2023
Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry
Mullen M, Gurol M, Prabhakaran S, Messé S, Kleindorfer D, Smith E, Fonarow G, Xu H, Zhao X, Cigarroa J, Schwamm L. Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry. Journal Of The American Heart Association 2023, 12: e031303. PMID: 38108258, PMCID: PMC10863791, DOI: 10.1161/jaha.123.031303.Peer-Reviewed Original ResearchConceptsHospital-level variabilityDiagnostic evaluationIschemic strokeDiagnostic testingStroke pathogenesisCryptogenic strokeSecondary preventionEtiologic subtypesRisk factorsLarge nationwide registryIschemic stroke subtypesLong-term cardiac rhythm monitoringCardiac rhythm monitoringAdequate diagnostic evaluationIntracranial vascular imagingEvidence-based interventionsNationwide registryStroke subtypesIS subtypesDocumentation ratesRhythm monitoringPatientsCardiac monitoringSubtypesStroke
2022
Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke
Xian Y, Xu H, Matsouaka R, Laskowitz D, Maisch L, Hannah D, Smith E, Fonarow G, Bhatt D, Schwamm L, Mac Grory B, Feng W, Fosbøl E, Peterson E, Johnson M. Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke. JAMA Network Open 2022, 5: e2224157. PMID: 35900761, PMCID: PMC9335137, DOI: 10.1001/jamanetworkopen.2022.24157.Peer-Reviewed Original ResearchConceptsAHA/ASA guidelinesAcute ischemic strokeMinor ischemic strokeUse of DAPTDual antiplatelet therapyIschemic strokeMinor strokeHospital-level variationAntiplatelet therapyASA guidelinesDAPT useCohort studySecondary preventionOdds ratioAmerican Heart Association/American Stroke AssociationMinor acute ischemic strokeMulticenter retrospective cohort studyMultivariable logistic regression analysisSubstantial hospital-level variationAHA/ASAGuidelines-Stroke programIdentical clinical featuresRetrospective cohort studyAmerican Stroke AssociationEvidence-based guidelinesEvaluation of Evidence-Based Dual Antiplatelet Therapy for Secondary Prevention in US Patients With Acute Ischemic Stroke
Xian Y, Xu H, Smith E, Fonarow G, Bhatt D, Schwamm L, Peterson E. Evaluation of Evidence-Based Dual Antiplatelet Therapy for Secondary Prevention in US Patients With Acute Ischemic Stroke. JAMA Internal Medicine 2022, 182: 559-564. PMID: 35344009, PMCID: PMC8961397, DOI: 10.1001/jamainternmed.2022.0323.Peer-Reviewed Original Research
2019
Ischaemic stroke
Campbell B, De Silva D, Macleod M, Coutts S, Schwamm L, Davis S, Donnan G. Ischaemic stroke. Nature Reviews Disease Primers 2019, 5: 70. PMID: 31601801, DOI: 10.1038/s41572-019-0118-8.Peer-Reviewed Original ResearchConceptsIschemic strokeIntravenous thrombolysisEndovascular thrombectomyStroke onsetSevere symptomatic carotid artery stenosisSymptomatic carotid artery stenosisSalvageable brain tissueBlood pressure controlCardiovascular risk managementLarge vessel occlusionMajority of strokesMechanism of strokeOnset of strokeCarotid artery stenosisCause of disabilitySecond highest causeSystems of careAntithrombotic medicationRapid reperfusionReperfusion therapySecondary preventionStroke symptomsArterial occlusionArtery stenosisCarotid endarterectomyRecommendations 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
2018
International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program
Wangqin R, Laskowitz D, Wang Y, Li Z, Wang Y, Liu L, Liang L, Matsouaka R, Saver J, Fonarow G, Bhatt D, Smith E, Schwamm L, Bettger J, Hernandez A, Peterson E, Xian Y. International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program. Journal Of The American Heart Association 2018, 7: e010623. PMID: 30371291, PMCID: PMC6474951, DOI: 10.1161/jaha.118.010623.Peer-Reviewed Original ResearchConceptsChina National Stroke RegistryNational Stroke RegistryAcute ischemic strokeStroke RegistryIschemic strokeChinese patientsDeep venous thrombosis prophylaxisHealth Stroke ScaleVenous thrombosis prophylaxisAcute stroke careAdministration of thrombolyticsEvidence-based guidelinesAmerican Heart AssociationQuality of careBackground AdherenceDischarge antithromboticsThrombosis prophylaxisCessation counselingStroke ProgramStroke ScaleClinical characteristicsHospital arrivalNeedle timePatient characteristicsSecondary prevention
2016
Prior 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
2015
Telestroke
Rubin M, Demaerschalk B, Schwamm L, Wechsler L. Telestroke. 2015, 47-57. DOI: 10.1007/978-1-4939-2349-6_5.Peer-Reviewed Original ResearchSecondary preventionStroke careHealth Stroke Scale scoreMajor public health problemStroke Scale scoreAcute ischemic strokeAcute stroke carePrimary stroke centerAcute stroke evaluationPrevention of complicationsEducation of patientsPublic health problemPrehospital emergency medical systemEmergency medical systemExcellent interrater agreementStroke practiceStroke providersTelestroke modelIschemic strokeStroke centersStroke evaluationCerebrovascular diseaseEvidence-based practicePoststroke outcomesBedside assessment
2014
Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, Fang MC, Fisher M, Furie KL, Heck DV, Johnston SC, Kasner SE, Kittner SJ, Mitchell PH, Rich MW, Richardson D, Schwamm LH, Wilson JA. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke 2014, 45: 2160-2236. PMID: 24788967, DOI: 10.1161/str.0000000000000024.Peer-Reviewed Original ResearchConceptsTransient ischemic attackEvidence-based recommendationsIschemic attackCerebral venous sinus thrombosisTimely evidence-based recommendationsAntiphospholipid antibody syndromeVenous sinus thrombosisPrevention of strokeAortic arch atherosclerosisSickle cell diseaseImplementation of guidelinesAntibody syndromeFuture strokeRecurrent strokeAnticoagulation therapyAntiplatelet therapyAntithrombotic therapySinus thrombosisIschemic strokeNoncardioembolic strokeSecondary preventionArterial dissectionHypercoagulable statePatent foramenIntracranial hemorrhageSecondary Prevention after Ischemic Stroke or Transient Ischemic Attack
Bangalore S, Schwamm L, Smith E, Singh I, Liang L, Fonarow G, Bhatt D, Committee and Investigators G. Secondary Prevention after Ischemic Stroke or Transient Ischemic Attack. The American Journal Of Medicine 2014, 127: 728-738. PMID: 24681258, DOI: 10.1016/j.amjmed.2014.03.011.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackIschemic strokeSecondary prevention measuresEvidence-based therapiesSecondary preventionRecurrent strokeEvidence-based secondary preventionInitial transient ischemic attackGuidelines-Stroke registryIntensive statin therapyLipid-lowering medicationsLDL cholesterol measurementsWeight loss recommendationsPrevention measuresCessation counselingStatin therapyAtrial fibrillationHospital characteristicsHospital adherenceObservational studyStroke educationLower oddsPatientsCholesterol measurement
2013
Review of Stroke Center Effectiveness and Other Get with the Guidelines Data
Silva G, Schwamm L. Review of Stroke Center Effectiveness and Other Get with the Guidelines Data. Current Atherosclerosis Reports 2013, 15: 350. PMID: 23892766, DOI: 10.1007/s11883-013-0350-8.Peer-Reviewed Original ResearchConceptsStroke systemsAcute careAcute stroke-ready hospitalGuidelines-Stroke programSpectrum of strokeStroke-ready hospitalsComprehensive stroke centerBest evidence-based careEvidence-based careAmerican Heart AssociationEmergency medical servicesSecondary preventionStroke centersStroke carePrimary preventionHeart AssociationCoordinated careCare processesPatient accessCareCare comprisesStrokeMedical servicesPreventionGuideline data
2009
A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care
Schwamm L, Holloway R, Amarenco P, Audebert H, Bakas T, Chumbler N, Handschu R, Jauch E, Knight W, Levine S, Mayberg M, Meyer B, Meyers P, Skalabrin E, Wechsler L. A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care. Stroke 2009, 40: 2616-2634. PMID: 19423852, DOI: 10.1161/strokeaha.109.192360.Peer-Reviewed Original ResearchConceptsUse of telemedicineStroke systemsStroke treatmentAmerican Heart Association/American CollegeStroke care deliveryAcute stroke treatmentEvidence-based reviewEvidence-based recommendationsEmergency medical servicesSecondary preventionNeurological assessmentPrimary preventionEmergency departmentCardiology FoundationConsensus recommendationsAmerican CollegeClass of evidenceCare deliveryAvailable evidenceCare frameworkMedical servicesPreventionTelemedicineTreatmentLevel of certainty
2008
Organizing regional stroke systems of care
Park S, Schwamm L. Organizing regional stroke systems of care. Current Opinion In Neurology 2008, 21: 43-55. PMID: 18180651, DOI: 10.1097/wco.0b013e3282f4304d.Peer-Reviewed Original ResearchConceptsStroke treatmentStroke systemsHospital-based stroke careMajor public health problemRegional stroke systemAcute stroke treatmentBetter patient outcomesPublic health problemCare delivery modelsContinuous quality improvement activitiesAcute stroke expertiseAir medical transportEmergency medical servicesHealth policy changesQuality improvement activitiesStroke survivalSecondary preventionStroke unitStroke careThrombolytic therapyPrimary preventionStroke expertisePatient outcomesStroke educationHealth problems
1999
Diffusion-Weighted Imaging Identifies a Subset of Lacunar Infarction Associated With Embolic Source
Ay H, Oliveira-Filho J, Buonanno F, Ezzeddine M, Schaefer P, Rordorf G, Schwamm L, Gonzalez R, Koroshetz W. Diffusion-Weighted Imaging Identifies a Subset of Lacunar Infarction Associated With Embolic Source. Stroke 1999, 30: 2644-2650. PMID: 10582991, DOI: 10.1161/01.str.30.12.2644.Peer-Reviewed Original ResearchConceptsLacunar syndromeSmall infarctsIdentifiable causeClinical syndromeCareful pathological studyClassic lacunar syndromeDWI hyperintense lesionsSingle lacunar infarctionBrain stem lesionsDay of admissionDistinct clinical syndromeDiffusion-weighted imagingMultiple infarctionsEmbolic mechanismEmbolic sourceArtery territoryClinical characteristicsLacunar infarctionSecondary preventionConsecutive patientsAcute lesionsIndex lesionSuch infarctsEmergency roomPathological studies