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 deathDisabilityPrediction 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 ResearchConceptsLarge 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 ScaleSecondary 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 controlExternal 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 cohortBurden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization.
de Havenon A, Callaghan B, Xu Y, Connor M, Hill C, Ney J, Esper G. Burden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization. Neurology 2024, 102: e209248. PMID: 38507675, DOI: 10.1212/wnl.0000000000209248.Peer-Reviewed Original ResearchConceptsHealth care encountersNeurological diagnosisCare encountersHealth careCollection of electronic health recordsHospital-based careHealth Research NetworkElectronic health recordsEmergency department visitsCohort of adultsYears of follow-upGlobal health research networkPatient-level dataElixhauser comorbidity scorePropensity score matchingHealth recordsMovement disordersDepartment visitsEMR dataPatient's residenceMarital statusAnalysis of patient-level dataNearest neighbor propensity score matchingIncident eventsHazard ratioCost-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-savingGenome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke.
Aldridge C, Braun R, Lohse K, de Havenon A, Cole J, Cramer S, Lindgren A, Keene K, Hsu F, Worrall B. Genome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke. Neurology 2024, 102: e208011. PMID: 38181310, PMCID: PMC11023036, DOI: 10.1212/wnl.0000000000208011.Peer-Reviewed Original Research
2023
National- and State-Level Trends in Medicare Hospice Beneficiaries for Stroke During 2013 to 2019 in the United States
de Havenon A, Skolarus L, Mac Grory B, Bangad A, Sheth K, Burke J, Creutzfeldt C. National- and State-Level Trends in Medicare Hospice Beneficiaries for Stroke During 2013 to 2019 in the United States. Stroke 2023, 55: 131-138. PMID: 38063013, PMCID: PMC10752263, DOI: 10.1161/strokeaha.123.045021.Peer-Reviewed Original ResearchDisability Status and Secondary Prevention Among Survivors of Stroke: A Cross‐Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey
Zhou T, de Havenon A, Sheth K, Ross J. Disability Status and Secondary Prevention Among Survivors of Stroke: A Cross‐Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey. Journal Of The American Heart Association 2023, 12: e030869. PMID: 38014672, PMCID: PMC10727323, DOI: 10.1161/jaha.123.030869.Peer-Reviewed Original ResearchClinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study
Abou Karam G, Tharmaseelan H, Aboian M, Malhotra A, Gilmore E, Falcone G, de Havenon A, Sheth K, Payabvash S. Clinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107375. PMID: 37738914, PMCID: PMC10591892, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107375.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSecondary brain injuryIntracerebral hemorrhagePerihematomal edemaSubacute intracerebral hemorrhageIntravoxel incoherent motion imagingAdmission NIHSSBrain injuryMedian baseline National InstitutesPilot studyBaseline National InstitutesHealth Stroke ScalePerfusion fractionSupratentorial intracerebral hemorrhageIVIM metricsIncoherent motion imagingStroke ScaleNeuroprotective therapiesParenchymal injuryRankin ScaleRisk patientsConsecutive patientsUnivariable analysisPoor outcomeICH volumePatient Travel Distance to Neurologist Visits
Lin C, Hill C, Kerber K, Burke J, Skolarus L, Esper G, de Havenon A, De Lott L, Callaghan B. Patient Travel Distance to Neurologist Visits. Neurology 2023, 101: e1807-e1820. PMID: 37704403, PMCID: PMC10634641, DOI: 10.1212/wnl.0000000000207810.Peer-Reviewed Original ResearchConceptsAmyotrophic lateral sclerosisPatient travel distanceNeurologist visitNeurologic conditionsCancer careMedicare beneficiariesPrimary care physician visitsCoordinated multidisciplinary careMedian driving distanceClustering of patientsHospital referral regionsCross-sectional analysisLocal neurologistsNeurologist carePhysician visitsClinical outcomesMultidisciplinary careMedicare sampleReferral regionsLateral sclerosisNeurologic carePatientsTravel burdenNeurologistsVisitsRates 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 ResearchConceptsAcute 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 strokeImprovement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity
de Havenon A, Smith E, Sharma R, Falcone G, Bangad A, Prabhakaran S, Sheth K. Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity. Journal Of The American Heart Association 2023, 12: e029374. PMID: 37345754, PMCID: PMC10356061, DOI: 10.1161/jaha.123.029374.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesIncident strokePrimary outcomeHypertensive individualsMatter hyperintensitiesAtherosclerotic cardiovascular disease risk scoreCognitive impairmentCardiovascular disease risk scoreVascular risk factorsCurrent cigarette smokingDisease risk scoreMagnetic resonance imagingLogistic regression modelsRandomization armCerebrovascular eventsVascular riskCigarette smokingPrognostic informationRisk factorsPrognostic abilityRisk scoreCognitive declineResonance imagingDeLong testStrokeTwenty-Year Disparity Trends in United States Stroke Death Rate by Age, Race/Ethnicity, Geography, and Socioeconomic Status
de Havenon A, Zhou L, Johnston K, Dangayach N, Ney J, Yaghi S, Sharma R, Abbasi M, Delic A, Majersik J, Anadani M, Tirschwell D, Sheth K. Twenty-Year Disparity Trends in United States Stroke Death Rate by Age, Race/Ethnicity, Geography, and Socioeconomic Status. Neurology 2023, 101: e464-e474. PMID: 37258298, PMCID: PMC10401675, DOI: 10.1212/wnl.0000000000207446.Peer-Reviewed Original ResearchConceptsStroke death ratesSocial deprivation indexSocial determinantsDeath rateOlder individualsYoung individualsCounty-level social determinantsHigher social deprivation indexDeprivation indexNon-Hispanic white individualsPublic health strategiesHigher substance abuseMedical insurance coverageCounty-level increasesRace/ethnicityStroke deathsStroke mortalityBlack raceDistinct social determinantsHealth strategiesAge groupsDisease controlSubstance abusePercentage changeSocioeconomic statusPerioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation
Shu L, Jiang W, Xiao H, Henninger N, Nguyen T, Siegler J, de Havenon A, Goldstein E, Mandel D, Rana M, Al‐Mufti F, Frontera J, Furie K, Yaghi S. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation. Annals Of Neurology 2023, 94: 321-329. PMID: 37183768, DOI: 10.1002/ana.26678.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAtrial fibrillationPerioperative acute ischemic strokeDiagnosis-related groupsRisk factors-VASc scoreActive cancerHigher CHA<sub>2</sub> DS<sub>2</sub> VASc score. TheElective proceduresInternational Classification of DiseasesRisk factors of acute ischemic strokeScoring systemIschemic strokeClassification of DiseasesNeurological surgeryDays of dischargeLogistic regression modelsNationwide Readmissions DatabaseElective surgical proceduresAnticoagulant therapyInternational ClassificationPeriprocedural periodRenal failureSurgical typeAdult patientsRecurrence risk in symptomatic intracranial stenosis treated medically in the real world
Yaghi S, Shu L, Goldstein E, Chang A, Kala N, Stretz C, Burton T, Perelstein E, Furie K, Jayaraman M, Torabi R, Moldovan K, de Havenon A, Khatri P, Gebregziabher M, Liebeskind D, Prabhakaran S. Recurrence risk in symptomatic intracranial stenosis treated medically in the real world. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107086. PMID: 37030126, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107086.Peer-Reviewed Original ResearchConceptsIntracranial atherosclerotic stenosisSymptomatic intracranial atherosclerotic stenosisClinical trialsRecurrence riskRecurrent strokeInclusion criteriaReal-world settingMaximal medical treatmentRecurrent stroke rateDual antiplatelet therapyAcute ischemic strokeReal-world cohortSymptomatic intracranial stenosisPharmacological treatment strategiesCox regression modelMeeting inclusion criteriaLow event ratesAntiplatelet therapyStroke RegistryIschemic eventsIschemic strokeWorld CohortHospitalized patientsEarly recurrenceIntracranial stenosisSecondary Ischemic Stroke Prevention
Bangad A, Abbasi M, de Havenon A. Secondary Ischemic Stroke Prevention. Neurotherapeutics 2023, 20: 721-731. PMID: 36877331, PMCID: PMC10275832, DOI: 10.1007/s13311-023-01352-w.Peer-Reviewed Original ResearchConceptsSecondary ischemic stroke preventionIschemic stroke preventionRecurrent ischemic strokeStroke preventionIschemic strokeRisk factorsMajor public health concernSecondary stroke preventionLifestyle risk factorsVascular risk factorsRecurrent stroke riskAvailability of treatmentPublic health concernHealth care systemAHA guidelinesStroke riskSurgical treatmentHealth burdenPatient burdenFirst strokeStrokeHealth concernCare systemPreventionTreatmentAssociation 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 ResearchConceptsCentral 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
Borderzone 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 strategiesDirect 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 ResearchConceptsAcute 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