2024
Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic
Wilcock A, Zubizarreta J, Wadhera R, Yeh R, Zachrison K, Schwamm L, Mehrotra A. Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic. JAMA Cardiology 2024, 9 PMID: 39083317, PMCID: PMC11292572, DOI: 10.1001/jamacardio.2024.2031.Peer-Reviewed Original ResearchHospital encountersAcute myocardial infarctionCare avoidanceShort-term acute careAcute myocardial infarction incidenceAcute myocardial infarction ratesTemporal trendsCOVID-19 pandemicPatient characteristicsTraditional Medicare claimsCross-sectional studyPandemic-related changesAMI incidenceCOVID-19 death ratesAcute careMyocardial infarctionMedicare claimsMain OutcomesExcess deathsExcess mortalityStudy samplePrepandemic levelsTraditional MedicareUnited StatesCOVID-19Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis
Peng T, Schwamm L, Fonarow G, Hassan A, Hill M, Messé S, Coronado F, Falcone G, Sharma R. Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis. JAMA Neurology 2024, 81: 722-731. PMID: 38767894, PMCID: PMC11106713, DOI: 10.1001/jamaneurol.2024.1312.Peer-Reviewed Original ResearchRisk of symptomatic intracerebral hemorrhageSymptomatic intracerebral hemorrhageTreated with IV-tPAAcute ischemic strokeIV-tPAAmerican Heart Association and American Stroke AssociationAssociated with lower oddsIschemic strokeDual antiplatelet therapyAssociated with increased riskPropensity score subclassificationAmerican Stroke AssociationIntracerebral hemorrhage riskGWTG-StrokeSymptomatic intracerebral hemorrhage riskGuidelines-StrokeDischarge modified Rankin Scale scoreIn-hospital deathStroke AssociationLower oddsRate of symptomatic intracerebral hemorrhageAntiplatelet therapyCohort studyAssociated with symptomatic intracerebral hemorrhagePrestrokeTenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial
Xiong Y, Wang L, Pan Y, Wang M, Schwamm L, Duan C, Campbell B, Li S, Hao M, Wu N, Cao Z, Wu S, Li Z, Wang Y. Tenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial. Stroke And Vascular Neurology 2024, svn-2023-003048. PMID: 38858097, DOI: 10.1136/svn-2023-003048.Peer-Reviewed Original ResearchSymptomatic intracranial haemorrhageAcute ischaemic strokeModified Rankin ScaleElderly patientsPost hoc analysisAlteplase groupTenecteplase groupHoc analysisAlternative to alteplaseModified Rankin scale 0Ischaemic strokeRisk-benefit profileNon-inferiority clinical trialBenefit-risk profileEfficacy outcomesProportion of participantsReperfusion therapyIntracranial haemorrhageClinical trialsRankin ScaleSymptom onsetTenecteplaseAlteplaseIntravenous thrombolyticsSafety outcomesMapping 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 3Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom
Witte K, Schwamm L, Bernstein R, Reynolds M, Rose D, Lip G, Ozturk E, Villinger J, Rosemas S, Ziegler P, Yaghi S. Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom. EP Europace 2024, 26: euae102.603. PMCID: PMC11120381, DOI: 10.1093/europace/euae102.603.Peer-Reviewed Original ResearchQuality-adjusted life yearsInsertable cardiac monitorCHA2DS2-VASc scoreContinuous cardiac monitoringStroke eventsAtrial fibrillationCardiac monitoringNational Health Service (NHSBase case incremental cost-effectiveness ratioCHA2DS2-VAScInsertable cardiac monitor implantationDetection of AFHealth-related benefitsRisk of AFUnited KingdomCost-effectiveLarge-arteryRisk of cerebrovascular eventsIschemic strokeWillingness-to-pay thresholdsDetect atrial fibrillationIncremental cost-effectiveness ratioCost-effectiveness analysisProbabilistic sensitivity analysesSmall vessel disease strokeStrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierTwenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges
Reeves M, Fonarow G, Smith E, Sheth K, Messe S, Schwamm L. Twenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges. Stroke 2024, 55: 1689-1698. PMID: 38738376, PMCID: PMC11208062, DOI: 10.1161/strokeaha.124.046527.Peer-Reviewed Original ResearchMP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE
Reynolds M, Pollit V, Schwamm L, Rose D, Witte K, Yahgi S, Cudworth S, Carpenter J, Rosemas S, Ziegler P, Neisen K, Franco N, Margetta J, Pouliot E, Bernstein R. MP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE. Heart Rhythm 2024, 21: s117. DOI: 10.1016/j.hrthm.2024.03.486.Peer-Reviewed Original ResearchTrends 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 ResearchTime to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage
Sheth K, Solomon N, Alhanti B, Messe S, Xian Y, Bhatt D, Hemphill J, Frontera J, Chang R, Danelich I, Huang J, Schwamm L, Smith E, Goldstein J, Mac Grory B, Fonarow G, Saver J. Time to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage. JAMA Neurology 2024, 81: 363-372. PMID: 38335064, PMCID: PMC11002694, DOI: 10.1001/jamaneurol.2024.0221.Peer-Reviewed Original ResearchDoor-to-treatment timeDoor-to-treatmentUS hospitalsQuality improvement registryOnset-to-treatment timeAmerican Heart AssociationFunctional outcomesLogistic regression modelsAssociated with decreased mortalityGuidelines-StrokeIntracerebral hemorrhageHospital characteristicsImprovement registryIntervention statusMain OutcomesAnticoagulation-associated intracerebral hemorrhageSystolic blood pressureInpatient mortalityRandom interceptCohort studyWhite raceSecondary outcomesStroke subtypesStroke severityWorkflow timesTenecteplase 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 onsetOutcomes associated to the time to treatment with intravenous tenecteplase for acute ischaemic stroke: subgroup analysis of the TRACE-2 randomised controlled clinical trial.
Li S, Wangqin R, Pan Y, Jin A, Li H, Schwamm L, Fisher M, Campbell B, Parsons M, Wang Z, Dai H, Li D, Li R, Wang J, Wang D, Wang Y, Zhao X, Li Z, Zheng H, Xiong Y, Meng X, Wang Y. Outcomes associated to the time to treatment with intravenous tenecteplase for acute ischaemic stroke: subgroup analysis of the TRACE-2 randomised controlled clinical trial. Stroke And Vascular Neurology 2024, svn-2023-002694. PMID: 38296586, DOI: 10.1136/svn-2023-002694.Peer-Reviewed Original ResearchOnset to treatment timeAcute ischaemic strokeEfficacy outcomesSubgroup analysisPost hoc subgroup analysisModified Rankin Scale scoreIschaemic strokeExcellent functional outcomeAcute ischaemic stroke patientsBenefit of intravenous alteplasePooled risk differenceRankin Scale scoreSymptomatic intracranial haemorrhageControlled clinical trialsStroke onset to treatment timePost hoc analysisNon-inferiority trialOpen-labelTenecteplase groupIntravenous tenecteplaseNon-inferior to alteplaseProportion of participantsReperfusion therapyIntracranial haemorrhageIntravenous alteplaseCOVID‐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 monitoringSubtypesStroke