2024
Disability and Recurrent Stroke Among Participants in Stroke Prevention Trials
de Havenon A, Viscoli C, Kleindorfer D, Sucharew H, Delic A, Becker C, Robinson D, Yaghi S, Li V, Lansberg M, Cramer S, Mistry E, Sarpong D, Kasner S, Kernan W, Sheth K. Disability and Recurrent Stroke Among Participants in Stroke Prevention Trials. JAMA Network Open 2024, 7: e2423677. PMID: 39028666, PMCID: PMC11259901, DOI: 10.1001/jamanetworkopen.2024.23677.Peer-Reviewed Original ResearchConceptsPrevention trialsPoststroke disabilityRecurrent stroke ratesRecurrent strokeCohort studyRate of recurrent strokeStroke Prevention TrialIncreased hazardInsulin Resistance InterventionSecondary prevention trialsBaseline disabilityAssociated with increased ratesStroke rateMain OutcomesFunctional statusResistance InterventionStudy baselineSecondary outcomesPrimary outcomeWorsening heart failureModified Rankin ScaleProfession's participationLong-term followVascular deathDisabilitySecondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure control
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 medicationSeparate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics
Hassan S, Viscoli C, O’Connor P, Dugdale L, Sofair A, Fitz M, Richards B, Feiereisel K, Lee S, Ost S, Swails J, Fishman M, Kernan W. Separate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics. Journal Of General Internal Medicine 2023, 38: 2318-2325. PMID: 36800147, PMCID: PMC10406732, DOI: 10.1007/s11606-023-08066-x.Peer-Reviewed Original ResearchConceptsProportion of patientsUS academic health centersPrimary care clinicsAcademic health centersCare clinicsLongitudinal carePrimary care internal medicine clinicsAcademic primary care clinicPre-specified secondary analysisInternal medicine clinicCross-sectional studyMore patientsMedicaid insuranceMedicine clinicHealth centersSeparate clinicsPatientsClinicResultsThirty-nineSecondary analysisClinic directorsPayor mixResident physiciansMedicaidNIH funding
2022
Caring for Patients With Diabetes in Stroke Neurology
Kernan W, Forman R, Inzucchi S. Caring for Patients With Diabetes in Stroke Neurology. Stroke 2022, 54: 894-904. PMID: 36541212, DOI: 10.1161/strokeaha.122.038163.Peer-Reviewed Original ResearchConceptsCerebral small vessel diseaseCoronary heart diseaseSmall vessel diseaseConsequence of diabetesNeurology cliniciansStroke neurologyPeripheral neuropathyRoutine careVessel diseaseHeart diseaseHeterogeneous diseasePerson's riskDiabetesDiseasePatientsBrainRiskHarmful effectsNephropathyNeuropathyMajor contributorRetinopathyWorld populationNeurologistsDementiaTechnical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly.
Forman R, Viscoli C, Meurer K, Sheth K, Sansing L, de Havenon A, Sharma R, Mariscal M, Kernan W. Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly. American Journal Of Hypertension 2022, 36: 195-200. PMID: 36520024, PMCID: PMC10016067, DOI: 10.1093/ajh/hpac129.Peer-Reviewed Original ResearchConceptsHome blood pressure monitoringBlood pressure monitoringBlood pressurePressure monitoringNon-Hispanic white patientsProportion of patientsCross-sectional studyNon-Hispanic white participantsStroke recurrenceRate of useMost patientsPrimary outcomeWhite patientsRate of possessionPatientsUnderrepresented patientsArm cuffHypertensionStrokeCorrect useWhite participantsSignificant disparitiesEthnic groupsParticipantsQuality of techniqueCentral vs site outcome adjudication in the IRIS trial
Forman R, Viscoli CM, Bath PM, Furie KL, Guarino P, Inzucchi SE, Young L, Kernan WN. Central vs site outcome adjudication in the IRIS trial. Journal Of Stroke And Cerebrovascular Diseases 2022, 31: 106667. PMID: 35901589, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106667.Peer-Reviewed Original ResearchConceptsCentral adjudicationHazard ratioStroke definitionsRecent transient ischemic attackInsulin Resistance InterventionMain secondary outcomesShorter symptom durationTransient ischemic attackPrevention of strokeNormal brain imagingClinical trial researchIschemic attackIschemic strokeSecondary outcomesSymptom durationPrimary outcomeStroke trialsIRIS trialMyocardial infarctionOutcome definitionsStroke typeOutcome eventsAdjudicated eventsOutcome adjudicationResistance Intervention
2021
Eating Well to Prevent Stroke
Kernan WN. Eating Well to Prevent Stroke. Stroke 2021, 52: 3551-3554. PMID: 34496614, DOI: 10.1161/strokeaha.121.036172.Peer-Reviewed Original ResearchPrimary 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
2020
Adherence to study drug in a stroke prevention trial"?>
Kiran A, Viscoli CM, Furie KL, Gorman M, Kernan WN. Adherence to study drug in a stroke prevention trial"?>. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105048. PMID: 32912514, PMCID: PMC7487071, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105048.Peer-Reviewed Original ResearchConceptsRate of discontinuationStudy drugDrug holidayTreatment groupsActive study drugAdverse effectsInsulin Resistance InterventionPremature drug discontinuationRecent ischemic strokeStroke Prevention TrialDouble-blind trialTransient ischemic attackClinical trial researchPhases of adherenceDrug discontinuationIschemic attackStroke preventionDiscontinuation ratesIschemic strokeActive therapyMedical therapyPatient adherencePrevention trialsStroke trialsPharmacodynamic effectsLDL (Low-Density Lipoprotein) Cholesterol Below 70
Endres M, Kernan W. LDL (Low-Density Lipoprotein) Cholesterol Below 70. Stroke 2020, 51: 2276-2278. PMID: 32513094, DOI: 10.1161/strokeaha.120.029429.Peer-Reviewed Original Research
2019
Achievement of Guideline-Recommended Weight Loss Among Patients With Ischemic Stroke and Obesity
Dearborn JL, Viscoli CM, Young LH, Gorman MJ, Furie KL, Kernan WN. Achievement of Guideline-Recommended Weight Loss Among Patients With Ischemic Stroke and Obesity. Stroke 2019, 50: 713-717. PMID: 30786849, PMCID: PMC6391736, DOI: 10.1161/strokeaha.118.024008.Peer-Reviewed Original ResearchConceptsTransient ischemic attackBody mass indexProportion of patientsIschemic strokeMass indexVascular eventsBaseline weightWeight lossAchievement of guidelineDays of randomizationRecent ischemic strokeAcute ischemic strokeFuture vascular eventsIschemic attackPlacebo groupObese patientsDiabetes mellitusMedian ageTrial entryIRIS trialMedian timeFunctional outcomeInsulin resistanceClinical trialsPatients
2018
Keeping Faith With Patients After Stroke or Transient Ischemic Attack
Kernan WN. Keeping Faith With Patients After Stroke or Transient Ischemic Attack. JAMA Neurology 2018, 75: 404-405. PMID: 29404565, DOI: 10.1001/jamaneurol.2017.4027.Peer-Reviewed Original Research
2017
Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction
Kernan WN, Viscoli CM, Dearborn JL, Kent DM, Conwit R, Fayad P, Furie KL, Gorman M, Guarino PD, Inzucchi SE, Stuart A, Young LH. Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction. JAMA Neurology 2017, 74: 1319-1327. PMID: 28975241, PMCID: PMC5710663, DOI: 10.1001/jamaneurol.2017.2136.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackMyocardial infarctionIschemic strokeHigh riskPioglitazone groupInsulin resistanceLower riskCox proportional hazards regression modelProportional hazards regression modelsMedian riskEfficacy of pioglitazoneInsulin Resistance InterventionQualifying ischemic strokePlacebo-controlled trialHazards regression modelsLow baseline riskType 2 diabetesGreater absolute benefitDay of entryFuture strokeHydrochloride therapyPlacebo groupHazard ratioSecondary preventionPioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke
Yaghi S, Furie KL, Viscoli CM, Kamel H, Gorman M, Dearborn J, Young LH, Inzucchi SE, Lovejoy AM, Kasner SE, Conwit R, Kernan WN. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke. Circulation 2017, 137: 455-463. PMID: 29084736, DOI: 10.1161/circulationaha.117.030458.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeIschemic attackNondiabetic patientsStroke outcomeStroke eventsInsulin resistanceRecent transient ischemic attackCox proportional hazards modelQualifying ischemic strokeEffect of pioglitazoneFirst stroke eventProportional hazards modelPrevents strokeHemorrhagic eventsComposite outcomeSecondary preventionRecent strokeIRIS trialMyocardial infarctionTreatment groupsHazards modelPioglitazoneConsensus criteriaSurvival analysisEffects 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 InterventionSmoking cessation and outcome after ischemic stroke or TIA
Epstein KA, Viscoli CM, Spence JD, Young LH, Inzucchi SE, Gorman M, Gerstenhaber B, Guarino PD, Dixit A, Furie KL, Kernan WN, Bladin C, Davis S, Wijeratne T, Levi C, Parsons M, Brodtmann A, Ng S, Archer J, Delcourt C, Winder T, Berger L, Boulanger J, Chan R, Spence J, Durocher A, Mackey A, Verreault S, Minuk J, Penn A, Shuaib A, Cote R, Selchen D, Bayer N, Sweet M, Malik S, Stotts G, Griewing B, Soda H, Weinhardt R, Berrouschot J, Stoll A, Witte O, Günther A, Bodechtel U, Schminke U, Hobohm C, Hetzel A, Lambeck J, Wartenberg K, Huttner H, Dittrich R, Nabavi D, Gröschel K, Thomalla G, Rosenkranz M, Jander S, Meisel A, Ludolph A, Althaus K, Huber R, Lorenz M, Tanne D, Merzlyak O, Bornstein N, Telman G, Lampl Y, Streifler J, Weller B, Ifergane G, Wirgin Y, Carolei A, Toni D, Stanzione P, Micieli G, Agnelli G, Caso V, Gandolfo C, Comi G, Consoli D, Rasura M, Di Lazzaro V, Dixit A, Jupp B, Shaw L, Salih I, Esisi B, Power M, Strain W, Elyas S, Manawadu D, Kalra L, O'Brien E, Warburton E, Chatterjee K, Hargroves D, Blight A, Moynihan B, Markus H, Macleod M, Broughton D, Rodgers H, Hlaing T, Muir S, Sajid M, Bath P, Price C, Sekaran L, Vahidassr D, Muir K, McIlmoyle J, Datta P, Davey R, Langhorne P, Stott D, Datta P, England T, Muhidden K, O'Connell J, Majmudar N, Schindler J, Clark W, Sethi P, Rordorf G, Kleindorfer D, Silliman S, Gorman M, Kelly M, Singleton L, Meyer B, Jackson C, Walker J, Ehtisham A, Goodpasture H, Wang D, Fayad P, Cordina S, Naritoku D, Chiu D, Lukovits T, Goddeau R, Clark‐Arbogast R, Leigh R, Wityk R, Pettigrew L, Tayal A, Jarouse J, Friday G, Sen S, Kim A, Johnston S, Elkins J, Barrett A, Leira E, Kelly A, Burgin S, Rempe D, Jacoby M, Hughes D, Majersik J, Skalabrin E, Lee J, Hsu C, Sundararajan S, Slivka A, Minagar A, Alicic R, Geraghty M, Kase C, Lansberg M, Albers G, Dietrich D, Hanna J, Gentile N, Santiago F, Katzan I, Ching M, Sawyer, Warwick T, Yilmaz E, Pedelty L, Schneck M, Coull B, Solenski N, Johnston K, Lee V, Prabhakaran S, Johnson M, Silverman I, Salgado M, Birkhahn R, Strawsburg R, Altafullah I, Cohen D, Zweifler R, Lee Kwen P, Hammer M, Vora N, Tietjen G, Albakri E, Dandapani B, Jickling G, Verro P, Roller M, Hughes R, Simpson J, Vidic T, Lash S, Sigsbee B, Rosenbaum D, Fonzetti P, Fleck J, Goldszmidt A, Alexandrov A, Halsey J, Hart R, Sattin J, Kumar S, Book D, Torbey M, Poock J, King M, Graham G, Sung G, Mirsen T, Dromerick A, Runheim A, Jackson C, Feen E, Reichwein R, Waters M, Amory C, Bernardini G, Bell R, Diamond B, Rosenbaum D, Palestrant D, Segal A, Burger K, Schwartz R, Mitsias P, Kramer J, Kramer J, Robbins D, Silver B, Easton J, Feldmann E, Rymer M, Dorssom J, Ali L, Ovbiagele B, Kirshner H. Smoking cessation and outcome after ischemic stroke or TIA. Neurology 2017, 89: 1723-1729. PMID: 28887378, PMCID: PMC5644463, DOI: 10.1212/wnl.0000000000004524.Peer-Reviewed Original ResearchConceptsMyocardial infarctionIschemic strokeIndex eventProspective observational cohort studyInsulin Resistance InterventionHistory of hypertensionObservational cohort studyDiastolic blood pressureHistory of strokeCoronary artery diseaseTime of randomizationTobacco use historySignificant health benefitsRecurrent strokeNondiabetic menCohort studyCurrent smokersTrial cohortArtery diseaseBlood pressurePrimary outcomeIRIS trialStroke trialsCigarette smokingSmoking cessationCardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack
Young LH, Viscoli CM, Curtis JP, Inzucchi SE, Schwartz GG, Lovejoy AM, Furie KL, Gorman MJ, Conwit R, Abbott JD, Jacoby DL, Kolansky DM, Pfau SE, Ling FS, Kernan WN. Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack. Circulation 2017, 135: 1882-1893. PMID: 28246237, PMCID: PMC5511545, DOI: 10.1161/circulationaha.116.024863.Peer-Reviewed Original ResearchConceptsAcute coronary syndromeType 1 myocardial infarctionTransient ischemic attackMyocardial infarctionCoronary syndromeInsulin resistanceIschemic attackIschemic strokeDiabetes mellitusSerum troponinAcute coronary syndrome episodeMean age 63 yearsAcute coronary syndrome eventIndependent clinical events committeeType 2 myocardial infarctionIRIS participantsImpact of pioglitazoneRecent cerebrovascular eventsRecent ischemic strokeClinical events committeeAge 63 yearsEffect of pioglitazoneSmall myocardial infarctionCoronary artery diseaseST-segment elevation