2020
Association 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
Relation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack
Bangalore S, Schwamm L, Smith E, Hellkamp A, Xian Y, Schulte P, Saver J, Fonarow G, Bhatt D, Committee and Investigators F. Relation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack. The American Journal Of Cardiology 2019, 123: 1083-1095. PMID: 30685057, DOI: 10.1016/j.amjcard.2018.12.037.Peer-Reviewed Original ResearchConceptsTransient ischemic attackSystolic blood pressureAdmission blood pressureDiastolic blood pressureMean arterial pressureBlood pressureIschemic attackPulse pressureHospital outcomesPostdischarge outcomesArterial pressureLower admission systolic blood pressureAdmission systolic blood pressureHigher admission blood pressureLower systolic blood pressureGuidelines-Stroke registryMajor cardiovascular eventsAdmission systolicPostdischarge mortalityCardiovascular eventsCardiovascular readmissionHospital deathInverse associationHigh riskPatients
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 casesSafety 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 onsetDiabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke
Echouffo-Tcheugui J, Xu H, Matsouaka R, Xian Y, Schwamm L, Smith E, Bhatt D, Hernandez A, Heidenreich P, Fonarow G. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. European Heart Journal 2018, 39: 2376-2386. PMID: 29438515, PMCID: PMC6031049, DOI: 10.1093/eurheartj/ehy036.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaDiabetes ComplicationsFemaleFollow-Up StudiesHumansMaleRegistriesStrokeTime FactorsUnited StatesConceptsComposite of mortalityNon-cardiovascular hospitalizationsTransient ischemic attackLong-term outcomesIschemic strokeHeart failureGuidelines-StrokeCause readmissionIS/transient ischemic attackHealth Stroke ScaleInfluence of diabetesRisk of deathOutcomes of interestPaucity of dataIschemic attackMore comorbiditiesTIA recurrenceCardiovascular readmissionCause mortalityHF readmissionStroke ScalePatient's diabetesAdverse outcomesInitial severityReadmission
2017
Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE-AF) randomized trial: Design and rationale
Bernstein R, Kamel H, Granger C, Kowal R, Ziegler P, Schwamm L. Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE-AF) randomized trial: Design and rationale. American Heart Journal 2017, 190: 19-24. PMID: 28760209, DOI: 10.1016/j.ahj.2017.04.007.Peer-Reviewed Original ResearchConceptsApparent atrial fibrillationInsertable cardiac monitorSmall vessel diseaseLarge vessel atherosclerosisStandard of careVessel diseaseIschemic strokeAtrial fibrillationPost-market clinical trialArrhythmia monitoringSecondary stroke preventionOral anticoagulation therapyContinuous arrhythmia monitoringAntithrombotic treatmentOral anticoagulationAnticoagulation therapyStroke preventionIntracranial atherosclerosisStroke etiologyClinical trialsIncidence rateCardiac monitorPatientsCardiac monitoringStroke
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 patients
2015
Treatment 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 hemorrhageClinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study
O'Brien E, Greiner M, Xian Y, Fonarow G, Olson D, Schwamm L, Bhatt D, Smith E, Maisch L, Hannah D, Lindholm B, Peterson E, Pencina M, Hernandez A. Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study. Circulation 2015, 132: 1404-1413. PMID: 26246175, DOI: 10.1161/circulationaha.115.016183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCardiovascular DiseasesDose-Response Relationship, DrugFemaleFollow-Up StudiesHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMedicaidMedical RecordsMedicarePatient DischargePatient Outcome AssessmentPatient ReadmissionRecurrenceRegistriesTreatment OutcomeUnited StatesConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsStatin therapyTime of admissionCardiovascular eventsIschemic strokePatient prefersCause mortalityHemorrhagic strokeOlder ischemic stroke patientsGuidelines-Stroke registryHigh-intensity doseIschemic stroke patientsModerate-intensity statinsPatient-centered outcomesReal-world effectivenessYears of ageOutcomes Research InstituteEffectiveness researchCoprimary outcomesCardiovascular readmissionCause readmissionSecondary outcomesStroke patientsClinical effectivenessReal world effectiveness of warfarin among ischemic stroke patients with atrial fibrillation: observational analysis from Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) study
Xian Y, Wu J, O'Brien E, Fonarow G, Olson D, Schwamm L, Bhatt D, Smith E, Suter R, Hannah D, Lindholm B, Maisch L, Greiner M, Lytle B, Pencina M, Peterson E, Hernandez A. Real world effectiveness of warfarin among ischemic stroke patients with atrial fibrillation: observational analysis from Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) study. The BMJ 2015, 351: h3786. PMID: 26232340, PMCID: PMC4521370, DOI: 10.1136/bmj.h3786.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsIschemic stroke patientsCoronary artery diseaseIschemic strokeWarfarin treatmentAtrial fibrillationArtery diseaseStroke patientsRisk of MACEImproved long-term clinical outcomesPrevious coronary artery diseaseLong-term clinical outcomesMore daysAdverse cardiovascular eventsHealth Stroke ScaleRecurrent ischemic strokeTerm clinical outcomesAtrial fibrillation patientsSurvivors of strokeLongitudinal outcomesReal-world effectivenessPatient prefersCardiovascular eventsOral anticoagulantsStroke Program
2014
Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke
Ovbiagele B, Smith E, Schwamm L, Grau-Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2014, 7: 929-935. PMID: 25249561, DOI: 10.1161/circoutcomes.114.001144.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedBrain IschemiaFemaleFibrinolytic AgentsFollow-Up StudiesGlomerular Filtration RateHemorrhageHospital MortalityHumansIncidenceInjections, IntravenousMaleOdds RatioRegistriesRenal Insufficiency, ChronicRetrospective StudiesThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorUnited StatesConceptsChronic kidney diseaseSerious systemic hemorrhageSymptomatic intracranial hemorrhagePresence of CKDIntravenous tissue-type plasminogen activatorIntracranial hemorrhageSystemic hemorrhageTissue-type plasminogen activatorKidney diseaseFunctional statusTissue-type plasminogen activator administrationPlasminogen activatorAdmission serum creatinineGuidelines-Stroke programIndependent functional statusIntravenous thrombolytic therapyPrimary end pointAcute ischemic strokeIschemic stroke patientsGlomerular filtration rateNormal kidney functionDischarge functional statusHigher unadjusted oddsTissue-type plasminogenHospital mortalityImpact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis
Morris S, Hunter R, Ramsay A, Boaden R, McKevitt C, Perry C, Pursani N, Rudd A, Schwamm L, Turner S, Tyrrell P, Wolfe C, Fulop N. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. The BMJ 2014, 349: g4757. PMID: 25098169, PMCID: PMC4122734, DOI: 10.1136/bmj.g4757.Peer-Reviewed Original ResearchMeSH KeywordsAgedEnglandFemaleFollow-Up StudiesHumansLength of StayLogistic ModelsMaleRisk AdjustmentStrokeUrban Health ServicesConceptsAcute stroke servicesAcute stroke careHospital stayHyperacute careStroke servicesStroke careHospital Episode Statistics databaseSymptoms of strokePatient-level dataSignificant declineIschemic strokeHospital admissionStayPatientsAbsolute reductionMortalityStrokeMortality dataCareStatistics databaseMonth periodGreater ManchesterAdmissionDaysRisk
2011
Secondary 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 effectsPatientsPrediction of Early Stroke Risk in Transient Symptoms With Infarction
Arsava E, Furie K, Schwamm L, Sorensen A, Ay H. Prediction of Early Stroke Risk in Transient Symptoms With Infarction. Stroke 2011, 42: 2186-2190. PMID: 21680907, PMCID: PMC3144273, DOI: 10.1161/strokeaha.110.604280.Peer-Reviewed Original ResearchConceptsTransient ischemic attackReceiver-operating characteristic curveIschemic attackStroke riskTransient symptomsDiffusion-weighted imagesStroke prevention strategiesHigh-risk patientsRisk of strokeEarly stroke riskCharacteristic curveNew infarctionRecurrent strokeClinical deteriorationConsecutive patientsIschemic strokeSymptom onsetIndex lesionRetrospective seriesPrevention strategiesPatientsEarly interventionInfarctionStrokeSubsequent stroke
2010
Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke
Fonarow G, Reeves M, Smith E, Saver J, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L. Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke. Circulation Cardiovascular Quality And Outcomes 2010, 3: 291-302. PMID: 20177051, DOI: 10.1161/circoutcomes.109.921858.Peer-Reviewed Original ResearchConceptsHospital mortality rateIntracerebral hemorrhageQuality of careIschemic strokeSubarachnoid hemorrhageMortality rateTransient ischemic attack admissionsTransient ischemic attack patientsIn-Hospital OutcomesAcute ischemic strokeIschemic stroke patientsAdjusted odds ratioLength of stayQuality improvement effortsGuidelines-StrokeGWTG-StrokeTIA admissionsTIA careTIA patientsHospital outcomesAcute strokeStroke patientsMean ageAttack patientsNational surveillance
2009
Remote Supervision of IV-tPA for Acute Ischemic Stroke by Telemedicine or Telephone Before Transfer to a Regional Stroke Center Is Feasible and Safe
Pervez M, Silva G, Masrur S, Betensky R, Furie K, Hidalgo R, Lima F, Rosenthal E, Rost N, Viswanathan A, Schwamm L. Remote Supervision of IV-tPA for Acute Ischemic Stroke by Telemedicine or Telephone Before Transfer to a Regional Stroke Center Is Feasible and Safe. Stroke 2009, 41: e18-e24. PMID: 19910552, PMCID: PMC3383769, DOI: 10.1161/strokeaha.109.560169.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain IschemiaFeasibility StudiesFemaleFollow-Up StudiesHospitalizationHumansInfusions, IntravenousMaleMiddle AgedPatient TransferProspective StudiesRemote ConsultationRetrospective StudiesStrokeTelemedicineTelephoneTime FactorsTissue Plasminogen ActivatorYoung AdultConceptsTissue plasminogen activatorOSH patientsCatheter-based reperfusionGuidelines-Stroke databaseAcute ischemic strokeOutcomes of patientsRegional stroke centerDischarge functional statusRSC patientsTelestroke patientsIntravenous thrombolysisIschemic strokeIV-tPARankin scoreSevere strokeStroke centersSymptom onsetTPA infusionRetrospective reviewStroke databaseStroke specialistsFunctional outcomeFunctional statusTelephone consultationsSystemic hemorrhageFeasibility of NIRS in the Neurointensive Care Unit: A Pilot Study in Stroke Using Physiological Oscillations
Muehlschlegel S, Selb J, Patel M, Diamond S, Franceschini M, Sorensen A, Boas D, Schwamm L. Feasibility of NIRS in the Neurointensive Care Unit: A Pilot Study in Stroke Using Physiological Oscillations. Neurocritical Care 2009, 11: 288. PMID: 19649749, PMCID: PMC2782535, DOI: 10.1007/s12028-009-9254-4.Peer-Reviewed Original ResearchConceptsCare unitStroke patientsPhysiological oscillationsHemoglobin concentrationMicrovascular hemodynamicsPilot studyIschemic brain injuryNeurointensive care unitNeurocritical care unitPre-hospital settingRespiratory oscillationsWarrants further validationAbsolute hemoglobin concentrationResultsNine patientsCerebral perfusionHemispheric strokeBrain injuryHealthy controlsFuture clinical applicationsPatientsOwn controlClinical feasibilityBedside modalityContinuous-wave NIRSClinical application
2006
Risk factors for stroke after acute coronary syndromes in the Orbofiban in Patients with Unstable Coronary Syndromes–Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 study
Smith E, Cannon C, Murphy S, Feske S, Schwamm L. Risk factors for stroke after acute coronary syndromes in the Orbofiban in Patients with Unstable Coronary Syndromes–Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 study. American Heart Journal 2006, 151: 338-344. PMID: 16442896, DOI: 10.1016/j.ahj.2005.03.031.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute coronary syndromeHistory of hypertensionPrior ischemic strokeIschemic strokeCerebrovascular eventsIntracranial hemorrhageRisk factorsCoronary syndromeHistory of TIAUnstable Coronary Syndromes-ThrombolysisHemorrhagic cerebrovascular eventsPlacebo-controlled trialCoronary artery diseaseLong-term patientsSignificant excess riskIschemic attackStroke outcomeArtery diseaseCoronary angiographyOverall incidenceCerebrovascular diseaseExcess riskHeart ratePatients
2004
Characterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis.
Schaefer P, Hassankhani A, Putman C, Sorensen A, Schwamm L, Koroshetz W, Gonzalez R. Characterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis. American Journal Of Neuroradiology 2004, 25: 951-7. PMID: 15205129, PMCID: PMC7975652.Peer-Reviewed Original ResearchConceptsIntra-arterial thrombolysisDiffusion-weighted imagingDWI findingsDWI ratioADC ratioReperfusion therapyAcute strokeApparent diffusion coefficientInitial diffusion-weighted imagingPretreatment diffusion-weighted imagingADC valuesRespective mean changesEventual infarctionAcute occlusionAnterior circulationStroke patientsLesion volumeMean changePatientsThrombolysisLesion growthMR imagingTissue viabilityLesionsInfarction
2003
Whole-Brain CT Perfusion Measurement of Perfused Cerebral Blood Volume in Acute Ischemic Stroke: Probability Curve for Regional Infarction
Hunter G, Silvennoinen H, Hamberg L, Koroshetz W, Buonanno F, Schwamm L, Rordorf G, Gonzalez R. Whole-Brain CT Perfusion Measurement of Perfused Cerebral Blood Volume in Acute Ischemic Stroke: Probability Curve for Regional Infarction. Radiology 2003, 227: 725-30. PMID: 12728181, DOI: 10.1148/radiol.2273012169.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCerebral blood volumeIschemic strokeBlood volumeMajor arterial occlusionLikelihood of infarctionLogistic regression analysisPositive predictive valueCT perfusion measurementsAcute strokeCerebral infarctionArterial occlusionIntracranial hemorrhagePerfusion scanCore infarctionPCBVInfarctionPositive followProbability of survivalRegional infarctionPredictive valuePatientsStrokePerfusion measurementsRegression analysis