2021
#MaternalStroke Trending Now
Miller EC, Leffert L. #MaternalStroke Trending Now. Neurology 2021, 96: 973-974. PMID: 33827955, DOI: 10.1212/wnl.0000000000011995.Peer-Reviewed Original Research
2020
Stroke in Pregnancy: A Focused Update.
Miller EC, Leffert L. Stroke in Pregnancy: A Focused Update. Anesthesia & Analgesia 2020, 130: 1085-1096. PMID: 31124843, PMCID: PMC7035913, DOI: 10.1213/ane.0000000000004203.Peer-Reviewed Original ResearchConceptsHemorrhagic strokeCesarean deliveryPregnant womenIschemic strokeGeneral anesthesiaObstetric anesthesiologistHigh-risk obstetriciansLarge stroke trialsPregnancy-related strokeHigh-risk groupRisk of herniationMaternal strokeObstetric indicationsTherapeutic anticoagulationExtremity weaknessStroke neurologistsAcute strokeDevastating complicationNeuraxial analgesiaNonpregnant womenStroke subtypesIntracranial hypertensionRecent strokeVaginal deliveryStroke trials
2018
Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy
Ladhani NNN, Swartz RH, Foley N, Nerenberg K, Smith EE, Gubitz G, Dowlatshahi D, Potts J, Ray JG, Barrett J, Bushnell C, Bal S, Chan WS, Chari R, Amrani M, Gandhi S, Hill MD, James A, Jeerakathil T, Jin A, Kirton A, Lanthier S, Lausman A, Leffert LR, Mandzia J, Menon B, Pikula A, Poppe A, Saposnik G, Sharma M, Bhogal S, Smitko E, Lindsay MP. Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy. International Journal Of Stroke 2018, 13: 743-758. PMID: 30021491, DOI: 10.1177/1747493018786617.Peer-Reviewed Original ResearchConceptsAcute stroke managementStroke managementConsensus statementPost-stroke managementSecondary stroke preventionAcute stroke treatmentGroup of patientsInitial emergency managementBest available literatureStroke preventionAcute strokePostpartum managementAnesthetic managementHemorrhagic strokeStroke treatmentObstetric carePregnant womenMaternal healthPrior historyClinical considerationsConsensus documentPregnancyExpert consensusStrokeHealthcare professionalsBuilding Cross-Disciplinary Research Collaborations
Miller EC, Leffert L. Building Cross-Disciplinary Research Collaborations. Stroke 2018, 49: e43-e45. PMID: 29438085, PMCID: PMC6446080, DOI: 10.1161/strokeaha.117.020437.Peer-Reviewed Original ResearchTiming and Risk Factors of Postpartum Stroke
Too G, Wen T, Boehme AK, Miller EC, Leffert LR, Attenello FJ, Mack WJ, D'Alton M, Friedman AM. Timing and Risk Factors of Postpartum Stroke. Obstetrics And Gynecology 2018, 131: 70-78. PMID: 29215510, PMCID: PMC6402829, DOI: 10.1097/aog.0000000000002372.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCohort StudiesConfidence IntervalsCost-Benefit AnalysisDatabases, FactualFemaleHumansHypertension, Pregnancy-InducedMaternal AgeOdds RatioPatient DischargePatient ReadmissionPostpartum PeriodPre-EclampsiaPregnancyPregnancy, High-RiskPrognosisRetrospective StudiesRisk AssessmentStrokeTime FactorsYoung AdultConceptsChronic hypertensionDays of dischargeNationwide Readmissions DatabaseHypertensive diseasePostpartum strokeStroke readmissionDelivery hospitalizationsIndex hospitalizationOdds ratioUtilization Project Nationwide Readmissions DatabaseOptimal blood pressure managementDelivery hospitalization dischargeRetrospective cohort studyBlood pressure managementRisk of readmissionCases of strokeMajority of readmissionsCases of readmissionCalendar year 2013Hospitalization dischargeCohort studyHospital dischargeMedian timeReadmission riskRisk factors
2017
Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy
Swartz RH, Ladhani NNN, Foley N, Nerenberg K, Bal S, Barrett J, Bushnell C, Chan WS, Chari R, Dowlatshahi D, Amrani ME, Gandhi S, Gubitz G, Hill MD, James A, Jeerakathil T, Jin A, Kirton A, Lanthier S, Lausman A, Leffert LR, Mandzia J, Menon B, Pikula A, Poppe A, Potts J, Ray J, Saposnik G, Sharma M, Smith EE, Bhogal S, Smitko E, Lindsay MP. Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy. International Journal Of Stroke 2017, 13: 406-419. PMID: 29171360, DOI: 10.1177/1747493017743801.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsAntihypertensive AgentsCanadaCounselingDiabetes, GestationalDiabetic AngiopathiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypertensionIschemic Attack, TransientPlatelet Aggregation InhibitorsPostnatal CarePreconception CarePregnancyPregnancy Complications, CardiovascularPregnancy in DiabeticsPrenatal CareProfessional PracticeRisk FactorsSecondary PreventionStrokeConceptsSecondary stroke preventionStroke preventionConsensus statementUse of antithromboticsTransient ischemic attackBlood pressure managementIschemic stroke etiologyAspects of pregnancyHealth care professionalsGeneral management considerationsBest available literatureIschemic attackRecurrent strokeLipid managementStroke etiologyStroke riskFetal healthMaternal healthPrior historyFetal wellbeingCare professionalsClinical considerationsPregnancyConsensus documentExpert consensusThe incidence of pregnancy-related stroke: A systematic review and meta-analysis
Swartz RH, Cayley ML, Foley N, Ladhani NNN, Leffert L, Bushnell C, McClure J, Lindsay MP. The incidence of pregnancy-related stroke: A systematic review and meta-analysis. International Journal Of Stroke 2017, 12: 687-697. PMID: 28884652, DOI: 10.1177/1747493017723271.Peer-Reviewed Original ResearchConceptsCerebral venous sinus thrombosisVenous sinus thrombosisPregnancy-related strokeSinus thrombosisStroke incidenceCrude rateSystematic reviewIncidence of strokeHigh-risk populationConclusions StrokePostpartum strokeNonhemorrhagic strokeIschemic strokePregnancy populationStroke riskPerinatal strokePooled analysisSubgroup analysisObstetrical careIncidence rateStroke typeOvid MEDLINEInclusion criteriaStroke ratePregnancyRisk Factors for Pregnancy-Associated Stroke in Women With Preeclampsia
Miller EC, Gatollari HJ, Too G, Boehme AK, Leffert L, Marshall RS, Elkind MSV, Willey JZ. Risk Factors for Pregnancy-Associated Stroke in Women With Preeclampsia. Stroke 2017, 48: 1752-1759. PMID: 28546324, PMCID: PMC5539968, DOI: 10.1161/strokeaha.117.017374.Peer-Reviewed Original ResearchConceptsPregnancy-associated strokeRisk factorsChronic hypertensionProthrombotic stateOdds ratioMultivariable conditional logistic regression modelsConditional logistic regression modelsNew York State hospitalsIndependent risk factorVascular risk factorsSeverity of preeclampsiaLogistic regression modelsRace/ethnicityPregnancy complicationsSevere preeclampsiaMultivariable analysisInpatient DatabaseProthrombotic conditionsPreeclampsiaHigh riskClose monitoringNew York State DepartmentState HospitalCoagulopathyBilling data
2016
Risk of Pregnancy-Associated Stroke Across Age Groups in New York State
Miller EC, Gatollari HJ, Too G, Boehme AK, Leffert L, Elkind MS, Willey JZ. Risk of Pregnancy-Associated Stroke Across Age Groups in New York State. JAMA Neurology 2016, 73: 1461-1467. PMID: 27775757, DOI: 10.1001/jamaneurol.2016.3774.Peer-Reviewed Original ResearchConceptsPregnancy-associated strokePregnant/postpartum womenRisk of strokeIncidence risk ratioRisk factorsPostpartum womenAge groupsNonpregnant womenStroke riskOlder womenCumulative riskAge-specific incidence ratiosPost partumCalendar year 2003Cerebral venous thrombosisStroke risk factorsTransient ischemic attackVascular risk factorsOverall median ageLogistic regression modelsActive smokingChronic hypertensionIschemic attackNPAS groupCerebrovascular events
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 hypertensionPatient 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 ambulationHypertensive Disorders and Pregnancy-Related Stroke
Leffert LR, Clancy CR, Bateman BT, Bryant AS, Kuklina EV. Hypertensive Disorders and Pregnancy-Related Stroke. Obstetrics And Gynecology 2015, 125: 124-131. PMID: 25560114, PMCID: PMC4445352, DOI: 10.1097/aog.0000000000000590.Peer-Reviewed Original ResearchConceptsTraditional stroke risk factorsPregnancy-associated strokeHypertensive disordersPregnancy hospitalizationsStroke risk factorsStroke-related complicationsStroke riskRisk factorsOdds ratioNationwide Inpatient SampleCongenital heart diseaseCross-sectional studyComplication rateStroke hospitalizationsInpatient SampleHeart diseaseNationwide rateHospitalizationPregnancyStrokeLogistic regressionCongenital coagulationDisordersConfidence intervalsComplications