2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohortSecondary 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
Sporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome
Mikhaiel J, Parasram M, Manning T, Al-Dulaimi M, Barnes E, Falcone G, Hwang D, Prust M. Sporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome. The Neurologist 2023, 29: 14-16. PMID: 37582680, DOI: 10.1097/nrl.0000000000000519.Peer-Reviewed Original ResearchConceptsSporadic Creutzfeldt-Jakob diseaseMagnetic resonance imagingReversible encephalopathy syndromeCreutzfeldt-Jakob diseaseEncephalopathy syndromeAntiseizure medicationsLumbar punctureDiagnosis of sCJDFluid-attenuated inversion recovery changesPosterior reversible encephalopathy syndromeRepeat magnetic resonance imagingCases of sCJDPeriodic dischargesMultiple antiseizure medicationsRepeat lumbar punctureStuporous mental stateInitial lumbar punctureInversion recovery hyperintensityNonconvulsive status epilepticusReal-time quaking-induced conversionFatal neurodegenerative conditionProgressive confusionRadiographic improvementNeurological declineStatus epilepticusImprovement 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 testStrokeA genome-wide association study of frailty identifies significant genetic correlation with neuropsychiatric, cardiovascular, and inflammation pathways
Ye Y, Noche R, Szejko N, Both C, Acosta J, Leasure A, Brown S, Sheth K, Gill T, Zhao H, Falcone G. A genome-wide association study of frailty identifies significant genetic correlation with neuropsychiatric, cardiovascular, and inflammation pathways. GeroScience 2023, 45: 2511-2523. PMID: 36928559, PMCID: PMC10651618, DOI: 10.1007/s11357-023-00771-z.Peer-Reviewed Original ResearchConceptsFried frailty scoreBiology of frailtyEuropean descent participantsOccurrence of frailtyGenome-wide association studiesMendelian randomization analysisFrailty scoreChronic painJoint disordersPolygenic risk scoresRespiratory diseaseInflammation pathwaysRisk scoreClinical phenotypeBrain tissueCausal associationFrailtyAge-related pathwaysRandomization analysisGenetic factorsAssociation studiesUK BiobankRetirement StudyPerson's vulnerabilitySignificant genetic correlations
2022
Effect of Intensive Blood Pressure Control on Incident Stroke Risk in Patients With Mild Cognitive Impairment
de Havenon A, Sharma R, Falcone GJ, Prabhakaran S, Sheth KN. Effect of Intensive Blood Pressure Control on Incident Stroke Risk in Patients With Mild Cognitive Impairment. Stroke 2022, 53: e242-e245. PMID: 35502662, PMCID: PMC9246875, DOI: 10.1161/strokeaha.122.038818.Peer-Reviewed Original ResearchConceptsIntensive BP controlIntensive blood pressure controlMild cognitive impairmentMontreal Cognitive Assessment scoreBlood pressure controlBP controlIncident strokePrimary outcomeCognitive Assessment scoreCognitive impairmentCox modelPressure controlAssessment scoresAnalysis of SPRINTIncident stroke riskStandard BP controlIncident stroke eventsRace/ethnicityBaseline BPRandomization armHazard ratioStroke riskPatient ageStroke eventsAtrial fibrillationCarotid Artery Disease Among Broadly Defined Underrepresented Groups: The All of Us Research Program
Renedo D, Acosta JN, Sujijantarat N, Antonios JP, Koo AB, Sheth KN, Matouk CC, Falcone GJ. Carotid Artery Disease Among Broadly Defined Underrepresented Groups: The All of Us Research Program. Stroke 2022, 53: e88-e89. PMID: 35109680, PMCID: PMC8944776, DOI: 10.1161/strokeaha.121.037554.Peer-Reviewed Original ResearchBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Cardiovascular Health Disparities in Racial and Other Underrepresented Groups: Initial Results From the All of Us Research Program
Acosta JN, Leasure AC, Both CP, Szejko N, Brown S, Torres‐Lopez V, Abdelhakim S, Schindler J, Petersen N, Sansing L, Gill TM, Sheth KN, Falcone GJ. Cardiovascular Health Disparities in Racial and Other Underrepresented Groups: Initial Results From the All of Us Research Program. Journal Of The American Heart Association 2021, 10: e021724. PMID: 34431358, PMCID: PMC8649271, DOI: 10.1161/jaha.121.021724.Peer-Reviewed Original ResearchPortable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonanceStroke Disparities Among Nonracial Minorities in the All of Us Research Program
Leasure AC, Acosta JN, Both C, Szejko N, Brown SC, Sheth KN, Falcone GJ. Stroke Disparities Among Nonracial Minorities in the All of Us Research Program. Stroke 2021, 52: e488-e490. PMID: 34139858, PMCID: PMC8316290, DOI: 10.1161/strokeaha.121.034903.Peer-Reviewed Original ResearchIntracerebral Hemorrhage in Patients With COVID-19
Leasure AC, Khan YM, Iyer R, Elkind MSV, Sansing LH, Falcone GJ, Sheth KN. Intracerebral Hemorrhage in Patients With COVID-19. Stroke 2021, 52: e321-e323. PMID: 34082576, PMCID: PMC8238884, DOI: 10.1161/strokeaha.121.034215.Peer-Reviewed Original ResearchAdolescentAdultAge FactorsAgedAnticoagulantsCerebral HemorrhageCOVID-19C-Reactive ProteinExtracorporeal Membrane OxygenationFemaleHeart Disease Risk FactorsHospital MortalityHospitalizationHumansIntensive Care UnitsInterleukin-6MaleMiddle AgedRegistriesRespiration, ArtificialRisk FactorsSARS-CoV-2Sex FactorsUnited StatesYoung AdultObstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Geer JH, Falcone GJ, Vanent KN, Leasure AC, Woo D, Molano JR, Sansing LH, Langefeld CD, Pisani MA, Yaggi HK, Sheth KN. Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage. Stroke 2021, 52: 1835-1838. PMID: 33827242, PMCID: PMC8085039, DOI: 10.1161/strokeaha.120.033342.Peer-Reviewed Original ResearchConceptsObstructive sleep apneaRisk factorsBerlin questionnaireIntracerebral hemorrhageSleep apneaEthnic/Racial VariationsHigher body mass indexMultivariable logistic regression modelBody mass indexIntracerebral hemorrhage riskCase-control studyExposure of patientsLogistic regression analysisLogistic regression modelsOSA statusHemorrhage riskMass indexHeart diseaseNontraumatic ICHRacial variationApneaHemorrhageRegression analysisICHRegression modelsAssociation of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Leasure AC, Kuohn LR, Vanent KN, Bevers MB, Kimberly WT, Steiner T, Mayer SA, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage. Stroke 2021, 52: 1733-1740. PMID: 33682454, PMCID: PMC8085132, DOI: 10.1161/strokeaha.120.032888.Peer-Reviewed Original ResearchConceptsIL-6 levelsPerihematomal edema volumeIntracerebral hemorrhageIL-6Edema volumeFunctional outcomeICH locationICH volumeTreatment groupsSerum IL-6 levelsBaseline ICHAcute brain injuryLarge intracerebral hemorrhageSerum IL-6Predictors of outcomeSpontaneous intracerebral hemorrhageRankin ScalePoor outcomeProinflammatory cytokinesTrial populationBrain injurySecondary analysisStrong associationFast trialsOutcomesAdmission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage
Acosta JN, Leasure AC, Kuohn LR, Both CP, Petersen NH, Sansing LH, Matouk CC, Testai F, Langefeld CD, Woo D, Kamel H, Murthy SB, Qureshi A, Mayer SA, Sheth KN, Falcone GJ. Admission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage. Critical Care Medicine 2021, 49: 828-837. PMID: 33591003, PMCID: PMC8611893, DOI: 10.1097/ccm.0000000000004891.Peer-Reviewed Original ResearchConceptsAdmission hemoglobin levelsHemoglobin levelsNontraumatic intracerebral hemorrhageIntracerebral hemorrhageHematoma volumePoor outcomeHematoma expansionIntracerebral hemorrhage patientsPredictors of outcomeSpontaneous intracerebral hemorrhageIndividual patient dataHigher hemoglobin levelsAdmission hematoma volumeExposure of interestDose-response analysisAdmission hemoglobinRankin ScalePrimary outcomeHemorrhage patientsFunctional outcomeRepeat CTClinical trialsObservational studyHemorrhage sizeBetter outcomesDiffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage and Risk of Stroke
Murthy SB, Zhang C, Gupta A, Cho SM, Rivera-Lara L, Avadhani R, Gruber J, Iadecola C, Falcone GJ, Sheth KN, Qureshi AI, Goldstein JN, Hanley DF, Kamel H, Ziai WC. Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage and Risk of Stroke. Stroke 2021, 52: 595-602. PMID: 33467877, PMCID: PMC8340082, DOI: 10.1161/strokeaha.120.031628.Peer-Reviewed Original ResearchConceptsRecurrent intracerebral hemorrhageRisk of strokeIntracerebral hemorrhageDWI lesionsIschemic strokeDiffusion-weighted imagingDiffusion-weighted imaging lesionsMultivariate Cox regression analysisMISTIE III trialIncident ischemic strokeCox regression analysisPoor functional outcomeCox regression modelIndividual patient dataATACH-2 trialLong-term riskMagnetic resonance imagingICH survivorsIncident strokeIII trialsImaging lesionsSecondary outcomesIschemic lesionsPrimary outcomeFunctional outcomeGenetically Determined Smoking Behavior and Risk of Nontraumatic Subarachnoid Hemorrhage
Acosta JN, Szejko N, Both CP, Vanent K, Noche RB, Gill TM, Matouk CC, Sheth KN, Gunel M, Falcone GJ. Genetically Determined Smoking Behavior and Risk of Nontraumatic Subarachnoid Hemorrhage. Stroke 2021, 52: 582-587. PMID: 33440997, PMCID: PMC7856108, DOI: 10.1161/strokeaha.120.031622.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedDatabases, FactualElectronic Health RecordsFemaleGenetic Predisposition to DiseaseGenetic VariationHumansIntracranial AneurysmMaleMendelian Randomization AnalysisMiddle AgedMultifactorial InheritanceOdds RatioRisk AssessmentSelf ReportSmokingStrokeSubarachnoid HemorrhageTreatment OutcomeUnited Kingdom
2020
A Pooled Analysis of Diffusion-Weighted Imaging Lesions in Patients With Acute Intracerebral Hemorrhage
Murthy SB, Cho SM, Gupta A, Shoamanesh A, Navi BB, Avadhani R, Gruber J, Li Y, Greige T, Lioutas VA, Norton C, Zhang C, Mandava P, Iadecola C, Falcone GJ, Sheth KN, Biffi A, Rosand J, Qureshi AI, Goldstein JN, Kidwell C, Awad I, Selim M, Hanley DF, Woo D, Kamel H, Ziai WC. A Pooled Analysis of Diffusion-Weighted Imaging Lesions in Patients With Acute Intracerebral Hemorrhage. JAMA Neurology 2020, 77: 1390-1397. PMID: 32687564, PMCID: PMC7372494, DOI: 10.1001/jamaneurol.2020.2349.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imaging lesionsModified Rankin scoreDWI lesionsImaging lesionsAcute intracerebral hemorrhageIntracerebral hemorrhageFunctional outcomeSubgroup analysisChronic cerebral small vessel diseaseAdmission systolic blood pressureCerebral small vessel diseaseMulticenter prospective studySystolic blood pressurePoor functional outcomeSmall vessel diseaseDeep intracerebral hemorrhageBaseline hematoma volumeIndividual patient dataMixed-effects logistic regressionMixed effects regression modelsAcute sequelaeHypertensive vasculopathyRankin scoreSecondary outcomesBlood pressureCause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study.
Kuohn LR, Leasure AC, Acosta JN, Vanent K, Murthy SB, Kamel H, Matouk CC, Sansing LH, Falcone GJ, Sheth KN. Cause of death in spontaneous intracerebral hemorrhage survivors: Multistate longitudinal study. Neurology 2020, 95: e2736-e2745. PMID: 32917797, PMCID: PMC7734723, DOI: 10.1212/wnl.0000000000010736.Peer-Reviewed Original ResearchConceptsCause of deathRecurrent intracranial hemorrhageIntracerebral hemorrhage survivorsAtrial fibrillationICH survivorsIschemic strokeIntracranial hemorrhageSpontaneous intracerebral hemorrhage survivorsMultivariable Cox proportional hazardsCox proportional hazardsLong-term survivalMedian followRespiratory failureHospital readmissionPrimary outcomePrimary diagnosisSpontaneous ICHCardiac diseaseClaims dataMultinomial logistic regressionNontraumatic ICHProportional hazardsAdult survivorsLogistic regressionPatientsAssociation of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma.
Brown SC, King ZA, Kuohn L, Kamel H, Gilmore EJ, Frontera JA, Murthy S, Kim JA, Omay SB, Falcone GJ, Sheth KN. Association of race and ethnicity to incident epilepsy, or epileptogenesis, after subdural hematoma. Neurology 2020, 95: e2890-e2899. PMID: 32907969, PMCID: PMC7734738, DOI: 10.1212/wnl.0000000000010742.Peer-Reviewed Original ResearchConceptsSubdural hematomaEmergency departmentMultivariable Cox regressionRetrospective cohort studyMedical risk factorsDevelopment of epilepsyNontraumatic subdural hematomaAssociation of raceDiagnosis of epilepsyCohort studyPrimary outcomeRenal diseaseStatus epilepticusWhite patientsBlack patientsHospital revisitsCox regressionBlack raceDiagnosis codesRisk factorsClaims dataInjury severityEpilepsyDrug useSurvival analysis