2024
Mapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study
Dhand A, Reeves M, Mu Y, Rosner B, Rothfeld-Wehrwein Z, Nieves A, Dhongade V, Jarman M, Bergmark R, Semco R, Ader J, Marshall B, Goedel W, Fonarow G, Smith E, Saver J, Schwamm L, Sheth K. Mapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study. Stroke 2024, 55: 1507-1516. PMID: 38787926, PMCID: PMC11299104, DOI: 10.1161/strokeaha.123.045521.Peer-Reviewed Original ResearchConceptsSocial Vulnerability IndexPrehospital delayHospital arrivalZIP Code Tabulation AreasEmergency medical servicesCommunity-level social vulnerabilityGuidelines-Stroke registryCommunity socioeconomic statusCommunity-level factorsPatient-level factorsNationwide registry studyAmerican Heart AssociationSocial vulnerabilityCox proportional hazards modelsSocially vulnerable areasAssociated with delaySocial determinantsProportional hazards modelAcute stroke treatmentGeospatial mappingSocioeconomic statusMedical servicesIncreased social vulnerabilityPrimary exposureQuartile 3Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021.
Skajaa N, Laugesen K, Lauffenburger J, Schwamm L, Sørensen H, Patorno E. Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021. Neurology 2024, 102: e209309. PMID: 38648572, PMCID: PMC11226314, DOI: 10.1212/wnl.0000000000209309.Peer-Reviewed Original ResearchConceptsMedication useOral anticoagulant medicationsGlucose-lowering medication useFactors associated with medication useLipid-lowering medication useSevere strokeIschemic stroke hospitalizationsAntihypertensive medication useAnticoagulant medicationOlder patientsCare of patientsSodium-glucose cotransporter-2 inhibitorsGlucagon-like peptide-1 receptor agonistsStroke preventionAnticoagulant medication useLipid-loweringPeptide-1 receptor agonistsGlucose-loweringReduced life expectancyIschemic strokeCotransporter-2 inhibitorsStroke careCohort of patientsStroke hospitalizationsSecondary ischemic stroke preventionAssociation of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study
Leppert M, Poisson S, Scarbro S, Suresh K, Lisabeth L, Putaala J, Schwamm L, Daugherty S, Bradley C, Burke J, Ho P. Association of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study. Circulation Cardiovascular Quality And Outcomes 2024, 17: e010307. PMID: 38529631, PMCID: PMC11021148, DOI: 10.1161/circoutcomes.123.010307.Peer-Reviewed Original ResearchConceptsTraditional risk factorsDevelopment of strokeNontraditional risk factorsCase-control studyRisk factorsRetrospective case-control studyAge groupsContribution of traditional risk factorsYoung adultsConditional logistic regression modelsPopulation attributable riskCount of risk factorsStroke-free controlsAll Payer Claims DatabaseAssociation of strokeColorado All Payer Claims DatabaseLogistic regression modelsPayer Claims DatabaseIncreased risk of strokeAttributable riskRisk of strokeStroke eventsYears of ageInsurance typeIncreased riskThrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis
Kamogawa N, Miwa K, Toyoda K, Jensen M, Inoue M, Yoshimura S, Fukuda-Doi M, Kitazono T, Boutitie F, Ma H, Ringleb P, Wu O, Schwamm L, Warach S, Hacke W, Davis S, Donnan G, Gerloff C, Thomalla G, Koga M, Investigators O. Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis. Stroke 2024, 55: 895-904. PMID: 38456303, PMCID: PMC10978262, DOI: 10.1161/strokeaha.123.043358.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageIntracranial hemorrhageIntravenous thrombolysisFavorable outcomeUnwitnessed strokeNon-WUSFrequency of favorable outcomesIndividual patient-data meta-analysisMultivariate logistic regression analysisModified Rankin Scale scoreSafety of intravenous thrombolysisRankin Scale scoreEffect of intravenous thrombolysisIntravenous thrombolysis groupLogistic regression analysisUnknown-onset strokeRandomized controlled trialsNo significant differencePatient-level dataData meta-analysisStandard treatmentInsufficient statistical powerPatientsSafety outcomesControlled trialsReimagining Stroke Quality of Care in the Age of Artificial Intelligence and Digital Enablement
Schwamm L. Reimagining Stroke Quality of Care in the Age of Artificial Intelligence and Digital Enablement. Stroke 2024, 55: 1683-1685. PMID: 38380550, DOI: 10.1161/strokeaha.123.044251.Peer-Reviewed Original ResearchTenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection
Albers G, Jumaa M, Purdon B, Zaidi S, Streib C, Shuaib A, Sangha N, Kim M, Froehler M, Schwartz N, Clark W, Kircher C, Yang M, Massaro L, Lu X, Rippon G, Broderick J, Butcher K, Lansberg M, Liebeskind D, Nouh A, Schwamm L, Campbell B. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. New England Journal Of Medicine 2024, 390: 701-711. PMID: 38329148, DOI: 10.1056/nejmoa2310392.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSymptomatic intracranial hemorrhageInternal carotid arteryMiddle cerebral arteryRankin ScalePlacebo groupTenecteplase groupIntracranial hemorrhageIncidence of symptomatic intracranial hemorrhageCerebral arteryIncidence of symptomatic intracerebral hemorrhageCarotid arteryPlacebo-controlled trialSymptomatic intracerebral hemorrhageEvidence of occlusionSafety populationDouble-blindPerfusion-imagingMedian timeClinical outcomesIntracerebral hemorrhagePlaceboPerfusion imagingPrimary outcomeOdds ratioTrends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021
Man S, Solomon N, Mac Grory B, Alhanti B, Saver J, Smith E, Xian Y, Bhatt D, Schwamm L, Uchino K, Fonarow G. Trends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021. JAMA Network Open 2024, 7: e2352927. PMID: 38324315, PMCID: PMC10851100, DOI: 10.1001/jamanetworkopen.2023.52927.Peer-Reviewed Original ResearchConceptsDoor-to-needleDoor-to-needle timeHispanic patientsWhite patientsAssociated with improvementsThrombolysis rateCohort studyEthnic groupsQuality InitiativeCohort study of patientsCare qualityCare metricsPre-testIschemic strokeEthnic disparitiesRetrospective cohort studyMain OutcomesPatient functionIschemic stroke onsetSecondary outcomesPrimary outcomeStudy of patientsOddsAcute ischemic strokeStroke onsetCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatientsCritical Domains Within the Self-Reported Patient Experience of Virtual Care
Zachrison K, Yan Z, Cui Y, Park L, Schwamm L. Critical Domains Within the Self-Reported Patient Experience of Virtual Care. JAMA Network Open 2024, 7: e2354159. PMID: 38294816, PMCID: PMC10831569, DOI: 10.1001/jamanetworkopen.2023.54159.Peer-Reviewed Original ResearchDigital Health for Oncological Care
Cohen A, Schwamm L. Digital Health for Oncological Care. The Cancer Journal 2024, 30: 34-39. PMID: 38265925, DOI: 10.1097/ppo.0000000000000693.Peer-Reviewed Original ResearchConceptsDigital health toolsHealth care systemMental health solutionsDigital biomarkersRemote patient monitoringOncology careCancer screeningHealth continuumCare systemHealth toolsHealth solutionsDigital healthDigital therapeuticsCareHealthTelemedicinePatient monitoringPreventionRecommendationsOncologyDiagnosisOutcomesScreening
2023
Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry
Mullen M, Gurol M, Prabhakaran S, Messé S, Kleindorfer D, Smith E, Fonarow G, Xu H, Zhao X, Cigarroa J, Schwamm L. Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry. Journal Of The American Heart Association 2023, 12: e031303. PMID: 38108258, PMCID: PMC10863791, DOI: 10.1161/jaha.123.031303.Peer-Reviewed Original ResearchConceptsHospital-level variabilityDiagnostic evaluationIschemic strokeDiagnostic testingStroke pathogenesisCryptogenic strokeSecondary preventionEtiologic subtypesRisk factorsLarge nationwide registryIschemic stroke subtypesLong-term cardiac rhythm monitoringCardiac rhythm monitoringAdequate diagnostic evaluationIntracranial vascular imagingEvidence-based interventionsNationwide registryStroke subtypesIS subtypesDocumentation ratesRhythm monitoringPatientsCardiac monitoringSubtypesStrokeAntithrombotic and Statin Prescription After Intracerebral Hemorrhage in the Get With The Guidelines-Stroke Registry
Murthy S, Zhang C, Shah S, Schwamm L, Fonarow G, Smith E, Bhatt D, Ziai W, Kamel H, Sheth K. Antithrombotic and Statin Prescription After Intracerebral Hemorrhage in the Get With The Guidelines-Stroke Registry. Stroke 2023, 54: 2972-2980. PMID: 37942641, PMCID: PMC10842167, DOI: 10.1161/strokeaha.123.043194.Peer-Reviewed Original ResearchConceptsIschemic vascular diseaseProportion of patientsGuidelines-Stroke registryLipid-lowering therapyIntracerebral hemorrhageVascular diseaseStatin therapyAnticoagulation therapyCardiovascular eventsAtrial fibrillationFuture major cardiovascular eventsLower admission National InstitutesPrevious lipid-lowering therapyAdmission National InstitutesFavorable discharge outcomeIschemic cardiovascular eventsHealth Stroke ScaleMajor cardiovascular eventsLipid-lowering medicationsCross-sectional studyMultiple logistic regressionLogistic regression analysisAntiplatelet medicationsAntiplatelet therapyStatin medicationEffects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients With Hypertension : An Observational Study.
Tang M, Nakamoto C, Stern A, Zubizarreta J, Marcondes F, Uscher-Pines L, Schwamm L, Mehrotra A. Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients With Hypertension : An Observational Study. Annals Of Internal Medicine 2023, 176: 1465-1475. PMID: 37931262, DOI: 10.7326/m23-1182.Peer-Reviewed Original ResearchConceptsObservational studyCare outcomesRemote patient monitoringAcute care encountersHypertension medication usePhysician outpatient visitsAcute care useChronic disease managementReceipt of careBlood pressure dataHypertension careUnique medicationsMedication usePrimary outcomeOutpatient visitsResidual confoundingCare useMedication fillsDays' supplyMedicare patientsCare encountersControl practicesHypertensionPatientsImaging useMost Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop
Wechsler L, Adeoye O, Alemseged F, Bahr-Hosseini M, Deljkich E, Favilla C, Fisher M, Grotta J, Hill M, Kamel H, Khatri P, Lyden P, Mirza M, Nguyen T, Samaniego E, Schwamm L, Selim M, Silva G, Yavagal D, Yenari M, Zachrison K, Boltze J, Yaghi S, Roundtable O. Most Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop. Stroke 2023, 54: 3202-3213. PMID: 37886850, DOI: 10.1161/strokeaha.123.044279.Peer-Reviewed Original ResearchPerformance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry
Raychev R, Sun J, Schwamm L, Smith E, Fonarow G, Messé S, Xian Y, Chiswell K, Blanco R, Mac Grory B, Saver J. Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry. Circulation 2023, 148: 2019-2028. PMID: 37855118, DOI: 10.1161/circulationaha.123.066114.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerThrombectomy-capable stroke centersAcute ischemic strokeGuidelines-Stroke registryEndovascular thrombectomyStroke centersReperfusion therapyIschemic strokeClinical outcomesHealth Stroke Scale scoreClinical efficacy outcomesStroke Scale scoreHigher National InstitutesOdds of dischargeGoal doorEVT proceduresHospital mortalityIntravenous thrombolysisEfficacy outcomesSuccessful reperfusionCohort studyDischarge destinationNeedle timePuncture timeInsurance-Based Disparities in Stroke Center Access in California: A Network Science Approach
Zachrison K, Hsia R, Schwamm L, Yan Z, Samuels-Kalow M, Reeves M, Camargo C, Onnela J. Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009868. PMID: 37746725, PMCID: PMC10592016, DOI: 10.1161/circoutcomes.122.009868.Peer-Reviewed Original ResearchConceptsInsurance-based disparitiesStroke centersEmergency departmentHospital clustersInitial emergency departmentIschemic stroke admissionsHospital emergency departmentClusters of hospitalsLogistic regression modelsStroke admissionsUninsured patientsPatient insuranceLower oddsPatientsLess strokeCenter accessOddsCenter transferHospitalLikelihood of transferInsurance groupsRegression modelsLower proportionDepartmentAssociationRecent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke
Mac Grory B, Holmes D, Matsouaka R, Shah S, Chang C, Rison R, Jindal J, Holmstedt C, Logan W, Corral C, Mackey J, Gee J, Bonovich D, Walker J, Gropen T, Benesch C, Dissin J, Pandey H, Wang D, Unverdorben M, Hernandez A, Reeves M, Smith E, Schwamm L, Bhatt D, Saver J, Fonarow G, Peterson E, Xian Y. Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke. JAMA 2023, 329: 2038-2049. PMID: 37338878, PMCID: PMC10282891, DOI: 10.1001/jama.2023.8073.Peer-Reviewed Original ResearchConceptsRisk of sICHSymptomatic intracranial hemorrhageVitamin K antagonistsAcute ischemic strokeSecondary end pointsEndovascular thrombectomyVKA useIschemic strokeHospital mortalityEnd pointIntracranial hemorrhageOral vitamin K antagonistsVitamin K antagonist useGuidelines-Stroke programPrior VKA usePrimary end pointObservational cohort studyLarge vessel occlusionRisk of complicationsAmerican Heart AssociationUse of anticoagulantsSignificant differencesHospital presentationSICH riskAntagonist useOutcomes of recurrent stroke in patients with atrial fibrillation according to presumed etiology
Pedreira B, Zachrison K, Singhal A, Yan Z, Oliveira-Filho J, Schwamm L. Outcomes of recurrent stroke in patients with atrial fibrillation according to presumed etiology. Arquivos De Neuro-Psiquiatria 2023, 81: 616-623. PMID: 37336506, PMCID: PMC10371407, DOI: 10.1055/s-0043-1769124.Peer-Reviewed Original ResearchConceptsUndetermined stroke etiologyAtrial fibrillationRecurrent strokeStroke etiologyAF patientsFavorable outcomeAcademic comprehensive stroke centerHealth Stroke Scale scoreMedian National InstitutesSingle-center sampleComprehensive stroke centerRecurrent ischemic strokeStroke Scale scoreHistory of strokePotent risk factorDifferent treatment strategiesHospital mortalitySecondary prophylaxisReperfusion therapyCardioembolic strokeIschemic strokeStroke centersDischarge outcomesRisk factorsTreatment strategiesMechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds
Das A, Gokcal E, Biffi A, Regenhardt R, Pasi M, Abramovitz Fouks A, Viswanathan A, Goldstein J, Schwamm L, Rosand J, Greenberg S, Gurol M. Mechanistic Implications of Cortical Superficial Siderosis in Patients With Mixed Location Intracerebral Hemorrhage and Cerebral Microbleeds. Neurology 2023, 101: e636-e644. PMID: 37290968, PMCID: PMC10424843, DOI: 10.1212/wnl.0000000000207476.Peer-Reviewed Original ResearchConceptsCortical superficial siderosisCerebral microbleedsSuperficial siderosisIntracerebral hemorrhageHypertensive end-organ damagePresence of CMBsCerebral small vessel diseaseAdjusted hazard ratioEnd-organ damageCoronary artery diseaseDeep cerebral microbleedsSmall vessel diseaseImaging-based classificationLogistic regression modelsICH survivorsProspective databaseHazard ratioReferral centerArtery diseaseConsecutive patientsVentricular hypertrophyVessel diseaseICH recurrenceWarrant confirmationICH riskDistinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke
Lin D, Hardstone R, DiCarlo J, Mckiernan S, Snider S, Jacobs H, Erler K, Rishe K, Boyne P, Goldsmith J, Ranford J, Finklestein S, Schwamm L, Hochberg L, Cramer S. Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke. Neurology 2023, 101: e347-e357. PMID: 37268437, PMCID: PMC10435065, DOI: 10.1212/wnl.0000000000207417.Peer-Reviewed Original ResearchConceptsDistal motor controlUpper extremity motor deficitsAcute strokeBarthel IndexMotor deficitsMotor controlAcute stroke patientsUpper extremity hemiparesisUpper extremity motor controlRegion of injuryLesion-symptom mappingMotor systemHealthy CNSDays poststrokeDistal injuriesRankin ScaleStroke onsetConsecutive patientsStroke patientsMotor scoresClinical syndromeFunctional outcomeIntact CNSPosterior aspectPrecentral gyrus