2024
Association of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study
Leppert M, Poisson S, Scarbro S, Suresh K, Lisabeth L, Putaala J, Schwamm L, Daugherty S, Bradley C, Burke J, Ho P. Association of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study. Circulation Cardiovascular Quality And Outcomes 2024, 17: e010307. PMID: 38529631, PMCID: PMC11021148, DOI: 10.1161/circoutcomes.123.010307.Peer-Reviewed Original ResearchConceptsTraditional risk factorsDevelopment of strokeNontraditional risk factorsCase-control studyRisk factorsRetrospective case-control studyAge groupsContribution of traditional risk factorsYoung adultsConditional logistic regression modelsPopulation attributable riskCount of risk factorsStroke-free controlsAll Payer Claims DatabaseAssociation of strokeColorado All Payer Claims DatabaseLogistic regression modelsPayer Claims DatabaseIncreased risk of strokeAttributable riskRisk of strokeStroke eventsYears of ageInsurance typeIncreased risk
2022
Systematic Review of Sex Differences in Ischemic Strokes Among Young Adults: Are Young Women Disproportionately at Risk?
Leppert M, Burke J, Lisabeth L, Madsen T, Kleindorfer D, Sillau S, Schwamm L, Daugherty S, Bradley C, Ho P, Poisson S. Systematic Review of Sex Differences in Ischemic Strokes Among Young Adults: Are Young Women Disproportionately at Risk? Stroke 2022, 53: 319-327. PMID: 35073188, PMCID: PMC8852306, DOI: 10.1161/strokeaha.121.037117.Peer-Reviewed Original ResearchConceptsIschemic strokeIncidence rate ratiosYoung adultsStroke incidenceSex-specific incidence rate ratiosSystematic reviewAge groupsSex differencesYoung womenMore womenRate ratioAdults 35Incidence rateStroke typeHigh riskAge adjustmentStrokeSignificant sex differencesRelevant articlesMore menWomenNonsignificant sex differencesAdultsRecent evidenceMen
2019
Hospital distance, socioeconomic status, and timely treatment of ischemic stroke.
Ader J, Wu J, Fonarow GC, Smith EE, Shah S, Xian Y, Bhatt DL, Schwamm LH, Reeves MJ, Matsouaka RA, Sheth KN. Hospital distance, socioeconomic status, and timely treatment of ischemic stroke. Neurology 2019, 93: e747-e757. PMID: 31320472, PMCID: PMC6711658, DOI: 10.1212/wnl.0000000000007963.Peer-Reviewed Original ResearchConceptsTPA administrationHome zip codeSocioeconomic statusHospital mortalityTime quartilesLower oddsHierarchical multivariable logistic regression modelsTissue plasminogen activator administrationPatient's home zip codeMultivariable logistic regression modelZip code median household incomeGuidelines-Stroke registryPatients' socioeconomic statusRetrospective observational studyLow socioeconomic statusEmergency medical servicesLogistic regression modelsLowest SES quintileHigher socioeconomic statusShorter OTTIschemic strokeSecondary outcomesPatient agePrimary outcomeObservational studyThrombolysis 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 treatmentTreatmentAdultsAgeOutcomesPatient and clinician experiences with telehealth for patient follow-up care.
Donelan K, Barreto E, Sossong S, Michael C, Estrada J, Cohen A, Wozniak J, Schwamm L. Patient and clinician experiences with telehealth for patient follow-up care. The American Journal Of Managed Care 2019, 25: 40-44. PMID: 30667610.Peer-Reviewed Original Research
2018
Intravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results
Schwamm L, Wu O, Song S, Latour L, Ford A, Hsia A, Muzikansky A, Betensky R, Yoo A, Lev M, Boulouis G, Lauer A, Cougo P, Copen W, Harris G, Warach S, Investigators O. Intravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results. Annals Of Neurology 2018, 83: 980-993. PMID: 29689135, PMCID: PMC6095471, DOI: 10.1002/ana.25235.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingSymptomatic intracranial hemorrhageLarge vessel occlusionIntravenous thrombolysisSymptom discoveryVessel occlusionAcute ischemic stroke patientsFluid-attenuated inversion recovery magnetic resonance imagingInversion recovery magnetic resonance imagingDiffusion-weighted magnetic resonance imagingIschemic stroke patientsStroke durationAnn NeurolSymptomatic edemaUnwitnessed onsetUnwitnessed strokeIntravenous alteplaseRankin ScaleSecondary outcomesStroke onsetSymptom onsetPrimary outcomeIntracranial hemorrhageProspective studyStroke patientsSafety and Efficacy of a 3-Dimensional Stent Retriever With Aspiration-Based Thrombectomy vs Aspiration-Based Thrombectomy Alone in Acute Ischemic Stroke Intervention: A Randomized Clinical Trial
Nogueira R, Frei D, Kirmani J, Zaidat O, Lopes D, Turk A, Heck D, Mason B, Haussen D, Levy E, Mehta S, Lazzaro M, Chen M, Dörfler A, Yoo A, Derdeyn C, Schwamm L, Langer D, Siddiqui A. Safety and Efficacy of a 3-Dimensional Stent Retriever With Aspiration-Based Thrombectomy vs Aspiration-Based Thrombectomy Alone in Acute Ischemic Stroke Intervention: A Randomized Clinical Trial. JAMA Neurology 2018, 75: 304-311. PMID: 29296999, PMCID: PMC5885851, DOI: 10.1001/jamaneurol.2017.3967.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeSerious adverse eventsProcedure-related serious adverse eventsStent retrieverMechanical thrombectomy devicesAspiration groupAdverse eventsEnd pointClinical trialsThrombectomy devicesLarge vessel acute ischemic strokeDevice-related serious adverse eventsScale scoreHealth Stroke Scale scoreMedian baseline NIHSS scorePrimary effectiveness end pointPrimary safety end pointAcute ischemic stroke interventionCerebral infarction (TICI) gradeEffectiveness end pointBaseline NIHSS scorePrimary end pointSafety end pointStroke Scale scoreHours of onset
2017
Multiparametric Magnetic Resonance Imaging for Prediction of Parenchymal Hemorrhage in Acute Ischemic Stroke After Reperfusion Therapy
Nael K, Knitter J, Jahan R, Gornbein J, Ajani Z, Feng L, Meyer B, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Liebeskind D, Guzy J, Starkman S, Saver J, Kidwell C. Multiparametric Magnetic Resonance Imaging for Prediction of Parenchymal Hemorrhage in Acute Ischemic Stroke After Reperfusion Therapy. Stroke 2017, 48: 664-670. PMID: 28138001, PMCID: PMC5325250, DOI: 10.1161/strokeaha.116.014343.Peer-Reviewed Original ResearchConceptsCerebral blood volumeAcute ischemic strokeParenchymal hemorrhageReperfusion therapyIschemic strokeReceiver-operating characteristic curve analysisApparent diffusion coefficientMultiparametric magnetic resonance imagingPretreatment magnetic resonanceMagnetic resonance perfusionValues of CBVCharacteristic curve analysisApparent diffusion coefficient (ADC) valuesMagnetic resonance imagingIndependent predictorsIschemic coreRisk stratificationUnivariate analysisClinical trialsMicrovascular permeabilityBlood volumeInfarction corePatientsResonance imagingDiagnostic accuracy
2016
Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age
Arora R, Salamon E, Katz J, Cox M, Saver J, Bhatt D, Fonarow G, Peterson E, Smith E, Schwamm L, Xian Y, Libman R. Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age. Stroke 2016, 47: 2347-2354. PMID: 27491734, DOI: 10.1161/strokeaha.116.012241.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdolescentAdultAge FactorsAgedAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesMaleMiddle AgedPractice Patterns, Physicians'PrognosisRegistriesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorAcute ischemic strokeSymptomatic hemorrhageTPA useIschemic strokeYounger patientsFunctional outcomeQuality improvement registryGood functional outcomeYears of ageYounger age groupsIntravenous thrombolysisHospital mortalityFibrinolytic therapyAcute rehabilitationIndependent ambulationDischarge outcomesMultivariable analysisHospice dischargePatientsAge groupsHemorrhagePlasminogen activatorMortality
2015
Treatment patterns and short-term outcomes in ischemic stroke in pregnancy or postpartum period
Leffert LR, Clancy CR, Bateman BT, Cox M, Schulte PJ, Smith EE, Fonarow GC, Kuklina EV, George MG, Schwamm LH. Treatment patterns and short-term outcomes in ischemic stroke in pregnancy or postpartum period. American Journal Of Obstetrics And Gynecology 2015, 214: 723.e1-723.e11. PMID: 26709084, DOI: 10.1016/j.ajog.2015.12.016.Peer-Reviewed Original ResearchConceptsAcute stroke reperfusion therapyStroke reperfusion therapyShort-term outcomesTissue plasminogen activatorGuidelines-Stroke registryPregnancy-related strokeReperfusion therapyIschemic stroke patientsIschemic strokeNonpregnant womenPostpartum womenStroke patientsPlasminogen activatorPostpartum periodIntravenous tissue plasminogen activator useIntravenous tissue plasminogen activatorFavorable short-term outcomesTissue plasminogen activator useAcute reperfusion therapyCatheter-based thrombolysisGreater stroke severityMajor systemic bleedingNonpregnant women 18Symptomatic intracranial hemorrhageHistory of hypertensionIncreased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1
Terry A, Jordan J, Schwamm L, Plotkin S. Increased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1. Stroke 2015, 47: 60-65. PMID: 26645253, DOI: 10.1161/strokeaha.115.011406.Peer-Reviewed Original ResearchConceptsNeurofibromatosis type 1Ischemic strokeIntracerebral hemorrhageGeneral populationCases of NF1US Nationwide Inpatient SampleType 1Hemorrhagic stroke typesNew neurological symptomsStroke risk factorsRisk of strokeOdds of strokeTime of strokeNationwide Inpatient SampleMultivariable logistic regressionCase-control studyType of strokeYounger mean ageAdult patientsPediatric patientsHemorrhagic strokeNeurological symptomsCerebrovascular diseaseMean ageInpatient SampleTreatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study
Yaghi S, Boehme A, Dibu J, Guerrero C, Ali S, Martin-Schild S, Sands K, Noorian A, Blum C, Chaudhary S, Schwamm L, Liebeskind D, Marshall R, Willey J. Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study. JAMA Neurology 2015, 72: 1-7. PMID: 26501741, PMCID: PMC4845894, DOI: 10.1001/jamaneurol.2015.2371.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageRecombinant tissue plasminogen activatorMulticenter retrospective studyHematoma expansionHospital mortalityMedian timeRetrospective studyIntravenous recombinant tissue plasminogen activatorHealth Stroke Scale scoreParenchymal hematoma type 2Code status changeOutcome of thrombolysisStroke-Monitoring StudyComprehensive stroke centerHospital mortality rateOutcomes of patientsStroke Scale scoreTissue plasminogen activatorIschemic strokePrimary outcomeRtPA therapySecondary outcomesStroke centersSymptom onsetIntracerebral hemorrhagePatient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy
Leffert LR, Clancy CR, Bateman BT, Cox M, Schulte PJ, Smith EE, Fonarow GC, Schwamm LH, Kuklina EV, George MG. Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy. Circulation Cardiovascular Quality And Outcomes 2015, 8: s170-s178. PMID: 26515206, DOI: 10.1161/circoutcomes.115.002242.Peer-Reviewed Original ResearchConceptsStroke risk factorsSubarachnoid hemorrhage patientsHemorrhagic strokeRisk factorsHS patientsHospital mortalityHemorrhage patientsDiseases-Ninth Revision codesBlood pressure criteriaGuidelines-Stroke registryPregnancy-related strokeAssociation of pregnancyNonpregnant female patientsConditional logistic regressionFisher's exact testWilcoxon rank sum testRank sum testGuidelines-StrokeSevere preeclampsiaHome dischargeIschemic strokeNonpregnant womenPatient characteristicsRisk patientsIndependent ambulation
2014
Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Holloway R, Smith E, Schwamm L, Reeves M, Bhatt D, Schulte P, Cox M, Olson D, Hernandez A, Lytle B, Anstrom K, Fonarow G, Peterson E. Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage. Stroke 2014, 45: 3243-3250. PMID: 25213344, DOI: 10.1161/strokeaha.114.005620.Peer-Reviewed Original ResearchConceptsWhite patientsAsian patientsRace/ethnicityCessation counselingLower oddsDeep venous thrombosis prophylaxisGuidelines-Stroke hospitalsStroke performance measuresVenous thrombosis prophylaxisHospital-level characteristicsMultivariable logistic regressionProcess of careEthnic differencesHospital mortalityThrombosis prophylaxisCause mortalityHospital outcomesSevere strokeDysphagia screeningBlack patientsIntracerebral hemorrhageMedian lengthHigher oddsStroke educationComfort measuresOutcomes of intravenous tissue plasminogen activator for acute ischaemic stroke in HIV‐infected adults
Sweeney E, Thakur K, Lyons J, Smith B, Willey J, Cervantes‐Arslanian A, Hickey M, Uchino K, Haussen D, Koch S, Schwamm L, Elkind M, Shinohara R, Mateen F. Outcomes of intravenous tissue plasminogen activator for acute ischaemic stroke in HIV‐infected adults. European Journal Of Neurology 2014, 21: 1394-1399. PMID: 25040336, DOI: 10.1111/ene.12506.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNationwide Inpatient SampleIntravenous tissue plasminogen activatorIV-tPA useIV-tPATissue plasminogen activatorUninfected patientsIschemic strokeAIS patientsUS Nationwide Inpatient SampleSex-adjusted odds ratiosPlasminogen activatorShort-term outcomesRisk of deathIV-tPA administrationProportion of deathsHospital mortalityHospital deathHIV serostatusIntracerebral hemorrhageInpatient SampleOdds ratioHIVAIS casesPatientsPatterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease
Ovbiagele B, Schwamm L, Smith E, Grau‐Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Patterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease. Journal Of The American Heart Association 2014, 3: e000905. PMID: 24904017, PMCID: PMC4309090, DOI: 10.1161/jaha.114.000905.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseIschemic stroke patientsSevere renal dysfunctionGlomerular filtration rateStroke patientsRenal dysfunctionQuality of careKidney diseaseHospitalized ischemic stroke patientsGuideline-based therapyGuideline-recommended therapiesGuidelines-Stroke programGWTG-Stroke programStroke performance measuresHospital mortality rateNormal kidney functionHospital mortalityHospital prognosisInpatient mortalityIschemic strokeCare complianceKidney functionModerate dysfunctionKidney failureFiltration rate
2013
Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients
Qian J, Payabvash S, Kemmling A, Lev MH, Schwamm LH, Betensky RA. Variable Selection and Prediction Using a Nested, Matched Case-Control Study: Application to Hospital Acquired Pneumonia in Stroke Patients. Biometrics 2013, 70: 153-163. PMID: 24320930, PMCID: PMC3954429, DOI: 10.1111/biom.12113.Peer-Reviewed Original ResearchConceptsMassachusetts General HospitalCase-control studyStroke patientsAcute ischemic stroke patientsBrain regionsMatched Case-Control StudyHospital-Acquired PneumoniaIschemic stroke patientsLarge prospective studiesUnconditional logistic regressionCase-control designSpecific brain regionsAcquired PneumoniaAcute infarctionClinical featuresProspective studyClinical variablesGeneral HospitalEpidemiologic studiesPatientsModern imagingLarger studyLogistic regressionAppropriate statistical analysisHAP studiesFactors Influencing the Decline in Stroke Mortality
Lackland DT, Roccella EJ, Deutsch AF, Fornage M, George MG, Howard G, Kissela BM, Kittner SJ, Lichtman JH, Lisabeth LD, Schwamm LH, Smith EE, Towfighi A. Factors Influencing the Decline in Stroke Mortality. Stroke 2013, 45: 315-353. PMID: 24309587, PMCID: PMC5995123, DOI: 10.1161/01.str.0000437068.30550.cf.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAgedAged, 80 and overAir PollutionAmerican Heart AssociationAspirinAssociationAtrial FibrillationBlood PressureClinical Trials as TopicDiabetes MellitusExerciseFemaleHeart DiseasesHumansHyperlipidemiasHypertensionIncidenceInternational Classification of DiseasesMaleMiddle AgedObesityObservational Studies as TopicPlatelet Aggregation InhibitorsPopulationPrevalenceSecondary PreventionSex FactorsSmokingStrokeThrombolytic TherapyUnited StatesYoung AdultConceptsStroke mortalityCause of deathStroke riskAmerican Heart Association Stroke Council's Scientific Statement Oversight CommitteeAmerican Heart Association's Manuscript Oversight CommitteeAmerican Heart Association Science AdvisoryScientific Statements Oversight Committee reviewStroke Council Leadership reviewLower case fatality rateEvidence-based public health programsMajor public health burdenControl of hypertensionChronic lung diseaseFourth leading causeCase fatality rateTreatment of hypertensionPublic health burdenWriting group membersAttributable risk estimatesPublic health guidelinesYears of ageMajor public healthPublic health programsCombination of interventionsDyslipidemia controlComparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status
Hanchate A, Schwamm L, Huang W, Hylek E. Comparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status. Stroke 2013, 44: 469-476. PMID: 23306327, PMCID: PMC3595403, DOI: 10.1161/strokeaha.112.669341.Peer-Reviewed Original ResearchConceptsRace/ethnicityAcute ischemic strokeInpatient mortalityRisk-adjusted ratesIschemic strokeSocioeconomic statusBlack patientsArea patientsNonfederal acute care hospitalsRisk-adjusted inpatient mortalityIschemic stroke outcomeInpatient mortality rateIschemic stroke admissionsCrude inpatient mortality rateLength of stayPatient's zip codeAcute care hospitalsLonger lengthStroke admissionsStroke outcomeStroke severityCare hospitalDischarge outcomesWhite patientsMechanical ventilationIschemic 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