2023
Higher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke
Nogueira R, Haussen D, Smith E, Sun J, Xian Y, Alhanti B, Blanco R, Mac Grory B, Doheim M, Bhatt D, Fonarow G, Hassan A, Joundi R, Mocco J, Frankel M, Schwamm L. Higher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke. Annals Of Neurology 2023, 95: 146-155. PMID: 37731004, DOI: 10.1002/ana.26803.Peer-Reviewed Original ResearchHigh procedural volumeProcedural volumeEndovascular therapyHospital mortalityPrimary cohortAIS patientsFaster treatment timesAcute ischemic stroke patientsGood discharge outcomeGuidelines-Stroke registryPretreatment National InstitutesHealth Stroke ScaleAcute ischemic strokeIschemic stroke patientsObservational cohort studyHospital procedural volumeLower ratesStroke ScaleCohort studyIschemic strokeArterial punctureDischarge outcomesEndovascular treatmentInterhospital transferStroke patientsRationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial
Xiong Y, Campbell B, Fisher M, Schwamm L, Parsons M, Li H, Pan Y, Meng X, Zhao X, Wang Y. Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial. Stroke And Vascular Neurology 2023, 9: 82-89. PMID: 37247876, PMCID: PMC10956103, DOI: 10.1136/svn-2023-002310.Peer-Reviewed Original ResearchLarge vessel occlusionAnterior circulation large vessel occlusionIschemic strokePerfusion-weighted imagingEfficacy outcomesReperfusion therapyMajor neurological improvementSecondary efficacy outcomesStandard medical therapyHealth Stroke ScalePrimary efficacy outcomeSymptomatic intracerebral hemorrhageRankin Scale scoreTissue-type plasminogen activatorDirect thrombectomyNeurological improvementStroke ScaleAnterior circulationMedical therapyMRS scoreIntracerebral hemorrhageSalvageable tissueVessel occlusionCT perfusionClinical trialsSMS-text messaging for collecting outcome measures after acute stroke
DiCarlo J, Erler K, Petrilli M, Emerson K, Gochyyev P, Schwamm L, Lin D. SMS-text messaging for collecting outcome measures after acute stroke. Frontiers In Digital Health 2023, 5: 1043806. PMID: 36910572, PMCID: PMC9996089, DOI: 10.3389/fdgth.2023.1043806.Peer-Reviewed Original ResearchModified Rankin ScaleAcute strokeOutcomes Measurement Information System (PROMIS) Global-10Acute stroke treatmentText messaging programsNIH Stroke ScaleOutcome data collectionHospitalization dischargeSMS text messagingHospital stayStroke ScaleMRS scoreRankin ScaleStroke treatmentFunctional outcomePROM scoresOutcome measuresWeighted Cohen's kappaPatientsSignificant associationStrokeTraditional followSMS textOutcomesParticipant satisfaction
2022
Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke
Sheriff F, Xu H, Maud A, Gupta V, Vellipuram A, Fonarow G, Matsouaka R, Xian Y, Reeves M, Smith E, Saver J, Rodriguez G, Cruz‐Flores S, Schwamm L. Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke. Journal Of The American Heart Association 2022, 11: e023212. PMID: 35229659, PMCID: PMC9075329, DOI: 10.1161/jaha.121.023212.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeEndovascular therapyEVT useIschemic strokeNon-Hispanic white patientsGuidelines-Stroke databaseHealth Stroke ScaleMortality/dischargeClinical trial publicationsPatient disparitiesDischarge homeEligible patientsNHW patientsStroke ScaleWhite patientsBlack patientsAsian patientsFunctional outcomeLarge cohortTrial publicationsPatientsFunctional independenceEthnic disparitiesRelated outcomesNational Institute
2021
Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-II (TRACE II): rationale and design
Li S, Campbell B, Schwamm L, Fisher M, Parsons M, Li H, Pan Y, Wang Y, . Tenecteplase Reperfusion therapy in Acute ischaemic Cerebrovascular Events-II (TRACE II): rationale and design. Stroke And Vascular Neurology 2021, 7: 71-76. PMID: 34446531, PMCID: PMC8899655, DOI: 10.1136/svn-2021-001074.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeExcellent functional outcomeFunctional outcomeReperfusion therapyRt-PAAcute ischemic cerebrovascular eventsIntravenous thrombolysis therapyMajor neurological improvementSecondary efficacy outcomesHealth Stroke ScaleIschemic cerebrovascular eventsSymptomatic intracranial hemorrhageFavorable functional outcomeIschemic stroke onsetPrimary study outcomeRankin Scale 0Non-inferiority studyTissue-type plasminogen activatorCerebrovascular eventsNeurological improvementStroke ScaleEfficacy outcomesIschemic strokeStroke onsetThrombolysis therapy
2019
Intravenous Tissue Plasminogen Activator in Stroke Mimics
Ali-Ahmed F, Federspiel J, Liang L, Xu H, Sevilis T, Hernandez A, Kosinski A, Prvu Bettger J, Smith E, Bhatt D, Schwamm L, Fonarow G, Peterson E, Xian Y. Intravenous Tissue Plasminogen Activator in Stroke Mimics. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005609. PMID: 31412730, PMCID: PMC6699639, DOI: 10.1161/circoutcomes.119.005609.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdultAgedAged, 80 and overBrain IschemiaDiagnosis, DifferentialFemaleFibrinolytic AgentsHumansIntracranial HemorrhagesMaleMiddle AgedPredictive Value of TestsRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeUnited StatesUnnecessary ProceduresConceptsTransient ischemic attackStroke mimicsIschemic strokeIschemic attackPrior stroke/transient ischemic attackStroke/transient ischemic attackIntravenous tissue plasminogen activatorGuidelines-Stroke registrySymptomatic intracranial hemorrhageCardiovascular risk factorsHealth Stroke ScaleHospital mortality rateAcute ischemic strokeStroke-like symptomsTissue plasminogen activatorUse of tPANonstroke diagnosisThrombolysis safetyIntravenous tPAStroke ScaleComplication rateIntracranial hemorrhagePresumed strokeRisk factorsFunctional disordersAssociation Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice
Jahan R, Saver J, Schwamm L, Fonarow G, Liang L, Matsouaka R, Xian Y, Holmes D, Peterson E, Yavagal D, Smith E. Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. JAMA 2019, 322: 252-263. PMID: 31310296, PMCID: PMC6635908, DOI: 10.1001/jama.2019.8286.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeEndovascular reperfusion therapySymptomatic intracranial hemorrhageLarge vessel occlusionRoutine clinical practiceHospice dischargePuncture timeClinical practiceSubstantial reperfusionIschemic strokeArterial punctureVessel occlusionLarge vessel occlusion acute ischemic strokeMedian pretreatment scoreHealth Stroke ScaleRetrospective cohort studyRandomized clinical trialsHigher likelihoodAssociation of speedAmbulatory statusReperfusion therapyStroke ScaleAdverse eventsCohort studyHospital arrivalDEFUSE 3 Non-DAWN Patients
Leslie-Mazwi T, Hamilton S, Mlynash M, Patel A, Schwamm L, Lansberg M, Marks M, Hirsch J, Albers G. DEFUSE 3 Non-DAWN Patients. Stroke 2019, 50: 618-625. PMID: 30727856, PMCID: PMC6768068, DOI: 10.1161/strokeaha.118.023310.Peer-Reviewed Original ResearchConceptsRankin Scale scoreNIHSS 6DEFUSE 3Functional outcomeInfarct volumeLarger patientsDAWN criteriaScale scoreEmergent large vessel occlusionRankin Scale score 0DEFUSE 3 patientsEffect of thrombectomyHealth Stroke ScaleLarge vessel occlusionBenefit of thrombectomyCore infarct volumeBeneficial treatment effectMethods Eligibility criteriaNIHSS scoreStroke ScaleConclusions PatientsEndovascular therapySymptom onsetDAWN trialVessel occlusion
2018
International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program
Wangqin R, Laskowitz D, Wang Y, Li Z, Wang Y, Liu L, Liang L, Matsouaka R, Saver J, Fonarow G, Bhatt D, Smith E, Schwamm L, Bettger J, Hernandez A, Peterson E, Xian Y. International Comparison of Patient Characteristics and Quality of Care for Ischemic Stroke: Analysis of the China National Stroke Registry and the American Heart Association Get With The Guidelines––Stroke Program. Journal Of The American Heart Association 2018, 7: e010623. PMID: 30371291, PMCID: PMC6474951, DOI: 10.1161/jaha.118.010623.Peer-Reviewed Original ResearchConceptsChina National Stroke RegistryNational Stroke RegistryAcute ischemic strokeStroke RegistryIschemic strokeChinese patientsDeep venous thrombosis prophylaxisHealth Stroke ScaleVenous thrombosis prophylaxisAcute stroke careAdministration of thrombolyticsEvidence-based guidelinesAmerican Heart AssociationQuality of careBackground AdherenceDischarge antithromboticsThrombosis prophylaxisCessation counselingStroke ProgramStroke ScaleClinical characteristicsHospital arrivalNeedle timePatient characteristicsSecondary preventionFactors associated with 1-year mortality after discharge for acute stroke: what matters?
Magdon-Ismail Z, Ledneva T, Sun M, Schwamm L, Sherman B, Qian F, Bettger J, Xian Y, Stein J. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Topics In Stroke Rehabilitation 2018, 25: 576-583. PMID: 30281414, DOI: 10.1080/10749357.2018.1499303.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute strokeDischarge destinationHealth Stroke ScaleHigher National InstitutesRetrospective cohort studyLong-term outcomesLong-term survivalCause mortalityStroke ScaleCohort studyIschemic strokeAmbulation statusIntracerebral hemorrhageMean ageMultivariate regression modelClinical dataNursing facilitiesRehabilitation facilityTherapeutic targetOlder ageMortalityStrokeNational InstituteShock Index Predicts Patient‐Related Clinical Outcomes in Stroke
Myint P, Sheng S, Xian Y, Matsouaka R, Reeves M, Saver J, Bhatt D, Fonarow G, Schwamm L, Smith E. Shock Index Predicts Patient‐Related Clinical Outcomes in Stroke. Journal Of The American Heart Association 2018, 7: e007581. PMID: 30371191, PMCID: PMC6222962, DOI: 10.1161/jaha.117.007581.Peer-Reviewed Original ResearchConceptsShock indexClinical outcomesWorse outcomesPatient-related clinical outcomesHealth Stroke ScaleBlood pressure componentsAcute stroke casesRankin Scale scoreSystolic blood pressureUseful prognostic indicatorMortality prediction modelIndividual stroke subtypesLinear spline modelsHospital mortalityHospital outcomesHospital stayStroke ScaleAcute strokeDischarge destinationBlood pressureStroke subtypesPoint of carePoor outcomePrognostic valueStroke casesDiabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke
Echouffo-Tcheugui J, Xu H, Matsouaka R, Xian Y, Schwamm L, Smith E, Bhatt D, Hernandez A, Heidenreich P, Fonarow G. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. European Heart Journal 2018, 39: 2376-2386. PMID: 29438515, PMCID: PMC6031049, DOI: 10.1093/eurheartj/ehy036.Peer-Reviewed Original ResearchConceptsComposite of mortalityNon-cardiovascular hospitalizationsTransient ischemic attackLong-term outcomesIschemic strokeHeart failureGuidelines-StrokeCause readmissionIS/transient ischemic attackHealth Stroke ScaleInfluence of diabetesRisk of deathOutcomes of interestPaucity of dataIschemic attackMore comorbiditiesTIA recurrenceCardiovascular readmissionCause mortalityHF readmissionStroke ScalePatient's diabetesAdverse outcomesInitial severityReadmission
2017
Ischemic Stroke Profile, Risk Factors, and Outcomes in India
Sylaja P, Pandian J, Kaul S, Srivastava M, Khurana D, Schwamm L, Kesav P, Arora D, Pannu A, Thankachan T, Singhal A. Ischemic Stroke Profile, Risk Factors, and Outcomes in India. Stroke 2017, 49: 219-222. PMID: 29167386, PMCID: PMC5742046, DOI: 10.1161/strokeaha.117.018700.Peer-Reviewed Original ResearchConceptsAdmission National InstitutesHealth Stroke ScaleStroke ScaleIschemic strokeDiabetes mellitusRisk factorsHealth Stroke Scale scoreLower admission National InstitutesMedian admission National InstitutesNational InstituteRankin Scale score 0Stroke etiologic subtypesIntra-arterial thrombolysisStroke Scale scoreAcademic tertiary hospitalCommon risk factorsMagnetic resonance imagingHospital mortalityEtiologic subtypesStroke careStroke ProjectTertiary hospitalAtrial fibrillationStroke guidelinesMean ageImmediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers
Boulouis G, Siddiqui K, Lauer A, Charidimou A, Regenhardt R, Viswanathan A, Leslie-Mazwi T, Rost N, Schwamm L. Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers. Stroke 2017, 48: 2297-2300. PMID: 28687641, DOI: 10.1161/strokeaha.117.017607.Peer-Reviewed Original ResearchConceptsThrombectomy-capable stroke centersEndovascular thrombectomyVascular imagingCurrent guidelinesAlberta Stroke Program Early CT ScoreUnnecessary transfersHealth Stroke ScaleAcute ischemic strokeMain outcome variablesBaseline vascularStroke ScaleIschemic strokeStroke centersCT scoreFutile transfersPatientsEfficient triageHospitalYielded sensitivityOutcome variablesOptimal selection criteriaNational InstituteStrokeImagingOcclusion levelCoexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke
Adams R, Cox M, Ozark S, Kanter J, Schulte P, Xian Y, Fonarow G, Smith E, Schwamm L. Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke. Stroke 2017, 48: 686-691. PMID: 28183857, DOI: 10.1161/strokeaha.116.015412.Peer-Reviewed Original ResearchConceptsSickle cell diseaseAcute ischemic strokeIschemic strokeThrombolytic therapyCell diseaseMultivariable logistic regression modelAdmission National InstitutesGuidelines-Stroke registrySymptomatic intracranial hemorrhageHealth Stroke ScaleIntracranial hemorrhage rateAmerican Stroke AssociationAmerican Heart AssociationNational Heart LungNational InstituteLogistic regression modelsLytic therapyStroke ScaleTPA useBlood pressureDischarge outcomesHemorrhage rateStroke patientsBlood InstituteExchange transfusion
2016
Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients
Erfe B, Siddiqui K, Schwamm L, Mejia N. Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients. Journal Of The American Heart Association 2016, 5: e003782. PMID: 27881425, PMCID: PMC5210419, DOI: 10.1161/jaha.116.003782.Peer-Reviewed Original ResearchConceptsLanguage preferencePatients' language preferenceAcute ischemic stroke patientsNon-English languageIschemic stroke patientsNIH Stroke ScaleAIS patientsDifferent languagesInitial NIH stroke scaleIntravenous thrombolysisPatient languageStroke ScaleStroke patientsLanguageStepwise logistic regression modelInitial stroke severityAmerican Heart AssociationEnglishLogistic regression modelsStroke severityMultivariable analysisPatient receiptHeart AssociationThrombolysisPatientsBaseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis
Ali S, Siddiqui K, Ay H, Silverman S, Singhal A, Viswanathan A, Rost N, Lev M, Schwamm L. Baseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis. Stroke 2016, 47: 2986-2992. PMID: 27834750, DOI: 10.1161/strokeaha.116.014871.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorHealth Stroke ScaleTissue-type plasminogen activatorPoor outcomeIntravenous thrombolysisStroke ScaleMultivariable analysisPlasminogen activatorHigher median National InstitutesConsecutive stroke admissionsCurrent safety profileGuidelines-Stroke databaseInitial National InstitutesMedian National InstitutesThird of patientsVascular risk factorsNational InstituteSkilled nursing facilitiesMultifocal infarctionPoor collateralsStroke admissionsImaging predictorsInpatient rehabilitationSafety profileImaging featuresDistinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics
Romano J, Smith E, Liang L, Gardener H, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Distinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics. Stroke 2016, 47: 1278-1285. PMID: 26987870, DOI: 10.1161/strokeaha.115.011528.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleShort-term outcomesMild strokeHome dischargeIndependent ambulationStroke ScaleHealth Stroke Scale 0National InstituteGuidelines-Stroke registryVascular risk factorsLength of stayHospital mortalityHospital deathIschemic strokeSymptom onsetDischarge outcomesStroke presentationStroke symptomsHospital covariatesAdjusted outcomesRisk factorsWorse outcomesMultivariable modelRetrospective analysisGreater severity
2015
Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals
Reeves M, Smith E, Fonarow G, Zhao X, Thompson M, Peterson E, Schwamm L, Olson D. Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2015, 8: s90-s98. PMID: 26515215, DOI: 10.1161/circoutcomes.115.001775.Peer-Reviewed Original ResearchConceptsGWTG-Stroke hospitalsHealth Stroke ScaleNIHSS scoreDocumentation ratesNIHSS dataStroke ScaleMultivariable logistic regression modelAcute ischemic strokeHospital-level factorsPrimary stroke centerImportant prognostic variablesPatient-level predictorsNational InstituteLogistic regression modelsMedian NIHSSIschemic strokeStroke centersThrombolysis candidatesClinical registryPrognostic variablesNIHSSHospitalPatientsStrokeLow documentationSafety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial
Albers G, von Kummer R, Truelsen T, Jensen J, Ravn G, Grønning B, Chabriat H, Chang K, Davalos A, Ford G, Grotta J, Kaste M, Schwamm L, Shuaib A, Investigators D. Safety and efficacy of desmoteplase given 3–9 h after ischaemic stroke in patients with occlusion or high-grade stenosis in major cerebral arteries (DIAS-3): a double-blind, randomised, placebo-controlled phase 3 trial. The Lancet Neurology 2015, 14: 575-584. PMID: 25937443, DOI: 10.1016/s1474-4422(15)00047-2.Peer-Reviewed Original ResearchConceptsMajor cerebral arteriesHigh-grade stenosisRankin Scale scoreIschemic strokeSymptom onsetCerebral arteryDay 90Scale scorePlacebo-controlled phase 3 trialComputer-generated randomisation listMajor cerebral artery occlusionModified Rankin Scale scoreSymptomatic cerebral edemaSymptomatic intracranial hemorrhageBaseline National InstitutesHealth Stroke ScaleSerious adverse eventsCerebral artery occlusionPhase 3 trialModified Rankin ScaleRandomisation listStroke ScaleStudy drugAdverse eventsArtery occlusion