2019
The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design
Romano J, Gardener H, Campo-Bustillo I, Khan Y, Riley N, Tai S, Sacco R, Khatri P, Smith E, Schwamm L. The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design. International Journal Of Stroke 2019, 14: 983-986. PMID: 31496438, DOI: 10.1177/1747493019873595.Peer-Reviewed Original ResearchConceptsStroke symptomsStroke Impact Scale-16Actual treatment ratesMild ischemic strokePrimary safety outcomeSymptomatic hemorrhagic transformationProportion of patientsThird of patientsProspective observational studyEffect of alteplaseAcute stroke trialsLong-term outcomesPredictors of outcomeAlteplase treatmentHemorrhagic transformationIschemic strokeRankin ScaleSecondary outcomesBarthel IndexPrimary outcomeResidual disabilityStroke presentationRetrospective studyStroke StudyStroke trialsRelation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack
Bangalore S, Schwamm L, Smith E, Hellkamp A, Xian Y, Schulte P, Saver J, Fonarow G, Bhatt D, Committee and Investigators F. Relation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack. The American Journal Of Cardiology 2019, 123: 1083-1095. PMID: 30685057, DOI: 10.1016/j.amjcard.2018.12.037.Peer-Reviewed Original ResearchConceptsTransient ischemic attackSystolic blood pressureAdmission blood pressureDiastolic blood pressureMean arterial pressureBlood pressureIschemic attackPulse pressureHospital outcomesPostdischarge outcomesArterial pressureLower admission systolic blood pressureAdmission systolic blood pressureHigher admission blood pressureLower systolic blood pressureGuidelines-Stroke registryMajor cardiovascular eventsAdmission systolicPostdischarge mortalityCardiovascular eventsCardiovascular readmissionHospital deathInverse associationHigh riskPatients
2018
Shock 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 casesIsolated Upper Limb Weakness From Ischemic Stroke: Mechanisms and Outcome
Topcuoglu M, Rocha E, Siddiqui A, Mills B, Silva G, Schwamm L, Lamuraglia G, Singhal A. Isolated Upper Limb Weakness From Ischemic Stroke: Mechanisms and Outcome. Journal Of Stroke And Cerebrovascular Diseases 2018, 27: 2712-2719. PMID: 30033098, DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.050.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCarotid StenosisCerebral AngiographyComputed Tomography AngiographyDiffusion Magnetic Resonance ImagingDisability EvaluationEmbolismFemaleHeart DiseasesHumansMagnetic Resonance AngiographyMaleMiddle AgedMotor ActivityMotor CortexMuscle StrengthMuscle WeaknessMuscle, SkeletalPlaque, AtheroscleroticPrognosisRecovery of FunctionRetrospective StudiesRisk FactorsRupture, SpontaneousStrokeUpper ExtremityConceptsCarotid artery stenosisArtery stenosisCarotid stenosisSubcortical white matter infarctsClinical imaging featuresUpper extremity weaknessDiffusion-weighted magnetic resonance imagingUpper limb weaknessRecurrent stroke riskWhite matter infarctsMagnetic resonance imagingCardioembolic mechanismRecurrent strokeBrainstem infarctsExtremity weaknessMultiple infarctsIschemic strokeLimb weaknessStroke riskMotor stripStroke evaluationMean agePlaque ulcerationStroke mechanismInfarcts
2017
Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke
Bangalore S, Schwamm L, Smith E, Hellkamp A, Suter R, Xian Y, Schulte P, Fonarow G, Bhatt D, Committee and Investigators F. Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke. European Heart Journal 2017, 38: 2827-2835. PMID: 28982227, PMCID: PMC5837595, DOI: 10.1093/eurheartj/ehx330.Peer-Reviewed Original ResearchConceptsMean arterial pressureSystolic blood pressureAcute ischemic strokeDiastolic blood pressureBlood pressureIschemic strokeShort-term outcomesHaemorrhagic complicationsThrombolytic therapyPulse pressureHospital outcomesAdmission diastolic blood pressureHigher systolic BP valuesPoor short-term outcomeHigher systolic blood pressureLower systolic blood pressureGuidelines-Stroke registryPost-stroke hypertensionLower blood pressureSystolic BP valuesOutcomes of interestAdmission systolicHospital mortalityHospital deathArterial pressureStroke of Known Cause and Underlying Atrial Fibrillation (STROKE-AF) randomized trial: Design and rationale
Bernstein R, Kamel H, Granger C, Kowal R, Ziegler P, Schwamm L. Stroke of Known Cause and Underlying Atrial Fibrillation (STROKE-AF) randomized trial: Design and rationale. American Heart Journal 2017, 190: 19-24. PMID: 28760209, DOI: 10.1016/j.ahj.2017.04.007.Peer-Reviewed Original ResearchConceptsApparent atrial fibrillationInsertable cardiac monitorSmall vessel diseaseLarge vessel atherosclerosisStandard of careVessel diseaseIschemic strokeAtrial fibrillationPost-market clinical trialArrhythmia monitoringSecondary stroke preventionOral anticoagulation therapyContinuous arrhythmia monitoringAntithrombotic treatmentOral anticoagulationAnticoagulation therapyStroke preventionIntracranial atherosclerosisStroke etiologyClinical trialsIncidence rateCardiac monitorPatientsCardiac monitoringStroke
2016
Baseline 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 featuresSex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage
James M, Cox M, Xian Y, Smith E, Bhatt D, Schulte P, Hernandez A, Fonarow G, Schwamm L. Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage. Journal Of Women's Health 2016, 26: 380-388. PMID: 27754758, DOI: 10.1089/jwh.2016.5849.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageSex-based interactionsTotal study populationWorse neurological deficitsAge/sexSex differencesAntiplatelet therapyHospital mortalityIschemic strokeNeurological deficitsPatient ageIndependent ambulationICH patientsStroke databaseAtrial fibrillationEarly outcomesPoor outcomeStudy populationCholesterol reducersLogistic regressionWomenTreatment differencesAgeMenHemorrhageUse and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age
Arora R, Salamon E, Katz J, Cox M, Saver J, Bhatt D, Fonarow G, Peterson E, Smith E, Schwamm L, Xian Y, Libman R. Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age. Stroke 2016, 47: 2347-2354. PMID: 27491734, DOI: 10.1161/strokeaha.116.012241.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdolescentAdultAge FactorsAgedAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesMaleMiddle AgedPractice Patterns, Physicians'PrognosisRegistriesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorAcute ischemic strokeSymptomatic hemorrhageTPA useIschemic strokeYounger patientsFunctional outcomeQuality improvement registryGood functional outcomeYears of ageYounger age groupsIntravenous thrombolysisHospital mortalityFibrinolytic therapyAcute rehabilitationIndependent ambulationDischarge outcomesMultivariable analysisHospice dischargePatientsAge groupsHemorrhagePlasminogen activatorMortalityPrior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke
Myint P, Hellkamp A, Fonarow G, Reeves M, Schwamm L, Schulte P, Xian Y, Suter R, Bhatt D, Saver J, Peterson E, Smith E. Prior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke. Stroke 2016, 47: 2066-2074. PMID: 27435402, DOI: 10.1161/strokeaha.115.012414.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeAntithrombotic useClinical outcomesVascular indicationsBetter outcomesPrevious antithrombotic therapyUse of antithromboticsMainstay of treatmentRankin Scale scoreImproved clinical outcomesAppropriate patient populationIndependent ambulatory statusGuidelines-StrokeHospital mortalityAmbulatory statusAntithrombotic therapyStroke preventionDischarge destinationHospital factorsSecondary preventionFavorable mortalityStroke patientsAcute eventFunctional outcome
2015
Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack
O'Brien E, Zhao X, Fonarow G, Schulte P, Dai D, Smith E, Schwamm L, Bhatt D, Xian Y, Saver J, Reeves M, Peterson E, Hernandez A. Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack. Circulation Cardiovascular Quality And Outcomes 2015, 8: s117-s124. PMID: 26515199, DOI: 10.1161/circoutcomes.115.002048.Peer-Reviewed Original ResearchConceptsTransient ischemic attackDefect-free careIschemic strokeIschemic stroke riskQuality of careIschemic attackStroke riskCare measuresRisk scoreOverall hospital admission rateRisk score quintilesYear post dischargeLow-risk patientsHospital admission ratesIschemic stroke admissionsPrevious myocardial infarctionAbsence of strokeMedicare inpatient claimsCox proportional hazardsModerate discriminative performanceTIA patientsCause mortalityCessation counselingStroke admissionsBaseline demographicsVariation 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 documentation
2014
Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection
Schaefer P, Pulli B, Copen W, Hirsch J, Leslie-Mazwi T, Schwamm L, Wu O, González R, Yoo A. Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection. American Journal Of Neuroradiology 2014, 36: 259-264. PMID: 25258369, PMCID: PMC4462135, DOI: 10.3174/ajnr.a4103.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainBrain IschemiaCerebral InfarctionDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Patient SelectionPrognosisReperfusionROC CurveSensitivity and SpecificitySeverity of Illness IndexStrokeUnited StatesConceptsPositive predictive valueAcute ischemic strokeLarge patient cohortReperfusion therapyPoor outcomeStroke sidePredictive valueNIHSS scoreIschemic strokeClinical outcomesPatient cohortPrognostic yieldAnterior circulation acute ischemic strokeAcute ischemic stroke patientsImaging thresholdsBeneficial treatment responseDiffusion-perfusion mismatchHigh positive predictive valueIschemic stroke patientsRight-sided strokeLeft-sided strokeUntreated patientsStroke onsetConsecutive patientsPatient selectionPatterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease
Ovbiagele B, Schwamm L, Smith E, Grau‐Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Patterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease. Journal Of The American Heart Association 2014, 3: e000905. PMID: 24904017, PMCID: PMC4309090, DOI: 10.1161/jaha.114.000905.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseIschemic stroke patientsSevere renal dysfunctionGlomerular filtration rateStroke patientsRenal dysfunctionQuality of careKidney diseaseHospitalized ischemic stroke patientsGuideline-based therapyGuideline-recommended therapiesGuidelines-Stroke programGWTG-Stroke programStroke performance measuresHospital mortality rateNormal kidney functionHospital mortalityHospital prognosisInpatient mortalityIschemic strokeCare complianceKidney functionModerate dysfunctionKidney failureFiltration rate
2013
Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry
Hsich E, Grau-Sepulveda M, Hernandez A, Eapen Z, Xian Y, Schwamm L, Bhatt D, Fonarow G. Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry. American Heart Journal 2013, 166: 1063-1071.e3. PMID: 24268222, DOI: 10.1016/j.ahj.2013.08.029.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptide levelsMedian BNP levelNatriuretic peptide levelsEjection fractionInhospital mortalityHeart failureBNP levelsHF patientsPeptide levelsPlasma B-type natriuretic peptide (BNP) levelsGuidelines-Heart Failure registryGuidelines-Heart FailurePrimary end pointInhospital outcomesBNP valuesHospital clusteringPrognostic significanceClinical variablesLarge registriesOdds ratioPatientsBNPHigh mortalityEnd pointMortalityRisk-Standardizing Survival for In-Hospital Cardiac Arrest to Facilitate Hospital Comparisons
Chan P, Berg R, Spertus J, Schwamm L, Bhatt D, Fonarow G, Heidenreich P, Nallamothu B, Tang F, Merchant R, Investigators A. Risk-Standardizing Survival for In-Hospital Cardiac Arrest to Facilitate Hospital Comparisons. Journal Of The American College Of Cardiology 2013, 62: 601-609. PMID: 23770167, PMCID: PMC3769937, DOI: 10.1016/j.jacc.2013.05.051.Peer-Reviewed Original Research
2012
Age and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction
Bangalore S, Fonarow G, Peterson E, Hellkamp A, Hernandez A, Laskey W, Peacock W, Cannon C, Schwamm L, Bhatt D, Committee and Investigators G. Age and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction. The American Journal Of Medicine 2012, 125: 1000-1009. PMID: 22748404, DOI: 10.1016/j.amjmed.2011.11.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overCohort StudiesFemaleGuideline AdherenceHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicPrognosisQuality Indicators, Health CareRegistriesRisk FactorsSex FactorsUnited StatesConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careYounger patientsMyocardial infarctionHospital outcomesOlder patientsST-segment elevation myocardial infarction casesGuidelines-Coronary Artery Disease registryTraditional cardiovascular risk factorsCoronary Artery Disease registryCardiovascular risk factorsAmerican Heart AssociationMyocardial infarction casesOlder counterpartsYounger cohortsTime trend analysisHospital mortalityHospital deathHeart AssociationRisk factorsWorse outcomesInfarction casesThrombolytic timeDisease RegistryCare and Outcomes of Hispanic Patients Admitted With Heart Failure With Preserved or Reduced Ejection Fraction
Vivo R, Krim S, Krim N, Zhao X, Hernandez A, Peterson E, Piña I, Bhatt D, Schwamm L, Fonarow G. Care and Outcomes of Hispanic Patients Admitted With Heart Failure With Preserved or Reduced Ejection Fraction. Circulation Heart Failure 2012, 5: 167-175. PMID: 22414939, DOI: 10.1161/circheartfailure.111.963546.Peer-Reviewed Original ResearchConceptsNon-Hispanic whitesEjection fractionHeart failureQuality of careHF patientsNon-Hispanic white patientsLeft ventricular ejection fractionGuidelines-Heart FailureVentricular ejection fractionOverweight/obesityLower mortality riskPercent of HispanicsHospital survivalInpatient mortalityWhite patientsHispanic patientsHispanic ethnicityMortality riskHigh riskEquitable carePerformance improvement programMultivariate analysisPatientsStudy periodCare
2011
Prediction of Early Stroke Risk in Transient Symptoms With Infarction
Arsava E, Furie K, Schwamm L, Sorensen A, Ay H. Prediction of Early Stroke Risk in Transient Symptoms With Infarction. Stroke 2011, 42: 2186-2190. PMID: 21680907, PMCID: PMC3144273, DOI: 10.1161/strokeaha.110.604280.Peer-Reviewed Original ResearchConceptsTransient ischemic attackReceiver-operating characteristic curveIschemic attackStroke riskTransient symptomsDiffusion-weighted imagesStroke prevention strategiesHigh-risk patientsRisk of strokeEarly stroke riskCharacteristic curveNew infarctionRecurrent strokeClinical deteriorationConsecutive patientsIschemic strokeSymptom onsetIndex lesionRetrospective seriesPrevention strategiesPatientsEarly interventionInfarctionStrokeSubsequent stroke
2010
Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield