2024
Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis
Kamogawa N, Miwa K, Toyoda K, Jensen M, Inoue M, Yoshimura S, Fukuda-Doi M, Kitazono T, Boutitie F, Ma H, Ringleb P, Wu O, Schwamm L, Warach S, Hacke W, Davis S, Donnan G, Gerloff C, Thomalla G, Koga M, Investigators O. Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis. Stroke 2024, 55: 895-904. PMID: 38456303, PMCID: PMC10978262, DOI: 10.1161/strokeaha.123.043358.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageIntracranial hemorrhageIntravenous thrombolysisFavorable outcomeUnwitnessed strokeNon-WUSFrequency of favorable outcomesIndividual patient-data meta-analysisMultivariate logistic regression analysisModified Rankin Scale scoreSafety of intravenous thrombolysisRankin Scale scoreEffect of intravenous thrombolysisIntravenous thrombolysis groupLogistic regression analysisUnknown-onset strokeRandomized controlled trialsNo significant differencePatient-level dataData meta-analysisStandard treatmentInsufficient statistical powerPatientsSafety outcomesControlled trialsOutcomes associated to the time to treatment with intravenous tenecteplase for acute ischaemic stroke: subgroup analysis of the TRACE-2 randomised controlled clinical trial.
Li S, Wangqin R, Pan Y, Jin A, Li H, Schwamm L, Fisher M, Campbell B, Parsons M, Wang Z, Dai H, Li D, Li R, Wang J, Wang D, Wang Y, Zhao X, Li Z, Zheng H, Xiong Y, Meng X, Wang Y. Outcomes associated to the time to treatment with intravenous tenecteplase for acute ischaemic stroke: subgroup analysis of the TRACE-2 randomised controlled clinical trial. Stroke And Vascular Neurology 2024, svn-2023-002694. PMID: 38296586, DOI: 10.1136/svn-2023-002694.Peer-Reviewed Original ResearchOnset to treatment timeAcute ischaemic strokeEfficacy outcomesSubgroup analysisPost hoc subgroup analysisModified Rankin Scale scoreIschaemic strokeExcellent functional outcomeAcute ischaemic stroke patientsBenefit of intravenous alteplasePooled risk differenceRankin Scale scoreSymptomatic intracranial haemorrhageControlled clinical trialsStroke onset to treatment timePost hoc analysisNon-inferiority trialOpen-labelTenecteplase groupIntravenous tenecteplaseNon-inferior to alteplaseProportion of participantsReperfusion therapyIntracranial haemorrhageIntravenous alteplase
2023
Effectiveness of a Quality Improvement Intervention on Reperfusion Treatment for Patients With Acute Ischemic Stroke
Wang C, Gu H, Zong L, Zhang X, Zhou Q, Jiang Y, Li H, Meng X, Yang X, Wang M, Huo X, Wangqin R, Bei Y, Qi X, Liu X, Hu S, Wang Z, Zhao X, Wang Y, Liu L, Ma X, Morgan L, Xian Y, Schwamm L, Wang Y, Li Z, Yang Q, Chen G, Ma Q, Li X, Chen J, Zhao X, Wang H, Niu X, Xu J, Zhao L, Wang Z, Huang D, Jin X, Chen S, Li J, Yu J, Liu P, Li G, Hao Y, Yang G, Huang X, Zhou C, Yang J, Gu J, Sun P, Guo Z, Ma G, Chen G, Tang M, Wang N, Chen L, Li J, Li A, Li S, Cao M, Guo J, Ren Y, Li T, Zhang L, Xie Z, Dong J, Kong X, Liang H, Zhang Y. Effectiveness of a Quality Improvement Intervention on Reperfusion Treatment for Patients With Acute Ischemic Stroke. JAMA Network Open 2023, 6: e2316465. PMID: 37266940, PMCID: PMC10238948, DOI: 10.1001/jamanetworkopen.2023.16465.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeQuality improvement interventionsTargeted quality improvement interventionsReperfusion therapy ratesProportion of patientsIschemic strokeEligible patientsStepped-wedge clusterSymptom onsetReperfusion therapyEndovascular thrombectomyImprovement interventionsTherapy ratesUsual careSecondary outcomesPrimary outcomeSecondary hospitalsClinical trialsIntravenous recombinant tissue plasminogen activatorModified Rankin Scale scoreRecombinant tissue plasminogen activatorRankin Scale scoreTissue plasminogen activatorEVT rateHospital mortalityRationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial
Xiong Y, Campbell B, Fisher M, Schwamm L, Parsons M, Li H, Pan Y, Meng X, Zhao X, Wang Y. Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial. Stroke And Vascular Neurology 2023, 9: 82-89. PMID: 37247876, PMCID: PMC10956103, DOI: 10.1136/svn-2023-002310.Peer-Reviewed Original ResearchLarge vessel occlusionAnterior circulation large vessel occlusionIschemic strokePerfusion-weighted imagingEfficacy outcomesReperfusion therapyMajor neurological improvementSecondary efficacy outcomesStandard medical therapyHealth Stroke ScalePrimary efficacy outcomeSymptomatic intracerebral hemorrhageRankin Scale scoreTissue-type plasminogen activatorDirect thrombectomyNeurological improvementStroke ScaleAnterior circulationMedical therapyMRS scoreIntracerebral hemorrhageSalvageable tissueVessel occlusionCT perfusionClinical trialsTenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial
Wang Y, Li S, Pan Y, Li H, Parsons M, Campbell B, Schwamm L, Fisher M, Che F, Dai H, Li D, Li R, Wang J, Wang Y, Zhao X, Li Z, Zheng H, Xiong Y, Meng X, Investigators T, Li R, Wang D, Wang Y, Chen S, Deng D, Zhang H, Wang J, Chen H, Zhang H, Wu Y, Liu H, Lu G, Zhao L, Zhu R, Liu Y, Yi F, Gao J, Dai H, Hao J, Che F, Cai X, Duan Z, Yu H, Wei T, Tang Y, Peng Z, Zhang B, Song Y, Chen X, Liu Y, Liu J, Li D, Zhao W, Wei X, Xue Q, Liu X, Yang Y, zhao C, Chen J, Sui Y, Sheng G, Zhang Y, Liu J, Zhang L, Wang W, Guo Z, Li H, Hu R, Chen G, Liang Z, Chen J, Xia L, Long Z. Tenecteplase versus alteplase in acute ischaemic cerebrovascular events (TRACE-2): a phase 3, multicentre, open-label, randomised controlled, non-inferiority trial. The Lancet 2023, 401: 645-654. PMID: 36774935, DOI: 10.1016/s0140-6736(22)02600-9.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeAlteplase groupTenecteplase groupNon-inferiority marginNon-inferiority trialIschemic strokeModified intentionTreat populationEndovascular thrombectomyIntracranial hemorrhageRisk ratioScale scoreAcute ischemic cerebrovascular eventsHealth Stroke Scale scoreMedical Sciences (CAMS) Innovation FundStandard intravenous thrombolysisIschemic cerebrovascular eventsPrimary efficacy outcomePrimary safety outcomeStroke Scale scoreRankin Scale scoreProportion of participantsIntravenous tenecteplaseIntravenous thrombolysis
2022
A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design
Albers G, Campbell B, Lansberg M, Broderick J, Butcher K, Froehler M, Schwamm L, Nouh A, Liebeskind D, Toy F, Yang M, Massaro L, Schoeffler M, Purdon B. A Phase III, prospective, double-blind, randomized, placebo-controlled trial of thrombolysis in imaging-eligible, late-window patients to assess the efficacy and safety of tenecteplase (TIMELESS): Rationale and design. International Journal Of Stroke 2022, 18: 237-241. PMID: 35262424, DOI: 10.1177/17474930221088400.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeInternal carotid arteryPlacebo-controlled trialRankin Scale scoreSymptom onsetDay 90Scale scoreMiddle cerebral artery occlusionEfficacy of tenecteplaseLate-window patientsSafety of tenecteplaseSymptomatic intracranial hemorrhageCerebral artery occlusionLarge vessel occlusionPhase IIIPrimary efficacy objectiveBetter clinical outcomesAdverse eventsArtery occlusionEndovascular thrombectomyIschemic strokeMCA occlusionClinical outcomesIntracranial hemorrhageSalvageable tissue
2019
DEFUSE 3 Non-DAWN Patients
Leslie-Mazwi T, Hamilton S, Mlynash M, Patel A, Schwamm L, Lansberg M, Marks M, Hirsch J, Albers G. DEFUSE 3 Non-DAWN Patients. Stroke 2019, 50: 618-625. PMID: 30727856, PMCID: PMC6768068, DOI: 10.1161/strokeaha.118.023310.Peer-Reviewed Original ResearchConceptsRankin Scale scoreNIHSS 6DEFUSE 3Functional outcomeInfarct volumeLarger patientsDAWN criteriaScale scoreEmergent large vessel occlusionRankin Scale score 0DEFUSE 3 patientsEffect of thrombectomyHealth Stroke ScaleLarge vessel occlusionBenefit of thrombectomyCore infarct volumeBeneficial treatment effectMethods Eligibility criteriaNIHSS scoreStroke ScaleConclusions PatientsEndovascular therapySymptom onsetDAWN trialVessel occlusion
2018
Shock Index Predicts Patient‐Related Clinical Outcomes in Stroke
Myint P, Sheng S, Xian Y, Matsouaka R, Reeves M, Saver J, Bhatt D, Fonarow G, Schwamm L, Smith E. Shock Index Predicts Patient‐Related Clinical Outcomes in Stroke. Journal Of The American Heart Association 2018, 7: e007581. PMID: 30371191, PMCID: PMC6222962, DOI: 10.1161/jaha.117.007581.Peer-Reviewed Original ResearchConceptsShock indexClinical outcomesWorse outcomesPatient-related clinical outcomesHealth Stroke ScaleBlood pressure componentsAcute stroke casesRankin Scale scoreSystolic blood pressureUseful prognostic indicatorMortality prediction modelIndividual stroke subtypesLinear spline modelsHospital mortalityHospital outcomesHospital stayStroke ScaleAcute strokeDischarge destinationBlood pressureStroke subtypesPoint of carePoor outcomePrognostic valueStroke cases
2016
Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke
von Kummer R, Mori E, Truelsen T, Jensen J, Grønning B, Fiebach J, Lovblad K, Pedraza S, Romero J, Chabriat H, Chang K, Dávalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Albers G. Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke. Stroke 2016, 47: 2880-2887. PMID: 27803391, DOI: 10.1161/strokeaha.116.013715.Peer-Reviewed Original ResearchConceptsPlacebo-treated patientsSymptomatic intracranial hemorrhageSerious adverse eventsAdverse eventsMRS scoreTreatment armsIntracranial hemorrhagePooled analysisDay 90Major artery occlusionIschemic stroke patientsRankin Scale scoreMajor cerebral arteriesHigh-grade stenosisSignificant clinical benefitExtended time windowIntravenous desmoteplaseArterial recanalizationArtery occlusionIntravenous treatmentIschemic strokePrimary outcomeCerebral arteryRecanalization rateStroke patientsPrior 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 outcomeRisks and Benefits Associated With Prestroke Antiplatelet Therapy Among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator
Xian Y, Federspiel J, Grau-Sepulveda M, Hernandez A, Schwamm L, Bhatt D, Smith E, Reeves M, Thomas L, Webb L, Bettger J, Laskowitz D, Fonarow G, Peterson E. Risks and Benefits Associated With Prestroke Antiplatelet Therapy Among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator. JAMA Neurology 2016, 73: 1-10. PMID: 26551916, DOI: 10.1001/jamaneurol.2015.3106.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorSymptomatic intracranial hemorrhageAcute ischemic strokePrestroke antiplatelet therapyTissue plasminogen activatorAntiplatelet therapyIschemic strokeGood functional outcomeHospital mortalityFunctional outcomeHigher oddsPlasminogen activatorDual antiplatelet treatmentGuidelines-Stroke registryRisk-adjusted likelihoodCardiovascular risk factorsRankin Scale scoreAmerican Heart AssociationAntiplatelet treatmentRegistry hospitalsRegistry patientsAmbulatory statusTPA administrationAdult patientsAntiplatelet agents
2015
Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Albers G, von Kummer R, Truelsen T, Jensen J, Ravn G, Grønning B, Chabriat H, Chang K, Davalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Investigators D. Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial. The Lancet Neurology 2015, 14: 575-584. PMID: 25937443, DOI: 10.1016/s1474-4422(15)00047-2.Peer-Reviewed Original ResearchConceptsMajor cerebral arteriesHigh-grade stenosisRankin Scale scoreIschemic strokeSymptom onsetCerebral arteryDay 90Scale scorePlacebo-controlled phase 3 trialComputer-generated randomisation listMajor cerebral artery occlusionModified Rankin Scale scoreSymptomatic cerebral edemaSymptomatic intracranial hemorrhageBaseline National InstitutesHealth Stroke ScaleSerious adverse eventsCerebral artery occlusionPhase 3 trialModified Rankin ScaleRandomisation listStroke ScaleStudy drugAdverse eventsArtery occlusion
2013
Impact of macroeconomic status on prehospital management, in-hospital care and functional outcome of acute stroke in China
Ji R, Wang D, Liu G, Shen H, Wang Y, Li H, Schwamm L, Wang Y. Impact of macroeconomic status on prehospital management, in-hospital care and functional outcome of acute stroke in China. Journal Of Clinical Practice 2013, 10: 701-712. DOI: 10.2217/cpr.13.68.Peer-Reviewed Original ResearchPrehospital managementFunctional outcomeChina National Stroke RegistryModified Rankin Scale scoreOpportunity-based scoreNational Stroke RegistryRankin Scale scoreGood functional outcomeGeneralized estimation equationsStroke RegistryIschemic strokeHospital careScale scoreHospital qualityStrokeComposite measureCareOutcomesScores
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
2008
Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study
Hacke W, Furlan A, Al-Rawi Y, Davalos A, Fiebach J, Gruber F, Kaste M, Lipka L, Pedraza S, Ringleb P, Rowley H, Schneider D, Schwamm L, Leal J, Söhngen M, Teal P, Wilhelm-Ogunbiyi K, Wintermark M, Warach S. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. The Lancet Neurology 2008, 8: 141-150. PMID: 19097942, PMCID: PMC2730486, DOI: 10.1016/s1474-4422(08)70267-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageDouble-Blind MethodFemaleFibrinolytic AgentsHumansInjections, IntravenousMagnetic Resonance ImagingMaleMiddle AgedPerfusionPlasminogen ActivatorsProspective StudiesSample SizeStrokeTomography, X-Ray ComputedTreatment FailureYoung AdultConceptsSymptomatic intracranial hemorrhageClinical response rateAcute ischemic strokeDiffusion-weighted imagingResponse rateNIHSS scoreIschemic strokeIntracranial hemorrhageLesion volumeDay 90Mortality ratePerfusion imagingScale scoreHealth Stroke Scale scoreMedian baseline NIHSS scoreModified Rankin Scale scoreMagnetic resonance perfusion imagingComposite of improvementBaseline NIHSS scorePlacebo-controlled studyStroke Scale scoreDose-ranging studyRankin Scale scoreSymptoms of strokeOnset of stroke
2001
Fever in subarachnoid hemorrhage
Oliveira–Filho J, Ezzeddine M, Segal A, Buonanno F, Chang Y, Ogilvy C, Rordorf G, Schwamm L, Koroshetz W, McDonald C. Fever in subarachnoid hemorrhage. Neurology 2001, 56: 1299-1304. PMID: 11376177, DOI: 10.1212/wnl.56.10.1299.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhagePoor outcomeTranscranial DopplerNeurologic intensive care unitOlder ageDaily transcranial DopplerGlasgow Coma ScoreHunt-Hess gradeRankin Scale scoreCause of feverIntensive care unitPresence of infectionNontraumatic subarachnoid hemorrhageSymptomatic vasospasmCerebral ischemiaComa ScoreConsecutive patientsAngiographic criteriaCare unitBrain injuryHemorrhage severityVasospasmPatientsFeverScale score