2024
Primary Prevention of Stroke: Identifying High-Risk Patients
Kaslow J, Kernan W. Primary Prevention of Stroke: Identifying High-Risk Patients. 2024, 431-443. DOI: 10.1007/978-3-031-66289-8_36.Peer-Reviewed Original ResearchRisk factorsPrimary careHealthy behaviorsPatient-centeredCoronary artery diseaseRisk of strokeChronic diseasesPreventable deathsMedical practicePublic healthUnhealthy onesIncreased riskRisk reductionHigh riskHigh-risk patientsStrokeRiskArtery diseaseCareHealthDisabilityPatientsMedicationFactorsGuidelinesSecondary 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
Separate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics
Hassan S, Viscoli C, O’Connor P, Dugdale L, Sofair A, Fitz M, Richards B, Feiereisel K, Lee S, Ost S, Swails J, Fishman M, Kernan W. Separate But Not Equal? A Cross-Sectional Study of Segregation by Payor Mix in Academic Primary Care Clinics. Journal Of General Internal Medicine 2023, 38: 2318-2325. PMID: 36800147, PMCID: PMC10406732, DOI: 10.1007/s11606-023-08066-x.Peer-Reviewed Original ResearchConceptsProportion of patientsUS academic health centersPrimary care clinicsAcademic health centersCare clinicsLongitudinal carePrimary care internal medicine clinicsAcademic primary care clinicPre-specified secondary analysisInternal medicine clinicCross-sectional studyMore patientsMedicaid insuranceMedicine clinicHealth centersSeparate clinicsPatientsClinicResultsThirty-nineSecondary analysisClinic directorsPayor mixResident physiciansMedicaidNIH funding
2022
Caring for Patients With Diabetes in Stroke Neurology
Kernan W, Forman R, Inzucchi S. Caring for Patients With Diabetes in Stroke Neurology. Stroke 2022, 54: 894-904. PMID: 36541212, DOI: 10.1161/strokeaha.122.038163.Peer-Reviewed Original ResearchConceptsCerebral small vessel diseaseCoronary heart diseaseSmall vessel diseaseConsequence of diabetesNeurology cliniciansStroke neurologyPeripheral neuropathyRoutine careVessel diseaseHeart diseaseHeterogeneous diseasePerson's riskDiabetesDiseasePatientsBrainRiskHarmful effectsNephropathyNeuropathyMajor contributorRetinopathyWorld populationNeurologistsDementiaTechnical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly.
Forman R, Viscoli C, Meurer K, Sheth K, Sansing L, de Havenon A, Sharma R, Mariscal M, Kernan W. Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly. American Journal Of Hypertension 2022, 36: 195-200. PMID: 36520024, PMCID: PMC10016067, DOI: 10.1093/ajh/hpac129.Peer-Reviewed Original ResearchConceptsHome blood pressure monitoringBlood pressure monitoringBlood pressurePressure monitoringNon-Hispanic white patientsProportion of patientsCross-sectional studyNon-Hispanic white participantsStroke recurrenceRate of useMost patientsPrimary outcomeWhite patientsRate of possessionPatientsUnderrepresented patientsArm cuffHypertensionStrokeCorrect useWhite participantsSignificant disparitiesEthnic groupsParticipantsQuality of technique
2019
Achievement of Guideline-Recommended Weight Loss Among Patients With Ischemic Stroke and Obesity
Dearborn JL, Viscoli CM, Young LH, Gorman MJ, Furie KL, Kernan WN. Achievement of Guideline-Recommended Weight Loss Among Patients With Ischemic Stroke and Obesity. Stroke 2019, 50: 713-717. PMID: 30786849, PMCID: PMC6391736, DOI: 10.1161/strokeaha.118.024008.Peer-Reviewed Original ResearchConceptsTransient ischemic attackBody mass indexProportion of patientsIschemic strokeMass indexVascular eventsBaseline weightWeight lossAchievement of guidelineDays of randomizationRecent ischemic strokeAcute ischemic strokeFuture vascular eventsIschemic attackPlacebo groupObese patientsDiabetes mellitusMedian ageTrial entryIRIS trialMedian timeFunctional outcomeInsulin resistanceClinical trialsPatients
2017
Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial
Furie KL, Viscoli CM, Gorman M, Ford GA, Young LH, Inzucchi SE, Guarino PD, Lovejoy AM, Conwit R, Tanne D, Kernan WN. Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial. Journal Of Neurology Neurosurgery & Psychiatry 2017, 89: 21. PMID: 28939682, DOI: 10.1136/jnnp-2017-316361.Peer-Reviewed Original ResearchConceptsTransient ischemic attackRecent ischemic strokeIschemic strokeCognitive functionHomeostasis model assessment insulin resistance scoreModified Mini-Mental State Examination scoresAssessment-insulin resistance scoreMini-Mental State Examination scoreInsulin Resistance InterventionPoststroke cognitive functionVascular risk factorsEffect of pioglitazoneInsulin-resistant patientsState Examination scoreIschemic attackPioglitazone groupPlacebo groupIRIS trialStroke trialsCerebrovascular diseaseInsulin resistanceRisk factorsCognitive dysfunctionPatientsResistance Intervention
2016
Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial
Viscoli CM, Inzucchi SE, Young LH, Insogna KL, Conwit R, Furie KL, Gorman M, Kelly MA, Lovejoy AM, Kernan WN, Investigators F. Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial. The Journal Of Clinical Endocrinology & Metabolism 2016, 102: 914-922. PMID: 27935736, PMCID: PMC5460686, DOI: 10.1210/jc.2016-3237.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeFracture riskBone fracturesRisk/benefit ratioAbsolute fracture riskInsulin Resistance InterventionPlacebo-treated patientsIschemic attackNondiabetic patientsPlacebo groupCardiovascular riskBone healthStroke trialsNondiabetic participantsPrevent fallsClinical trialsRelative riskSafety dataFracture classificationQuarterly interviewsPioglitazonePatientsResistance InterventionRisk increment
2011
Boosting enrolment in clinical trials: validation of a regional network model
Kernan W, Viscoli C, Brass L, Amatangelo M, Birch A, Clark W, Conwit R, Furie K, Gorman M, Pesapane B, Kleindorfer D, Lovejoy A, Osborne J, Silliman S, Zweifler R, Horwitz R. Boosting enrolment in clinical trials: validation of a regional network model. Clinical Trials 2011, 8: 645-653. PMID: 21824978, PMCID: PMC3852692, DOI: 10.1177/1740774511414925.Peer-Reviewed Original ResearchConceptsClinical trialsTransient ischemic attackNames of patientsEligible patientsIschemic attackStroke preventionDrug adherenceStroke therapyActive surveillanceAverage monthly rateHome visitsPatientsHospitalTrial researchParticipant costsOutreach NetworkMultiple hospitalsTrialsStudy intervalNational InstituteEnrollmentMonthly rateStrokeParticipantsReproducible method
2009
Boosting enrollment in neurology trials with Local Identification and Outreach Networks (LIONs)
Kernan WN, Viscoli CM, DeMarco D, Mendes B, Shrauger K, Schindler JL, McVeety JC, Sicklick A, Moalli D, Greco P, Bravata DM, Eisen S, Resor L, Sena K, Story D, Brass LM, Furie KL, Gutmann L, Hinnau E, Gorman M, Lovejoy AM, Inzucchi SE, Young LH, Horwitz RI. Boosting enrollment in neurology trials with Local Identification and Outreach Networks (LIONs). Neurology 2009, 72: 1345-1351. PMID: 19365056, PMCID: PMC2677492, DOI: 10.1212/wnl.0b013e3181a0fda3.Peer-Reviewed Original ResearchConceptsOutreach NetworkCentral coordinating centerInsulin Resistance InterventionSecondary stroke preventionNames of patientsResults of surveillanceStroke preventionMore patientsStroke siteConnecticut hospitalsTrial participantsHome visitsPatientsResistance InterventionPersonal physicianElectronic admissionRandomization ratesCoordinating CenterMore rapid completionMonthsHigher enrollment ratesHospitalRecruitment strategiesTrialsParticipants
2005
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive Sleep Apnea as a Risk Factor for Stroke and Death. New England Journal Of Medicine 2005, 353: 2034-2041. PMID: 16282178, DOI: 10.1056/nejmoa043104.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeSleep apnea syndromeApnea-hypopnea indexMean apnea-hypopnea indexRisk of strokeApnea syndromeRisk factorsSleep apneaComposite end pointObservational cohort studyObstructive sleep apneaProportional hazards analysisComparison groupAlcohol consumption statusBody mass indexImportant risk factorCohort studyComposite outcomeConsecutive patientsDiabetes mellitusSmoking statusAtrial fibrillationUnadjusted analysesSyndromePatients
2003
Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke. Neurology 2003, 60: 1447-1451. PMID: 12743229, DOI: 10.1212/01.wnl.0000063318.66140.a3.Peer-Reviewed Original ResearchConceptsImpaired insulin sensitivityIschemic strokeInsulin sensitivityRecent TIANondiabetic patientsMyocardial infarctionComposite insulin sensitivity indexInsulin sensitivity index valuesOral glucose tolerance testAge 45 yearsGlucose tolerance testInsulin sensitivity indexImportant therapeutic implicationsEligible patientsNondiabetic menStroke etiologyEligible subjectsMedian ageYounger patientsTolerance testHeart diseaseTherapeutic implicationsPatientsGlucose valuesStrokePioglitazone Improves Insulin Sensitivity Among Nondiabetic Patients With a Recent Transient Ischemic Attack or Ischemic Stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Pioglitazone Improves Insulin Sensitivity Among Nondiabetic Patients With a Recent Transient Ischemic Attack or Ischemic Stroke. Stroke 2003, 34: 1431-1436. PMID: 12730556, DOI: 10.1161/01.str.0000071108.00234.0e.Peer-Reviewed Original ResearchConceptsRecent transient ischemic attackTransient ischemic attackGlucose tolerance testOral glucose tolerance testHistory of diabetesInsulin sensitivityTolerance testIschemic attackNondiabetic patientsEligible subjectsIschemic strokeMean C-reactive protein concentrationC-reactive protein concentrationsEffectiveness of pioglitazoneMonths of therapyGlucose blood levelsYears of ageMean proportional increaseIndex eventBlood levelsPatientsPlaceboPioglitazoneStrokeDiabetes
2001
A Quality-of-Life Instrument for Young Hemorrhagic Stroke Patients
Hamedani A, Wells C, Brass L, Kernan W, Viscoli C, Maraire J, Awad I, Horwitz R. A Quality-of-Life Instrument for Young Hemorrhagic Stroke Patients. Stroke 2001, 32: 687-695. PMID: 11239188, DOI: 10.1161/01.str.32.3.687.Peer-Reviewed Original ResearchConceptsOutcome measuresHemorrhagic strokeQuality of lifeValid QOL instrumentHemorrhagic stroke patientsHemorrhagic stroke survivorsAvailable outcome measuresDistinct subject groupsYounger patientsStroke patientsPatient interviewsNeurological impairmentStroke survivorsMotor functionQOL instrumentsLife instrumentsMortality ratePatient's lifeHigh initial mortality rateStrokePatientsCeiling effectsSubject groupsInitial mortality rateInternal consistency
2000
Phenylpropanolamine and the Risk of Hemorrhagic Stroke
Kernan W, Viscoli C, Brass L, Broderick J, Brott T, Feldmann E, Morgenstern L, Wilterdink J, Horwitz R. Phenylpropanolamine and the Risk of Hemorrhagic Stroke. New England Journal Of Medicine 2000, 343: 1826-1832. PMID: 11117973, DOI: 10.1056/nejm200012213432501.Peer-Reviewed Original ResearchConceptsUse of coughHemorrhagic strokeAppetite suppressantsCold remediesControl subjectsOdds ratioIndependent risk factorCase-control studyYears of ageRandom digit dialingIntracerebral hemorrhageCase reportRisk factorsBrain lesionsWomen 18CoughEligibility criteriaStrokeU.S. hospitalsPhenylpropanolamineWomenPatientsMenRiskAssociationBlood Pressure Exceeding National Guidelines Among Women After Stroke
Kernan W, Viscoli C, Brass L, Makuch R, Sarrel P, Horwitz R. Blood Pressure Exceeding National Guidelines Among Women After Stroke. Stroke 2000, 31: 415-419. PMID: 10657415, DOI: 10.1161/01.str.31.2.415.Peer-Reviewed Original ResearchConceptsHistory of hypertensionBlood pressure valuesNational guidelinesBlood pressureFirst examinationTrial of estrogenSecondary stroke preventionTransient ischemic attackBlood pressure controlTreatment of hypertensionProportion of womenIschemic attackSevere hypertensionStroke preventionSecondary preventionDiabetic patientsMean ageHypertensionPatientsPressure valuesPersonal physicianPressure controlSeparate guidelinesStrokeWomen
1999
Stratified Randomization for Clinical Trials
Kernan W, Viscoli C, Makuch R, Brass L, Horwitz R. Stratified Randomization for Clinical Trials. Journal Of Clinical Epidemiology 1999, 52: 19-26. PMID: 9973070, DOI: 10.1016/s0895-4356(98)00138-3.Peer-Reviewed Original ResearchConceptsStratified randomizationSmall trialsInterim analysisActive-control equivalence trialsClinical factorsLarge trialsSuperiority trialSubgroup analysisClinical trialsTreatment responsivenessTreatment outcomesMEDLINE searchTreatment groupsStratification factorsEquivalence trialPrognosisTrialsRandomizationType ITheoretical benefitsImportance of stratificationStratificationSample sizeInvestigatorsPatients
1991
A methodological appraisal of research on prognosis after transient ischemic attacks.
Kernan W, Feinstein A, Brass L. A methodological appraisal of research on prognosis after transient ischemic attacks. Stroke 1991, 22: 1108-1116. PMID: 1926253, DOI: 10.1161/01.str.22.9.1108.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTransient ischemiaIschemic attackEligible studiesAspects of prognosisObservational cohort studyPrognosis of patientsSubgroup of patientsAppropriate end pointsPeer-reviewed journalsCohort studyInception cohortOutcome ratesIndividual patientsDiagnostic criteriaPatientsOutcome riskIschemiaMultivariate analysisPrognosisEnd pointSubsequent strokeAdherencePredictive variablesStrokeA prognostic system for transient ischemia or minor stroke.
Kernan WN, Horwitz RI, Brass LM, Viscoli CM, Taylor KJ. A prognostic system for transient ischemia or minor stroke. Annals Of Internal Medicine 1991, 114: 552-7. PMID: 2001088, DOI: 10.7326/0003-4819-114-7-552.Peer-Reviewed Original ResearchConceptsCarotid transient ischemic attacksTransient ischemic attackMinor strokeOutcome ratesRisk group 1Ischemic attackTransient ischemiaPrognostic systemGroup 1Urban community teaching hospitalInception cohort studyCommunity teaching hospitalEligible patientsCohort studyClinical featuresOriginal cohortTeaching hospitalTest cohortStrokePatientsSubsequent strokeHypertensionIschemiaDeathDiabetes