2023
Shorter Door-to-Needle Times Are Associated With Better Outcomes After Intravenous Thrombolytic Therapy and Endovascular Thrombectomy for Acute Ischemic Stroke
Man S, Solomon N, Mac Grory B, Alhanti B, Uchino K, Saver J, Smith E, Xian Y, Bhatt D, Schwamm L, Hussain M, Fonarow G. Shorter Door-to-Needle Times Are Associated With Better Outcomes After Intravenous Thrombolytic Therapy and Endovascular Thrombectomy for Acute Ischemic Stroke. Circulation 2023, 148: 20-34. PMID: 37199147, PMCID: PMC10356148, DOI: 10.1161/circulationaha.123.064053.Peer-Reviewed Original ResearchConceptsIntravenous thrombolytic therapyAcute ischemic strokeGood long-term functional outcomeLong-term functional outcomeShorter DTN timesEndovascular thrombectomyFunctional outcomeDTN timeIschemic strokeCause mortalityNeedle timeThrombolytic therapyCox proportional hazards modelModified Rankin Scale (mRS) 0Older US patientsRankin Scale 0Multivariate logistic regressionProportional hazards modelLongitudinal functional outcomesHome timeEligible patientsEVT candidatesEVT timesGuidelines-StrokeThrombolytic administration
2021
Patterns of antidepressant therapy and clinical outcomes among ischaemic stroke survivors
Etherton M, Shah S, Haolin X, Xian Y, Maisch L, Hannah D, Lindholm B, Lytle B, Thomas L, Smith E, Fonarow G, Schwamm L, Bhatt D, Hernandez A, O'Brien E. Patterns of antidepressant therapy and clinical outcomes among ischaemic stroke survivors. Stroke And Vascular Neurology 2021, 6: 384-394. PMID: 33526632, PMCID: PMC8485250, DOI: 10.1136/svn-2020-000691.Peer-Reviewed Original ResearchConceptsAntidepressant medicationIschemic strokeCause mortalityClinical outcomesOutcome measuresAD useHealth Stroke Scale scoreHigher admission National InstitutesMajor adverse cardiac eventsAdmission National InstitutesGuidelines-Stroke hospitalsPrior ischemic strokeAdverse cardiac eventsIschemic stroke survivorsStroke Scale scorePoor prognostic signPoor clinical outcomeLogistic regression modelsFalsification endpointsAntidepressant therapyCause readmissionNaïve patientsCardiac eventsPoststroke depressionStroke severity
2020
Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries. Circulation Cardiovascular Quality And Outcomes 2020, 13: e007150. PMID: 33302714, DOI: 10.1161/circoutcomes.120.007150.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousInsurance BenefitsIschemic StrokeMaleMedicarePatient ReadmissionQuality ImprovementQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsAcute ischemic strokeIschemic strokeNeedle timeIntravenous thrombolysisCardiovascular readmissionCause mortalityThrombolytic treatmentThrombolytic therapyMedicare beneficiariesGuidelines-Stroke hospitalsIntravenous thrombolytic therapyIntravenous thrombolytic treatmentOne-year outcomesProportion of patientsProportional hazards analysisAmerican Heart AssociationQuality InitiativeCause readmissionMedian doorHospital clusteringMedian ageHeart AssociationHospital characteristicsReadmissionImproved doorAssociation Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. JAMA 2020, 323: 2170-2184. PMID: 32484532, PMCID: PMC7267850, DOI: 10.1001/jama.2020.5697.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorAcute ischemic strokeTissue plasminogen activatorCause mortalityNeedle timeCause readmissionIschemic strokeLong-term outcomesShorter doorBetter long-term outcomesImproved long-term outcomesPlasminogen activatorRetrospective cohort studyGood functional outcomeGuidelines-StrokeCohort studyHospital arrivalHospital dischargeMedian doorEarly administrationMedian agePrimary outcomeThrombolytic therapyFunctional outcomeReadmission
2018
Factors 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 InstituteDiabetes 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
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 demographicsClinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study
O'Brien E, Greiner M, Xian Y, Fonarow G, Olson D, Schwamm L, Bhatt D, Smith E, Maisch L, Hannah D, Lindholm B, Peterson E, Pencina M, Hernandez A. Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient‐Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study. Circulation 2015, 132: 1404-1413. PMID: 26246175, DOI: 10.1161/circulationaha.115.016183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCardiovascular DiseasesDose-Response Relationship, DrugFemaleFollow-Up StudiesHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMedicaidMedical RecordsMedicarePatient DischargePatient Outcome AssessmentPatient ReadmissionRecurrenceRegistriesTreatment OutcomeUnited StatesConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsStatin therapyTime of admissionCardiovascular eventsIschemic strokePatient prefersCause mortalityHemorrhagic strokeOlder ischemic stroke patientsGuidelines-Stroke registryHigh-intensity doseIschemic stroke patientsModerate-intensity statinsPatient-centered outcomesReal-world effectivenessYears of ageOutcomes Research InstituteEffectiveness researchCoprimary outcomesCardiovascular readmissionCause readmissionSecondary outcomesStroke patientsClinical effectiveness
2014
Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Holloway R, Smith E, Schwamm L, Reeves M, Bhatt D, Schulte P, Cox M, Olson D, Hernandez A, Lytle B, Anstrom K, Fonarow G, Peterson E. Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage. Stroke 2014, 45: 3243-3250. PMID: 25213344, DOI: 10.1161/strokeaha.114.005620.Peer-Reviewed Original ResearchConceptsWhite patientsAsian patientsRace/ethnicityCessation counselingLower oddsDeep venous thrombosis prophylaxisGuidelines-Stroke hospitalsStroke performance measuresVenous thrombosis prophylaxisHospital-level characteristicsMultivariable logistic regressionProcess of careEthnic differencesHospital mortalityThrombosis prophylaxisCause mortalityHospital outcomesSevere strokeDysphagia screeningBlack patientsIntracerebral hemorrhageMedian lengthHigher oddsStroke educationComfort measures
2012
Death and Rehospitalization after Transient Ischemic Attack or Acute Ischemic Stroke: One-year Outcomes from the Adherence Evaluation of Acute Ischemic Stroke–Longitudinal Registry
Olson D, Cox M, Pan W, Sacco R, Fonarow G, Zorowitz R, LaBresh K, Schwamm L, Williams L, Goldstein L, Bushnell C, Peterson E, Registry A. Death and Rehospitalization after Transient Ischemic Attack or Acute Ischemic Stroke: One-year Outcomes from the Adherence Evaluation of Acute Ischemic Stroke–Longitudinal Registry. Journal Of Stroke And Cerebrovascular Diseases 2012, 22: e181-e188. PMID: 23273788, DOI: 10.1016/j.jstrokecerebrovasdis.2012.11.001.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute ischemic strokeIschemic stroke Longitudinal (AVAIL) registryAIS patientsIschemic attackTIA patientsIschemic strokeAdherence evaluationPrimary composite outcomeOne-year outcomesRehospitalization of patientsRate of deathCause deathGuidelines-StrokePostdischarge riskCause mortalityCause rehospitalizationComposite outcomeHospital dischargeMedication useAdjusted ratesRehospitalizationPreventive guidelinesPatientsOne-year
2011
Comparison of Composite Measure Methodologies for Rewarding Quality of Care
Eapen Z, Fonarow G, Dai D, O'Brien S, Schwamm L, Cannon C, Heidenreich P, Bhatt D, Peterson E, Hernandez A. Comparison of Composite Measure Methodologies for Rewarding Quality of Care. Circulation Cardiovascular Quality And Outcomes 2011, 4: 610-618. PMID: 22010200, DOI: 10.1161/circoutcomes.111.961391.Peer-Reviewed Original ResearchConceptsReadmission ratesHospital rankingsRisk-standardized readmission ratesRisk-standardized mortality ratesOpportunity-based scoreAcute myocardial infarctionBottom quintileComposite scoreModest correlationQuality Improvement ProgramComposite measureCause mortalityNumber of hospitalsHealth care performanceMyocardial infarctionMortality rateHospitalCare performanceScoresSimilar changesMortalityQuintileObservational analysisComposite performance measure