch J, González R, Schwamm L, Yoo A. Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy. Stroke 2012, 43: 2356-2361. PMID: 22744644, DOI: 10.1161/strokeaha.112.650713.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overAngioplasty, BalloonCerebral InfarctionCohort StudiesEndovascular ProceduresEndpoint DeterminationFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesReperfusionRiskStentsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsIntra-arterial therapyParenchymal hematoma type 2Elderly patientsBaseline disabilityClinical outcomesBaseline healthType 2Cerebral infarction 2Worse baseline healthElderly stroke patientsRankin Scale scoreWorse clinical outcomesCoronary artery diseaseAngiographic reperfusionBaseline demographicsStroke severityArtery diseaseStroke patientsAtrial fibrillationPoor outcomeSignificant hemorrhageHigh riskReperfusionPatientsBetter outcomesInfarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Yoo A, Chaudhry Z, Nogueira R, Lev M, Schaefer P, Schwamm L, Hirsch J, González R. Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy. Stroke 2012, 43: 1323-1330. PMID: 22426317, DOI: 10.1161/strokeaha.111.639401.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkersBrain InfarctionCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPredictive Value of TestsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsFinal infarct volumeIntra-arterial therapyAcute ischemic strokeInfarct volumeFunctional outcomeBetter outcomesIschemic strokePoor outcomeAnterior circulation acute ischemic strokeScale scoreHealth Stroke Scale scoreMedian admission National InstitutesMedian final infarct volumesLong-term functional outcomeIntra-arterial stroke therapyAdmission National InstitutesProximal artery occlusionStroke Scale scoreOnly independent predictorRankin Scale scoreArtery occlusionProspective cohortRankin ScaleIndependent predictorsClinical outcomes
2010
Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield
2009
Number Needed to Treat to Benefit and to Harm for Intravenous Tissue Plasminogen Activator Therapy in the 3- to 4.5-Hour Window
Saver J, Gornbein J, Grotta J, Liebeskind D, Lutsep H, Schwamm L, Scott P, Starkman S. Number Needed to Treat to Benefit and to Harm for Intravenous Tissue Plasminogen Activator Therapy in the 3- to 4.5-Hour Window. Stroke 2009, 40: 2433-2437. PMID: 19498197, PMCID: PMC2724988, DOI: 10.1161/strokeaha.108.543561.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorRankin ScaleIntravenous tissue plasminogen activator therapyIntravenous tissue plasminogen activatorTissue plasminogen activator therapyPlasminogen activatorAcute cerebral ischemiaModified Rankin ScalePlasminogen activator therapyResults of therapyEffect sizeCerebral ischemiaPoststroke disabilityAdditional patientsActivator therapyWorse outcomesGlobal disabilityTreatment decisionsBetter outcomesClinical practicePatientsNNTBLikelihood of helpEffect size estimatesTable analysis