2024
Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis
Mac Grory B, Sun J, Alhanti B, Lusk J, Li F, Adeoye O, Furie K, Hasan D, Messe S, Sheth K, Schwamm L, Smith E, Bhatt D, Fonarow G, Saver J, Xian Y, Grotta J. Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis. JAMA Neurology 2024, 81 PMID: 39466286, DOI: 10.1001/jamaneurol.2024.3659.Peer-Reviewed Original ResearchEmergency medical servicesEmergency medical service managementMobile stroke unitPrehospital managementSymptomatic intracranial hemorrhageHospital dischargeGlobal disabilityIn-hospital mortalityEfficacy end pointUtility-weighted modified Rankin scaleStroke unit managementAcute ischemic strokeIschemic strokePrimary analytic cohortDiagnosis of ischemic strokeIntravenous thrombolysisAmerican Heart AssociationEnd pointsGuidelines-StrokeUW-mRSSecondary efficacy end pointsMain OutcomesMedical servicesStroke unitAmbulation status
2022
The relationship between stroke system organization and disparities in access to stroke center care in California
Zachrison K, Samuels‐Kalow M, Li S, Yan Z, Reeves M, Hsia R, Schwamm L, Camargo C. The relationship between stroke system organization and disparities in access to stroke center care in California. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12706. PMID: 35316966, PMCID: PMC8921441, DOI: 10.1002/emp2.12706.Peer-Reviewed Original ResearchIschemic stroke patientsInterhospital transferStroke patientsReperfusion interventionsCenter careEthnic disparitiesAcute ischemic stroke patientsNon-Hispanic black patientsAsian/Pacific Islander patientsAcute ischemic strokeComprehensive stroke centerOdds of dischargeHospital-level characteristicsPacific Islander patientsNon-Hispanic Asian/Pacific IslandersNon-Hispanic blacksAsian/Pacific IslandersInterhospital patient transfersOutcomes of interestNon-Hispanic whitesHierarchical logistic regressionReperfusion therapyHospital dischargeIschemic strokeStroke centers
2020
Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era
Akbik F, Xu H, Xian Y, Shah S, Smith E, Bhatt D, Matsouaka R, Fonarow G, Schwamm L. Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era. JAMA Neurology 2020, 77: 1486-1495. PMID: 32955582, PMCID: PMC7506601, DOI: 10.1001/jamaneurol.2020.3362.Peer-Reviewed Original ResearchConceptsHospital stroke onsetHospital onsetIntravenous thrombolysisStroke onsetEndovascular therapyReperfusion therapyHospital strokeCohort studyIschemic strokeFunctional outcomeNational registryIn-Hospital Ischemic StrokeIntravenous thrombolysis treatmentLimited contemporary dataRetrospective cohort studyAcute ischemic strokeVascular risk factorsWorse functional outcomeEndovascular reperfusion therapyLonger median timeKey patient characteristicsTherapy eraThrombolysis treatmentHospital dischargePatient characteristicsAssociation Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. JAMA 2020, 323: 2170-2184. PMID: 32484532, PMCID: PMC7267850, DOI: 10.1001/jama.2020.5697.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorAcute ischemic strokeTissue plasminogen activatorCause mortalityNeedle timeCause readmissionIschemic strokeLong-term outcomesShorter doorBetter long-term outcomesImproved long-term outcomesPlasminogen activatorRetrospective cohort studyGood functional outcomeGuidelines-StrokeCohort studyHospital arrivalHospital dischargeMedian doorEarly administrationMedian agePrimary outcomeThrombolytic therapyFunctional outcomeReadmission
2019
Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association
Adeoye O, Nyström K, Yavagal D, Luciano J, Nogueira R, Zorowitz R, Khalessi A, Bushnell C, Barsan W, Panagos P, Alberts M, Tiner A, Schwamm L, Jauch E. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association. Stroke 2019, 50: e187-e210. PMID: 31104615, DOI: 10.1161/str.0000000000000173.Peer-Reviewed Original ResearchConceptsAmerican Stroke AssociationStroke systemsStroke AssociationStroke center certificationMobile stroke unitEmergency medical servicesHospital dischargeSecondary preventionStroke centersEndovascular therapyStroke unitPrimary preventionCenter certificationNeurocritical careAssociation recommendationsCareBasis of improvementStroke recognitionMedical servicesHealthcare agenciesScientific evidenceHealthcare policyAppropriate facilitiesPreventionSignificant changes
2017
Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol
Reeves M, Hughes A, Woodward A, Freddolino P, Coursaris C, Swierenga S, Schwamm L, Fritz M. Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol. BMC Neurology 2017, 17: 115. PMID: 28623892, PMCID: PMC5474297, DOI: 10.1186/s12883-017-0895-1.Peer-Reviewed Original ResearchConceptsAcute stroke patientsCase management programPatient Activation MeasureStroke patientsCaregiver outcomesTransition trialsRehabilitation facilityAdult acute stroke patientsBakas Caregiving Outcomes ScalePrimary caregiversOutcome 3 monthsPrimary patient outcomePatient's primary caregiverEvidence-based standardsHealth-related challengesUsual careHospital dischargeSuperiority trialEligible participantsOutcome ScaleTrial protocolPatient outcomesStudy interventionMichigan hospitalsOutcome data
2014
Use of Renin–Angiotensin System Blockers in Acute Coronary Syndromes
Bainey K, Armstrong P, Fonarow G, Cannon C, Hernandez A, Peterson E, Peacock W, Laskey W, Zhao X, Schwamm L, Bhatt D. Use of Renin–Angiotensin System Blockers in Acute Coronary Syndromes. Circulation Cardiovascular Quality And Outcomes 2014, 7: 227-235. PMID: 24569634, DOI: 10.1161/circoutcomes.113.000422.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersAcute coronary syndromeACEI/angiotensin receptor blockerACEI/ARB therapyCoronary artery bypassCoronary syndromeAmerican CollegeARB therapyArtery bypassRenal insufficiencyMyocardial infarctionCardiology/American Heart Association class ICardiology/American Heart Association guidelinesGuidelines-Coronary Artery Disease programHospital coronary artery bypassRenin-angiotensin system blockersAmerican Heart Association guidelinesU.S. National RegistryHeart Association guidelinesRate of treatmentQuality improvement effortsEligible patientsSystem blockersReceptor blockersHospital discharge
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
Death and Rehospitalization after Transient Ischemic Attack or Acute Ischemic Stroke: One-year Outcomes from the Adherence Evaluation of Acute Ischemic Stroke–Longitudinal Registry
Olson D, Cox M, Pan W, Sacco R, Fonarow G, Zorowitz R, LaBresh K, Schwamm L, Williams L, Goldstein L, Bushnell C, Peterson E, Registry A. Death and Rehospitalization after Transient Ischemic Attack or Acute Ischemic Stroke: One-year Outcomes from the Adherence Evaluation of Acute Ischemic Stroke–Longitudinal Registry. Journal Of Stroke And Cerebrovascular Diseases 2012, 22: e181-e188. PMID: 23273788, DOI: 10.1016/j.jstrokecerebrovasdis.2012.11.001.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute ischemic strokeIschemic stroke Longitudinal (AVAIL) registryAIS patientsIschemic attackTIA patientsIschemic strokeAdherence evaluationPrimary composite outcomeOne-year outcomesRehospitalization of patientsRate of deathCause deathGuidelines-StrokePostdischarge riskCause mortalityCause rehospitalizationComposite outcomeHospital dischargeMedication useAdjusted ratesRehospitalizationPreventive guidelinesPatientsOne-yearTemporal Trends and Predictors in the Use of Aldosterone Antagonists Post-Acute Myocardial Infarction
Rassi A, Cavender M, Fonarow G, Cannon C, Hernandez A, Peterson E, Peacock W, Laskey W, Rosas S, Zhao X, Schwamm L, Bhatt D. Temporal Trends and Predictors in the Use of Aldosterone Antagonists Post-Acute Myocardial Infarction. Journal Of The American College Of Cardiology 2012, 61: 35-40. PMID: 23137936, DOI: 10.1016/j.jacc.2012.08.1019.Peer-Reviewed Original ResearchMeSH KeywordsAgedDiabetes MellitusDrug PrescriptionsDrug UtilizationFemaleGuideline AdherenceHeart FailureHospital Bed CapacityHumansKidney DiseasesMaleMineralocorticoid Receptor AntagonistsMultivariate AnalysisMyocardial InfarctionMyocardial RevascularizationPatient DischargePractice Guidelines as TopicRegistriesSmokingStroke VolumeUnited StatesConceptsPost-acute myocardial infarctionAldosterone antagonist useAldosterone antagonist therapyAldosterone antagonistsEjection fractionAntagonist useEligible patientsAntagonist therapyHospital dischargeHeart failureMyocardial infarctionActual prescribing patternsGuideline-based therapyAbsence of contraindicationsHistory of diabetesPost-AMI patientsHigher ejection fractionAmerican Heart AssociationLarger hospital sizeCoronary revascularizationPrescribing patternsAMI patientsKidney dysfunctionPost-AMITobacco abuseSafety of full-dose intravenous recombinant tissue plasminogen activator followed by multimodal endovascular therapy for acute ischemic stroke
Nogueira R, Yoo A, Masrur S, Batista L, Hakimelahi R, Hirsch J, Schwamm L. Safety of full-dose intravenous recombinant tissue plasminogen activator followed by multimodal endovascular therapy for acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: 298. PMID: 22705875, DOI: 10.1136/neurintsurg-2012-010376.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCombined Modality TherapyEndovascular ProceduresFemaleHumansInjections, IntravenousMaleMiddle AgedProspective StudiesRecombinant ProteinsRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsMultimodal endovascular therapySymptomatic intracranial hemorrhageIntravenous recombinant tissue plasminogen activatorRecombinant tissue plasminogen activatorEndovascular therapyTissue plasminogen activatorParenchymal hematomaSafety endpointHospital dischargeFunctional outcomeFull-dose intravenous recombinant tissue plasminogen activatorPlasminogen activatorIndependent functional outcomeIntravenous rt-PAPrimary safety endpointRt-PA dosageSecondary safety endpointSevere systemic bleedingSimilar safety profileAcute ischemic strokeRate of recanalizationClinical efficacy endpointsT-PA doseBridging therapyGroin hematoma
2011
Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke
Lewis W, Fonarow G, Grau-Sepulveda M, Smith E, Bhatt D, Hernandez A, Olson D, Peterson E, Schwamm L. Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke. American Heart Journal 2011, 162: 692-699.e2. PMID: 21982662, DOI: 10.1016/j.ahj.2011.07.019.Peer-Reviewed Original ResearchConceptsTransient ischemic attackUse of anticoagulationAtrial fibrillationAnticoagulation therapyGWTG-StrokeEligible patientsStroke patientsIschemic stroke/transient ischemic attackJoint Commission Primary Stroke CentersStroke/transient ischemic attackEligible AF patientsGuidelines-Stroke programIschemic stroke patientsPrimary stroke centerHospital-level characteristicsAnticoagulation useGuidelines-StrokeIschemic attackThromboembolic eventsHospital dischargeIschemic strokeOlder patientsStroke centersAF patientsHispanic patientsOutcomes in Mild or Rapidly Improving Stroke Not Treated With Intravenous Recombinant Tissue-Type Plasminogen Activator
Smith E, Fonarow G, Reeves M, Cox M, Olson D, Hernandez A, Schwamm L. Outcomes in Mild or Rapidly Improving Stroke Not Treated With Intravenous Recombinant Tissue-Type Plasminogen Activator. Stroke 2011, 42: 3110-3115. PMID: 21903949, DOI: 10.1161/strokeaha.111.613208.Peer-Reviewed Original ResearchConceptsRecombinant tissue-type plasminogen activatorIntravenous recombinant tissue-type plasminogen activatorHealth Stroke Scale scoreStroke Scale scoreTissue-type plasminogen activatorHospital dischargePoor outcomeRisk factorsNationwide studyScale scorePoor short-term outcomePlasminogen activatorInitial National InstitutesHigher National InstitutesIschemic stroke patientsLipid-lowering medicationsVascular risk factorsMultivariable-adjusted analysesShort-term outcomesStroke-related disabilityLarge nationwide studyNational InstituteReperfusion therapyHome dischargeIndependent predictorsSecondary preventive medication persistence and adherence 1 year after stroke
Bushnell C, Olson D, Zhao X, Pan W, Zimmer L, Goldstein L, Alberts M, Fagan S, Fonarow G, Johnston S, Kidwell C, LaBresh K, Ovbiagele B, Schwamm L, Peterson E. Secondary preventive medication persistence and adherence 1 year after stroke. Neurology 2011, 77: 1182-1190. PMID: 21900638, PMCID: PMC3265047, DOI: 10.1212/wnl.0b013e31822f0423.Peer-Reviewed Original ResearchConceptsSecondary prevention medicationsPrevention medicationsSystem-level factorsMedication persistenceHospital dischargeIndependent predictorsIschemic stroke Longitudinal (AVAIL) registryGuidelines-Stroke programSecondary preventive medicationsUse of warfarinPrimary care providersAmerican Heart AssociationHealth care providers' instructionsLong-term useHospitalization dischargeModifiable patientDiabetes medicationsIschemic strokePreventive medicationsStroke patientsHeart AssociationCare providersMedicationsSide effectsPatients
2010
Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Smith E, Reeves M, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke. Stroke 2010, 42: 159-166. PMID: 21164109, DOI: 10.1161/strokeaha.110.601831.Peer-Reviewed Original ResearchConceptsIschemic strokeMedicare beneficiariesReadmission ratesPrimary stroke center designationGuidelines-Stroke hospitalsHospital-level outcomesStroke center designationAcute ischemic strokeCause readmission rateIschemic stroke mortalityHospital-level variationCause of deathRisk-adjusted outcomesHospital-level performanceRisk-adjusted ratesHospital dischargeRehospitalization ratesUnadjusted mortalityHospital admissionMean ageCenter designationStroke mortalityFavorable outcomeAcademic hospitalOutcome dataPersistence With Stroke Prevention Medications 3 Months After Hospitalization
Bushnell C, Zimmer L, Pan W, Olson D, Zhao X, Meteleva T, Schwamm L, Ovbiagele B, Williams L, LaBresh K, Peterson E. Persistence With Stroke Prevention Medications 3 Months After Hospitalization. JAMA Neurology 2010, 67: 1456-1463. PMID: 20697032, PMCID: PMC10197116, DOI: 10.1001/archneurol.2010.190.Peer-Reviewed Original ResearchConceptsSecondary prevention medicationsPrevention medicationsLong-term secondary stroke preventionGuidelines-Stroke programStroke prevention medicationsLipid-lowering therapyPatients 18 yearsSecondary stroke preventionTransient ischemic attackMonths of hospitalizationObservational cohort designAmerican Heart AssociationMedication-taking behaviorCombination of patientQuality of lifeSystem-level factorsAntihypertensive therapyIschemic attackAntiplatelet therapyDiabetes medicationsMedication classesStroke preventionAcute strokeHospital dischargeIschemic stroke
2009
The Adherence eValuation After Ischemic Stroke Longitudinal (AVAIL) Registry: Design, rationale, and baseline patient characteristics
Bushnell C, Zimmer L, Schwamm L, Goldstein L, Clapp-Channing N, Harding T, Drew L, Zhao X, Peterson E. The Adherence eValuation After Ischemic Stroke Longitudinal (AVAIL) Registry: Design, rationale, and baseline patient characteristics. American Heart Journal 2009, 157: 428-435.e2. PMID: 19249411, DOI: 10.1016/j.ahj.2008.11.002.Peer-Reviewed Original ResearchConceptsIschemic stroke Longitudinal (AVAIL) registryTransient ischemic attackIschemic attackRecurrent strokePrevention medicationsLongitudinal registryAdherence evaluationSecondary preventive therapyBaseline patient characteristicsModified Rankin scoreSecondary prevention measuresMedication-taking behaviorSystem-level barriersLevel of adherenceFuture strokeCardiovascular eventsRankin scoreVascular eventsAcute hospitalizationHospital dischargePatient characteristicsPreventive therapySecondary outcomesMedication usePrimary outcome
2008
Differential Use of Warfarin for Secondary Stroke Prevention in Patients With Various Types of Atrial Fibrillation
Lewis W, Fonarow G, LaBresh K, Cannon C, Pan W, Super D, Sorof S, Schwamm L. Differential Use of Warfarin for Secondary Stroke Prevention in Patients With Various Types of Atrial Fibrillation. The American Journal Of Cardiology 2008, 103: 227-231. PMID: 19121441, PMCID: PMC3086549, DOI: 10.1016/j.amjcard.2008.08.062.Peer-Reviewed Original ResearchConceptsECG-documented atrial fibrillationType of AFAtrial fibrillationQuality Improvement ProgramEligible patientsStroke preventionHistory of AFForm of AFSuch high-risk groupsSecondary stroke preventionTransient ischemic attackParoxysmal atrial fibrillationHigh-risk groupAnticoagulation guidelinesIschemic attackWarfarin useAnticoagulation therapyThromboembolic eventsElderly patientsHospital dischargeIschemic strokePresent admissionWarfarin therapyWarfarin treatmentMedical history