2024
Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research.
de Havenon A, Ayodele I, Alhanti B, Mac Grory B, Xian Y, Fonarow G, Smith E, Worrall B. Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research. Neurology 2024, 102: e209424. PMID: 38759133, PMCID: PMC11175650, DOI: 10.1212/wnl.0000000000209424.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesCross-Sectional StudiesFemaleHumansIschemic StrokeMaleMiddle AgedRegistriesRetrospective StudiesStrokeConceptsLarge vessel occlusionNIH Stroke ScaleConsistent with previous studiesAdult acute ischemic stroke patientsCross-sectional cohort analysisAcute ischemic stroke patientsLarge vessel occlusion strokePosterior circulation strokeDiagnosis of ischemic strokeReceiver operating curveNeuroimagingGWTG-StrokeIschemic stroke patientsVascular neuroimagingAdult patientsAtrial fibrillationCirculation strokeCohort analysisClinical covariatesStroke patientsOcclusion strokeVessel occlusionPrevious studiesCut-pointsStroke ScaleExternal validation of the SI2NCAL2C score for outcomes following cerebral venous thrombosis
Klein P, Shu L, Lindgren E, de Winter M, Siegler J, Simpkins A, Omran S, Heldner M, de Havenon A, Abdalkader M, Al Kasab S, Stretz C, Wu T, Wilson D, Asad S, Almallouhi E, Frontera J, Kuohn L, Rothstein A, Bakradze E, Henninger N, Zubair A, Sharma R, Kerrigan D, Aziz Y, Mistry E, van Kammen M, Tatlisumak T, Krzywicka K, Aguiar de Sousa D, Jood K, Field T, Yaghi S, Coutinho J, Nguyen T. External validation of the SI2NCAL2C score for outcomes following cerebral venous thrombosis. Journal Of Stroke And Cerebrovascular Diseases 2024, 33: 107720. PMID: 38614162, DOI: 10.1016/j.jstrokecerebrovasdis.2024.107720.Peer-Reviewed Original ResearchConceptsCerebral venous thrombosisArea under the receiver operating characteristic curvePoor outcomeVenous thrombosisCentral nervous system infectionInternational retrospective studyNervous system infectionExternal validation cohortFocal neurological deficitsReceiver operating characteristic curvePoor outcome dataLevels of hemoglobinLack of follow-upPoorer outcome scoresConsecutive patientsClinical presentationRetrospective studyValidation cohortIntracerebral hemorrhageNeurological deficitsFollow-upOutcome scoresSystemic infectionLevels of glucoseInternational cohortCost-benefit analysis of intraoperative neuromonitoring for cardiac surgery
Jain B, Rahim F, Thirumala P, McGarvey M, Balzer J, Nogueira R, van der Goes D, de Havenon A, Sultan I, Ney J. Cost-benefit analysis of intraoperative neuromonitoring for cardiac surgery. Journal Of Stroke And Cerebrovascular Diseases 2024, 33: 107576. PMID: 38232584, DOI: 10.1016/j.jstrokecerebrovasdis.2024.107576.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionCardiac surgeryIntraoperative neuromonitoringModified Rankin ScaleDetect large vessel occlusionHigh-risk patientsOne-way sensitivity analysesLifetime costsProbabilistic sensitivity analysesNeurological complicationsRankin ScaleSurgeryFunctional outcomesLifetime horizonVessel occlusionPatientsDecision-analysis treeSocietal perspectiveNeuromonitoringCost-saving
2023
Rates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort
Zhou L, Lansberg M, de Havenon A. Rates and reasons for hospital readmission after acute ischemic stroke in a US population-based cohort. PLOS ONE 2023, 18: e0289640. PMID: 37535655, PMCID: PMC10399731, DOI: 10.1371/journal.pone.0289640.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedDatabases, FactualHumansIschemic StrokeMedicarePatient ReadmissionRetrospective StudiesRisk FactorsSepsisStrokeUnited StatesConceptsAcute ischemic strokeAcute renal failureHospital readmissionIschemic strokeReadmission ratesRenal failureRisk factorsUS population-based cohortUnplanned hospital readmissionNationwide Readmissions DatabaseRisk of readmissionVascular risk factorsHospital-level characteristicsPopulation-based cohortKaplan-Meyer analysisWorsened patient outcomesState administrative databasesModifiable comorbiditiesRecurrent strokeInitial hospitalizationDisadvantaged patientsLonger initial lengthMedicare insuranceAIS patientsSecondary strokeAssociation of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke
Stulberg E, Harris B, Zheutlin A, Delic A, Sheibani N, Anadani M, Yaghi S, Petersen N, de Havenon A. Association of Blood Pressure Variability With Death and Discharge Destination Among Critically Ill Patients With and Without Stroke. Neurology 2023, 101: e1145-e1157. PMID: 37487742, PMCID: PMC10513881, DOI: 10.1212/wnl.0000000000207599.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlood PressureCritical IllnessHospital MortalityHumansPatient DischargeRetrospective StudiesStrokeConceptsAverage real variabilityNonstroke patientsDischarge destinationHospital deathIschemic strokeIll patientsIllness severityWorse outcomesAdult intensive care unit patientsMinimum mean arterial pressureIntensive care unit patientsIntensive Care III databaseBlood pressure goalsAcute ischemic strokeMean arterial pressureBlood pressure variabilityCare unit patientsRisk of deathMedical Information MartUnit patientsArterial pressureIntracerebral hemorrhageSubarachnoid hemorrhageRisk factorsEffect modificationIdentification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrainFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesRetrospective StudiesWhite MatterConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation indexHigher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses
Renedo D, Acosta J, Koo A, Rivier C, Sujijantarat N, de Havenon A, Sharma R, Gill T, Sheth K, Falcone G, Matouk C. Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses. Stroke 2023, 54: 1538-1547. PMID: 37216451, PMCID: PMC10212531, DOI: 10.1161/strokeaha.122.041891.Peer-Reviewed Original ResearchMeSH KeywordsHemorrhagic StrokeHospitalsHumansPopulation HealthRetrospective StudiesRisk FactorsStrokeConceptsHospital Frailty Risk ScoreRisk of strokeHighest Hospital Frailty Risk ScoresDate of consentFrailty Risk ScoreMendelian randomization analysisStroke riskRisk scoreRandomization analysisTime of enrollmentAvailable electronic health recordsMendelian randomizationElectronic health recordsLook-back periodIncident strokeDose-response wayFrailty statusHemorrhagic strokeMultivariable analysisStroke eventsObservational studyHigh riskFrailtySignificant associationSimilar associationEffect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample
de Havenon A, Zhou L, Yaghi S, Frontera J, Sheth K. Effect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample. Stroke 2023, 54: e194-e198. PMID: 37021563, PMCID: PMC10121243, DOI: 10.1161/strokeaha.122.041929.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleStroke ScaleStroke severityLowest quartileCOVID-19Acute ischemic stroke outcomesAcute ischemic stroke severityHigher stroke severityHospital stroke mortalityIschemic stroke outcomeHigher National InstitutesNational Inpatient SampleCross-sectional cohortIschemic stroke severityCOVID-19 statusNational InstituteHospital mortalityAdjusted riskHospital dischargeIschemic strokeStroke outcomeStroke mortalityAIS severityInpatient SampleExposure statusComplications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Rose D, Cavalier A, Kam W, Cantrell S, Lusk J, Schrag M, Yaghi S, Stretz C, de Havenon A, Saldanha I, Wu T, Ranta A, Barber P, Marriott E, Feng W, Kosinski A, Laskowitz D, Poli S, Mac Grory B. Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke 2023, 54: 1192-1204. PMID: 36951049, PMCID: PMC10133185, DOI: 10.1161/strokeaha.122.042335.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntracranial hemorrhageIschemic strokeSystematic reviewIntravenous tenecteplaseRelative riskHigh-dose groupRisk of complicationsPrior systematic reviewsTenecteplase-treated patientsFull-text articlesWeb of ScienceGastrointestinal hemorrhageAdult patientsExtracranial hemorrhageNoncomparative studySecondary outcomesPooled riskPrimary outcomeTreatment complicationsAbsolute riskCochrane LibraryInterventional studyMedium doseLarge Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes
de Havenon A, Zaidat O, Amin-Hanjani S, Nguyen T, Bangad A, Abbasi M, Anadani M, Almallouhi E, Chatterjee R, Mazighi M, Mistry E, Yaghi S, Derdeyn C, Hong K, Kvernland A, Leslie-Mazwi T, Al Kasab S. Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes. Stroke 2023, 54: 1695-1705. PMID: 36938708, PMCID: PMC10202848, DOI: 10.1161/strokeaha.122.040008.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaEndovascular ProceduresHumansIntracranial ArteriosclerosisRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusion strokeIntracranial atherosclerotic diseaseEndovascular thrombectomyAtherosclerotic diseaseOcclusion strokeFunctional outcome benefitsVascular risk factorsAdjunctive medicationsMedical managementPatient factorsInterventional treatmentOutcome benefitsRisk factorsObservational studyEarly identificationTreatment planningThrombectomyUnique considerationsPatientsStrokeLVODiseaseRevascularizationMedicationsReviewAssociation Between Hospital-Documented Atrial Fibrillation and Central Retinal Artery Occlusion
Lusk J, Song A, Unnithan S, Al-Khalidi H, Delic A, de Havenon A, Biousse V, Schrag M, Poli S, Piccini J, Xian Y, O’Brien E, Mac Grory B. Association Between Hospital-Documented Atrial Fibrillation and Central Retinal Artery Occlusion. Stroke 2023, 54: 983-991. PMID: 36729390, PMCID: PMC11173326, DOI: 10.1161/strokeaha.122.042292.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtrial FibrillationCohort StudiesFemaleHospitalsHumansIncidenceMaleRetinal Artery OcclusionRetrospective StudiesRisk FactorsStrokeConceptsCentral retinal artery occlusionRetinal artery occlusionCardiovascular comorbiditiesArtery occlusionAtrial fibrillationInverse associationNon-Hispanic white race/ethnicityState Emergency Department DatabasesWhite race/ethnicityPrespecified sensitivity analysisPrimary end pointRisk of strokeCause-specific hazards modelEmergency Department DatabasesEmergency department settingPrimary risk factorState Inpatient DatabasesPositive control outcomesRace/ethnicityMedian followCohort studyCumulative incidenceIschemic strokeAF statusInpatient Database
2022
CGRP, Migraine, and Brain MRI in CADASIL
Goldstein E, Gopal N, Badi M, Hodge D, de Havenon A, Glover P, Durham P, Huang J, Lin M, Baradaran H, Majersik J, Meschia J. CGRP, Migraine, and Brain MRI in CADASIL. The Neurologist 2022, 28: 231-236. PMID: 36729391, PMCID: PMC10277309, DOI: 10.1097/nrl.0000000000000478.Peer-Reviewed Original ResearchConceptsCalcitonin gene-related peptideMigraine-related disabilitySerum calcitonin gene-related peptideSerum CGRP levelsCGRP levelsBrain magnetic resonance imagingCerebral autosomal dominant arteriopathyGene-related peptideAutosomal dominant arteriopathyMagnetic resonance imagingCross-sectional analysisRadiographic associationRadiographic implicationsPrimary outcomeT2 hyperintensityCerebral microbleedsDisability ScaleSubcortical infarctsMigraine pathophysiologyVasoactive peptidesBrain MRIMigraine pathologyMigraineResonance imagingCADASILBorderzone infarction and recurrent stroke in intracranial atherosclerosis
Kvernland A, Torres J, Raz E, Nossek E, de Havenon A, Gebregziabher M, Khatri P, Prabhakaran S, Liebeskind D, Yaghi S. Borderzone infarction and recurrent stroke in intracranial atherosclerosis. Journal Of Stroke And Cerebrovascular Diseases 2022, 32: 106897. PMID: 36402094, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106897.Peer-Reviewed Original ResearchConceptsRecurrent cerebrovascular eventsIntracranial stenosisBorderzone infarctsInfarct patternsIschemic strokeBorderzone infarctionRetrospective single-center studyAcute ischemic strokeRecurrent ischemic strokeSingle-center studySymptomatic intracranial stenosisHigh-risk cohortBinary logistic regression analysisDistal blood flowAlternative treatment strategiesLogistic regression analysisLogistic regression modelsCerebrovascular eventsRecurrent strokeIntracranial atherosclerosisPrimary outcomeCenter studyMean ageSurrogate markerTreatment strategiesMutation of breast cancer susceptibility genes increases cerebral microbleeds: A pilot study
Pope B, Wolcott Z, Castillo M, Jin J, Wong KH, Havenon A, Yaghi S, Goldstein ED. Mutation of breast cancer susceptibility genes increases cerebral microbleeds: A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2022, 31: 106729. PMID: 36116220, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106729.Peer-Reviewed Original ResearchMeSH KeywordsAdultBreast NeoplasmsCerebral HemorrhageCerebral Small Vessel DiseasesCross-Sectional StudiesFemaleHumansMutationPilot ProjectsRetrospective StudiesConceptsCerebral small vessel diseaseCerebrovascular risk factorsBRCA mutationsCerebral microbleedsRisk factorsOdds ratioMarkers of CSVDBreast cancer susceptibility gene mutationsRetrospective cross-sectional analysisCancer susceptibility gene mutationsAdjusted odds ratioSmall vessel diseaseHosmer-Lemeshow testSusceptibility gene mutationsCross-sectional analysisLogistic regression modelsBreast cancer susceptibility genesVessel diseaseWildtype individualsBrain MRICancer susceptibility genesStudent's t-test analysisT-test analysisMalignancy evaluationClinical implicationsDirect cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**
de Havenon A, Orlando C, Delic A, McNally JS, Majersik JJ, Harman T, Alexander M, Reddy V, Lyden S, Anzai Y. Direct cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**. The Neuroradiology Journal 2022, 36: 142-147. PMID: 35701745, PMCID: PMC10034695, DOI: 10.1177/19714009221108681.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCosts and Cost AnalysisEmergency Service, HospitalFemaleHumansIschemic StrokeMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesStrokeConceptsAcute ischemic strokeHospital lengthIschemic strokeBrain attackRapid MRIAIS patientsEmergency departmentCT perfusionMRI cohortRapid MRI protocolTotal hospital lengthEmergency department evaluationDirect costsNeurologic symptom onsetTotal direct costsDirect cost analysisHospital LOSSequential patientsSymptom onsetDepartment evaluationED LOSPrimary outcomeDischarge diagnosisPatientsMRI protocol
2021
Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke
de Havenon A, Castonguay A, Nogueira R, Nguyen TN, English J, Satti SR, Veznedaroglu E, Saver JL, Mocco J, Khatri P, Mistry E, Zaidat OO. Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2021, 97: e1914-e1919. PMID: 34544817, PMCID: PMC8601211, DOI: 10.1212/wnl.0000000000012827.Peer-Reviewed Original ResearchMeSH KeywordsArterial Occlusive DiseasesBrain IschemiaEndovascular ProceduresHumansIschemic StrokeRetrospective StudiesStentsStrokeThrombectomyTreatment OutcomeConceptsPremorbid mRS scoreAnterior circulation acute ischemic strokeLarge vessel occlusion strokeAcute ischemic strokeEndovascular thrombectomyMRS scoreIschemic strokePrimary outcomeOcclusion strokeOdds ratioAnterior circulation large vessel occlusion strokeMiddle cerebral artery occlusionAcute Stroke RegistryCerebral artery occlusionClass II evidenceStudy of patientsPrestroke disabilityStroke RegistryArtery occlusionConsecutive patientsEndovascular therapyPremorbid disabilityFurther disabilityTrevo deviceMore disabilityIpsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis
Mac Grory B, Nossek E, Reznik ME, Schrag M, Jayaraman M, McTaggart R, de Havenon A, Yaghi S, Feng W, Furie K, Boyanpally A. Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis. PLOS ONE 2021, 16: e0257697. PMID: 34534252, PMCID: PMC8448368, DOI: 10.1371/journal.pone.0257697.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarotid Artery DiseasesCarotid Artery, InternalFemaleHumansIschemic StrokeMaleRetrospective StudiesConceptsCarotid artery webCarotid webIschemic stroke patientsCryptogenic strokeComputed tomography angiographyStroke patientsSystematic reviewCohort studyIschemic strokeRelative riskSimilar cohortAcute ischemic stroke patientsCompelling potential mechanismsCryptogenic stroke patientsComprehensive stroke centerAcute ischemic strokeEmbolic ischemic strokeEligible patientsSecondary preventionStroke centersStroke subtypesYounger patientsPooled prevalenceTomography angiographyPatientsInvestigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke
Grandhi R, Ravindra VM, Ney JP, Zaidat O, Taussky P, de Havenon A. Investigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106013. PMID: 34375859, PMCID: PMC8511062, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106013.Peer-Reviewed Original ResearchMeSH KeywordsAfter-Hours CareAgedAged, 80 and overCross-Sectional StudiesDatabases, FactualEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansInpatientsIschemic StrokeLength of StayMaleMiddle AgedPatient DischargeRetrospective StudiesRisk AssessmentRisk FactorsThrombectomyTime FactorsTreatment OutcomeUnited StatesConceptsAcute ischemic strokeEndovascular thrombectomyIschemic strokeLarge vessel occlusion ischemic strokeHealth Stroke Scale scoreNationwide Inpatient Sample dataStroke Scale scoreExtended hospital stayWorse clinical outcomesCross-sectional analysisLogistic regression modelsHospital deathHospital staySecondary outcomesPrimary outcomeClinical outcomesAIS patientsNormal working hoursPatientsScale scoreFavorable dischargeExposure variablesStrokeWeekends/National InstituteThe association between transthoracic echocardiogram parameters and white matter hyperintensities
Navarro KS, Wong KH, Ibrahim MM, de Havenon AH, Goldstein ED. The association between transthoracic echocardiogram parameters and white matter hyperintensities. Clinical Neurology And Neurosurgery 2021, 206: 106672. PMID: 33979694, DOI: 10.1016/j.clineuro.2021.106672.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainCerebral Small Vessel DiseasesEchocardiographyFemaleHeart AtriaHeart VentriclesHumansMaleMiddle AgedRetrospective StudiesWhite MatterConceptsMagnetic resonance imagingBrain magnetic resonance imagingCerebral small vessel diseaseVentricular ejection fractionCardiac chamber sizeTransthoracic echocardiogramFazekas scoreEjection fractionAtrial areaTricuspid annular plane systolic excursionAnnular plane systolic excursionRight ventricular ejection fractionRight ventricular internal diameterRetrospective chart reviewRight atrial areaSmall vessel diseaseVentricular internal diameterMultivariate ordinal logistic regression modelWhite matter hyperintensitiesChamber sizeLogistic regression modelsOrdinal logistic regression modelsMore WMHChart reviewSystolic excursionCarotid Stenosis and Recurrent Ischemic Stroke
Yaghi S, de Havenon A, Rostanski S, Kvernland A, Mac Grory B, Furie KL, Kim AS, Easton JD, Johnston SC, Henninger N. Carotid Stenosis and Recurrent Ischemic Stroke. Stroke 2021, 52: 2414-2417. PMID: 33940954, PMCID: PMC8268075, DOI: 10.1161/strokeaha.121.034089.Peer-Reviewed Original ResearchConceptsHigh-risk transient ischemic attackTransient ischemic attackEffect of clopidogrelMinor ischemic strokeIschemic strokeIschemic stroke riskCarotid stenosisIschemic attackStroke riskCervical internal carotid arteryAddition of clopidogrelDual antiplatelet therapyRecurrent ischemic strokeCox regression modelInternal carotid arteryAntiplatelet therapyPrimary outcomePoint trialCarotid arteryInclusion criteriaClopidogrelAdjusted modelStenosisPatientsStroke