2024
Primary Prevention of Stroke: Identifying High-Risk Patients
Kaslow J, Kernan W. Primary Prevention of Stroke: Identifying High-Risk Patients. 2024, 431-443. DOI: 10.1007/978-3-031-66289-8_36.Peer-Reviewed Original ResearchRisk factorsPrimary careHealthy behaviorsPatient-centeredCoronary artery diseaseRisk of strokeChronic diseasesPreventable deathsMedical practicePublic healthUnhealthy onesIncreased riskRisk reductionHigh riskHigh-risk patientsStrokeRiskArtery diseaseCareHealthDisabilityPatientsMedicationFactorsGuidelines
2023
A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association
Ndumele C, Neeland I, Tuttle K, Chow S, Mathew R, Khan S, Coresh J, Baker-Smith C, Carnethon M, Després J, Ho J, Joseph J, Kernan W, Khera A, Kosiborod M, Lekavich C, Lewis E, Lo K, Ozkan B, Palaniappan L, Patel S, Pencina M, Powell-Wiley T, Sperling L, Virani S, Wright J, Singh R, Elkind M, Rangaswami J, Association O. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association. Circulation 2023, 148: 1636-1664. PMID: 37807920, DOI: 10.1161/cir.0000000000001186.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseMetabolic risk factorsMetabolic syndromeRisk factorsKidney diseaseCardiovascular diseaseSocial determinantsEarly life preventionUnique management considerationsManagement of patientsInterdisciplinary care modelAmerican Heart AssociationBiological risk factorsScientific statementKidney outcomesLifestyle modificationHeart AssociationClinical managementCare modelClinical careSyndromeClinical phenotypeDiseaseMajor guidelinesWeight lossCardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association
Ndumele C, Rangaswami J, Chow S, Neeland I, Tuttle K, Khan S, Coresh J, Mathew R, Baker-Smith C, Carnethon M, Despres J, Ho J, Joseph J, Kernan W, Khera A, Kosiborod M, Lekavich C, Lewis E, Lo K, Ozkan B, Palaniappan L, Patel S, Pencina M, Powell-Wiley T, Sperling L, Virani S, Wright J, Singh R, Elkind M, Association O. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation 2023, 148: 1606-1635. PMID: 37807924, DOI: 10.1161/cir.0000000000001184.Peer-Reviewed Original ResearchConceptsMetabolic risk factorsMetabolic healthMetabolic syndromeRisk factorsPresidential AdvisorySocial determinantsCardiovascular disease eventsChronic kidney diseaseAdverse social determinantsAmerican Heart AssociationSignificant clinical impactMetabolic stagingSubspecialty guidelinesCardiovascular mortalityCardioprotective effectsKidney functionKidney diseaseTherapeutic optionsHeart AssociationInterdisciplinary careCardiovascular diseaseClinical impactHigh prevalenceCare fragmentationCare modelBaseline Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes and Coronary Disease Versus Stroke: Secondary Analysis of Cardiovascular Outcome Trials
Balasubramanian P, Kernan W, Sheth K, Ofstad A, Rosenstock J, Wanner C, Zinman B, Mattheus M, Marx N, Inzucchi S. Baseline Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes and Coronary Disease Versus Stroke: Secondary Analysis of Cardiovascular Outcome Trials. Stroke 2023, 54: 2013-2021. PMID: 37449424, PMCID: PMC10358436, DOI: 10.1161/strokeaha.122.042053.Peer-Reviewed Original ResearchConceptsCardiovascular risk factor controlRisk factor controlCoronary artery diseaseEMPA-REG OUTCOMECardiovascular outcome trialsType 2 diabetesRisk factorsOutcome trialsBlood pressureOdds ratioAntiplatelet/anticoagulant medicationsAntiplatelet/anticoagulant therapyDiabetes cardiovascular outcome trialsSuboptimal risk factor controlCardiovascular risk factorsRecurrent ischemic eventsDiastolic blood pressureSystolic blood pressureRespective odds ratiosFactor controlCross-sectional analysisLogistic regression modelsMacrovascular complicationsStatin useAnticoagulant medication
2021
Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association
Kernan WN, Viera AJ, Billinger SA, Bravata DM, Stark SL, Kasner SE, Kuritzky L, Towfighi A, Arteriosclerosis T. Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke 2021, 52: e558-e571. PMID: 34261351, DOI: 10.1161/str.0000000000000382.Peer-Reviewed Original ResearchConceptsRecurrent strokePoststroke carePrimary careAmerican Heart Association/American Stroke AssociationOngoing functional impairmentPatient-centered primary careAmerican Stroke AssociationHigh blood pressureEvidence-based carePrimary care practicesPrimary care teamsPatient-centered careQuality of lifePoststroke managementLifestyle modificationAdult patientsLate complicationsQuality improvement strategiesBlood pressureAtrial fibrillationCarotid stenosisStroke AssociationOngoing careRisk factorsCare team
2017
Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial
Furie KL, Viscoli CM, Gorman M, Ford GA, Young LH, Inzucchi SE, Guarino PD, Lovejoy AM, Conwit R, Tanne D, Kernan WN. Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial. Journal Of Neurology Neurosurgery & Psychiatry 2017, 89: 21. PMID: 28939682, DOI: 10.1136/jnnp-2017-316361.Peer-Reviewed Original ResearchConceptsTransient ischemic attackRecent ischemic strokeIschemic strokeCognitive functionHomeostasis model assessment insulin resistance scoreModified Mini-Mental State Examination scoresAssessment-insulin resistance scoreMini-Mental State Examination scoreInsulin Resistance InterventionPoststroke cognitive functionVascular risk factorsEffect of pioglitazoneInsulin-resistant patientsState Examination scoreIschemic attackPioglitazone groupPlacebo groupIRIS trialStroke trialsCerebrovascular diseaseInsulin resistanceRisk factorsCognitive dysfunctionPatientsResistance Intervention
2016
Pioglitazone after Ischemic Stroke or Transient Ischemic Attack
Kernan WN, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, Guarino PD, Lovejoy AM, Peduzzi PN, Conwit R, Brass LM, Schwartz GG, Adams HP, Berger L, Carolei A, Clark W, Coull B, Ford GA, Kleindorfer D, O'Leary JR, Parsons MW, Ringleb P, Sen S, Spence JD, Tanne D, Wang D, Winder TR. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. New England Journal Of Medicine 2016, 374: 1321-1331. PMID: 26886418, PMCID: PMC4887756, DOI: 10.1056/nejmoa1506930.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeInsulin resistanceMyocardial infarctionIschemic attackPrimary outcomeRecent ischemic strokeDouble-blind trialFuture cardiovascular eventsHomeostasis model assessmentInsulin resistance indexRisk of strokeEligible patientsNonfatal strokePioglitazone groupCardiovascular eventsCause mortalityPlacebo groupPreventive therapyCerebrovascular diseaseInsulin sensitivityRisk factorsResistance indexHigh riskLower risk
2010
What Is the Future of Stroke Prevention?
Kernan WN, Launer LJ, Goldstein LB. What Is the Future of Stroke Prevention? Stroke 2010, 41: s35-s38. PMID: 20876501, PMCID: PMC4795938, DOI: 10.1161/strokeaha.110.592022.Peer-Reviewed Original ResearchConceptsRisk factorsPolypill approachDrug-related side effectsCardiovascular risk factorsFirst ischemic strokeStroke risk factorsMultiple risk factorsOlder adult populationStroke preventionIschemic strokeBlood pressureCholesterol levelsClinical trialsSide effectsAdult populationPolypillStrokeEntire populationRiskLarge populationPopulationCertain ageMedicationsPharmacodynamicsPharmacokinetics
2005
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive Sleep Apnea as a Risk Factor for Stroke and Death. New England Journal Of Medicine 2005, 353: 2034-2041. PMID: 16282178, DOI: 10.1056/nejmoa043104.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeSleep apnea syndromeApnea-hypopnea indexMean apnea-hypopnea indexRisk of strokeApnea syndromeRisk factorsSleep apneaComposite end pointObservational cohort studyObstructive sleep apneaProportional hazards analysisComparison groupAlcohol consumption statusBody mass indexImportant risk factorCohort studyComposite outcomeConsecutive patientsDiabetes mellitusSmoking statusAtrial fibrillationUnadjusted analysesSyndromePatientsMajor Risk Factors for Intracerebral Hemorrhage in the Young Are Modifiable
Feldmann E, Broderick JP, Kernan WN, Viscoli CM, Brass LM, Brott T, Morgenstern LB, Wilterdink JL, Horwitz RI. Major Risk Factors for Intracerebral Hemorrhage in the Young Are Modifiable. Stroke 2005, 36: 1881-1885. PMID: 16081867, DOI: 10.1161/01.str.0000177480.62341.6b.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageIntracerebral hemorrhageMajor risk factorRisk factorsHemorrhagic strokeCase subjectsIndependent risk factorHistory of strokeCurrent cigarette smokingCase-control studyType of strokeMultivariate regression analysisCigarette smokingStroke ProjectControl subjectsStructural lesionsArteriovenous malformationsBrain lesionsEligibility criteriaStrokeYoung menAlcoholic drinksFurther studiesHemorrhageMenopauseAssociation between Impaired Insulin Sensitivity and Stroke
Bravata DM, Wells CK, Kernan WN, Concato J, Brass LM, Gulanski BI. Association between Impaired Insulin Sensitivity and Stroke. Neuroepidemiology 2005, 25: 69-74. PMID: 15947493, DOI: 10.1159/000086286.Peer-Reviewed Original ResearchConceptsHomeostasis model assessmentInsulin sensitivityGlycemic controlMultivariable logistic regression analysisStroke risk factorsLower insulin sensitivityThird National HealthImpaired insulin sensitivityLogistic regression analysisStroke historyInsulin resistancePlasma insulinPlasma glucoseRisk factorsNational HealthNutrition SurveyModel assessmentStrokeRegression analysisAssociationParticipantsClaudicationInsulinRacial Disparities in Stroke Risk Factors
Bravata DM, Wells CK, Gulanski B, Kernan WN, Brass LM, Long J, Concato J. Racial Disparities in Stroke Risk Factors. Stroke 2005, 36: 1507-1511. PMID: 15961710, DOI: 10.1161/01.str.0000170991.63594.b6.Peer-Reviewed Original ResearchConceptsStroke risk factorsRisk factorsStroke historyHigh prevalenceLow high-density lipoprotein cholesterolHigher C-reactive proteinHigh-density lipoprotein cholesterolCommunity-dwelling stroke survivorsC-reactive proteinThird National HealthSevere strokeLipoprotein cholesterolMyocardial infarctionNational HealthStroke survivorsNutrition SurveyHigh incidenceUS populationStrokeOlder ageCross-sectional samplePrevalenceRacial disparitiesEthnic differencesAssociation
2003
Major Risk Factors for Aneurysmal Subarachnoid Hemorrhage in the Young Are Modifiable
Broderick JP, Viscoli CM, Brott T, Kernan WN, Brass LM, Feldmann E, Morgenstern LB, Wilterdink JL, Horwitz RI. Major Risk Factors for Aneurysmal Subarachnoid Hemorrhage in the Young Are Modifiable. Stroke 2003, 34: 1375-1381. PMID: 12764233, DOI: 10.1161/01.str.0000074572.91827.f4.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge DistributionBody Mass IndexCase-Control StudiesCocaine-Related DisordersCohort StudiesComorbidityCooperative BehaviorFemaleHumansHypertensionLogistic ModelsMaleMiddle AgedOdds RatioPhenylpropanolamineRisk FactorsSex DistributionSmokingStrokeSubarachnoid HemorrhageThinnessUnited StatesConceptsAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageRisk factorsLower body mass indexIndependent risk factorCurrent cigarette smokersPrevalent risk factorsBody mass indexMajor risk factorCase-control studyYears of ageRandom digit dialingWarrants further studyHemorrhagic strokeIntracerebral hemorrhageCigarette smokersMass indexPreventable diseaseWomen 18Multivariable modelFamily historyCase subjectsAssociation of caffeineCocaine useHemorrhage
2002
Insulin resistance and risk for stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Horwitz RI. Insulin resistance and risk for stroke. Neurology 2002, 59: 809-815. PMID: 12349850, DOI: 10.1212/wnl.59.6.809.Peer-Reviewed Original ResearchConceptsInsulin resistanceRisk factorsProspective observational cohort studyType 2 diabetes mellitusInsulin-mediated glucose uptakeObservational cohort studyPrevalent risk factorsImportant risk factorType 2 diabetesCase-control studyPertinent English-language publicationsEnglish-language publicationsCardinal defectsPhysical deconditioningStroke preventionCohort studyMost patientsDiabetes mellitusPathophysiologic defectsNondiabetic individualsVascular diseasePeripheral tissuesElderly personsStrokeDefective glycogen synthesis
2000
Phenylpropanolamine and the Risk of Hemorrhagic Stroke
Kernan W, Viscoli C, Brass L, Broderick J, Brott T, Feldmann E, Morgenstern L, Wilterdink J, Horwitz R. Phenylpropanolamine and the Risk of Hemorrhagic Stroke. New England Journal Of Medicine 2000, 343: 1826-1832. PMID: 11117973, DOI: 10.1056/nejm200012213432501.Peer-Reviewed Original ResearchConceptsUse of coughHemorrhagic strokeAppetite suppressantsCold remediesControl subjectsOdds ratioIndependent risk factorCase-control studyYears of ageRandom digit dialingIntracerebral hemorrhageCase reportRisk factorsBrain lesionsWomen 18CoughEligibility criteriaStrokeU.S. hospitalsPhenylpropanolamineWomenPatientsMenRiskAssociation
1998
Estrogen after ischemic stroke: Clinical basis and design of The Women's Estrogen for Stroke Trial
Kernan W, Brass L, Viscoli C, Sarrel P, Makuch R, Horwitz R. Estrogen after ischemic stroke: Clinical basis and design of The Women's Estrogen for Stroke Trial. Journal Of Stroke And Cerebrovascular Diseases 1998, 7: 85-95. PMID: 17895061, DOI: 10.1016/s1052-3057(98)80026-8.Peer-Reviewed Original ResearchIschemic strokeStroke trialsWomen's EstrogenSecondary stroke preventionStroke risk factorsTransient ischemic attackTime of strokeUse of estrogenEffectiveness of estrogenIschemic attackRecurrent strokeEstrogen usersPostmenopausal womenStroke preventionUterine bleedingEndometrial hyperplasiaAsymptomatic womenVaginal ultrasonographyUterine cancerRisk factorsImproved outcomesObservational studyTherapeutic effectClinical basisExclusion criteria