2024
Time 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 ratioCOVID‐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 dataPatients
2023
Antithrombotic 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 medicationMechanistic 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 riskRationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial
Xiong Y, Campbell B, Fisher M, Schwamm L, Parsons M, Li H, Pan Y, Meng X, Zhao X, Wang Y. Rationale and design of Tenecteplase Reperfusion Therapy in Acute Ischaemic Cerebrovascular Events III (TRACE III): a randomised, phase III, open-label, controlled trial. Stroke And Vascular Neurology 2023, 9: 82-89. PMID: 37247876, PMCID: PMC10956103, DOI: 10.1136/svn-2023-002310.Peer-Reviewed Original ResearchLarge vessel occlusionAnterior circulation large vessel occlusionIschemic strokePerfusion-weighted imagingEfficacy outcomesReperfusion therapyMajor neurological improvementSecondary efficacy outcomesStandard medical therapyHealth Stroke ScalePrimary efficacy outcomeSymptomatic intracerebral hemorrhageRankin Scale scoreTissue-type plasminogen activatorDirect thrombectomyNeurological improvementStroke ScaleAnterior circulationMedical therapyMRS scoreIntracerebral hemorrhageSalvageable tissueVessel occlusionCT perfusionClinical trialsInfluence of Cortical Superficial Siderosis in Patients with Mixed Location Cerebral Microbleeds and Intracerebral Hemorrhage (S36.006)
Das A, Gokcal E, Biffi A, Regenhardt R, Fouks A, Viswanathan A, Kimberly W, Goldstein J, Schwamm L, Rosand J, Greenberg S, Gurol E. Influence of Cortical Superficial Siderosis in Patients with Mixed Location Cerebral Microbleeds and Intracerebral Hemorrhage (S36.006). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000204075.Peer-Reviewed Original Research
2022
Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage
Das A, Gokcal E, Regenhardt R, Horn M, Schwab K, Daoud N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Rost N, Rosand J, Schwamm L, Greenberg S, Gurol M. Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage. Stroke And Vascular Neurology 2022, 8: 26-33. PMID: 35981809, PMCID: PMC9985798, DOI: 10.1136/svn-2022-001653.Peer-Reviewed Original ResearchConceptsLeft ventricular hypertrophyCerebral amyloid angiopathyLobar intracerebral hemorrhageIntracerebral hemorrhageImaging markerFrequency of LVHCerebral small vessel diseaseSmall vessel diseaseAetiologic groupsLobar lacunesAmyloid angiopathyVentricular hypertrophyVessel diseasePresence/distributionPatientsDisease etiologyHemorrhageLacunesMarkersRegression modelsAngiopathyHigh frequencyHypertrophyEtiologyDisease
2021
Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease
Das A, Regenhardt R, Gokcal E, Horn M, Daoud N, Schwab K, Rost N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Schwamm L, Rosand J, Greenberg S, Gurol M. Idiopathic primary intraventricular hemorrhage and cerebral small vessel disease. International Journal Of Stroke 2021, 17: 645-653. PMID: 34427471, PMCID: PMC10947797, DOI: 10.1177/17474930211043957.Peer-Reviewed Original ResearchConceptsCerebral small vessel diseaseCerebral amyloid angiopathyPrimary intraventricular hemorrhageIdiopathic primary intraventricular hemorrhageProbable cerebral amyloid angiopathyAmyloid angiopathySmall vessel diseaseIntraventricular hemorrhageVessel diseaseMean initial blood pressureNon-traumatic intracerebral hemorrhageBrain magnetic resonance imagingInitial blood pressurePrimary intraparenchymal hemorrhageSingle referral centerBrain magnetic resonanceMagnetic resonance imagingCSVD subtypesBoston criteriaReferral centerBlood pressureConsecutive patientsCerebral amyloidIntracerebral hemorrhageIntraparenchymal hemorrhageSeizure Prophylaxis After Spontaneous Intracerebral Hemorrhage
Jones F, Sanches P, Smith J, Zafar S, Blacker D, Hsu J, Schwamm L, Newhouse J, Westover M, Moura L. Seizure Prophylaxis After Spontaneous Intracerebral Hemorrhage. JAMA Neurology 2021, 78: 1128-1136. PMID: 34309642, PMCID: PMC8314179, DOI: 10.1001/jamaneurol.2021.2249.Peer-Reviewed Original ResearchConceptsEarly seizure prophylaxisSpontaneous intracerebral hemorrhageAdverse drug reactionsRisk-guided strategyLate seizuresLong-term therapyHigh riskSeizure prophylaxisPrimary prophylaxisIntracerebral hemorrhageLower riskLong-term adverse drug reactionsLow-risk patientsShort-term prophylaxisDecision analytical modelSecondary therapyProphylaxis strategiesDrug reactionsProphylaxisMAIN OUTCOMESeizuresPatientsClinical decisionTherapyAverage riskClinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China
Gu H, Yang X, Wang C, Zhao X, Wang Y, Liu L, Meng X, Jiang Y, Li H, Liu C, Wangqin R, Fonarow G, Schwamm L, Xian Y, Li Z, Wang Y. Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China. JAMA Network Open 2021, 4: e2120745. PMID: 34387677, PMCID: PMC8363916, DOI: 10.1001/jamanetworkopen.2021.20745.Peer-Reviewed Original ResearchConceptsTransient ischemic attackChinese Stroke Center AllianceMajor adverse cardiovascular eventsHospital clinical outcomesQuality improvement studyIschemic strokeIntracerebral hemorrhageIschemic attackClinical characteristicsClinical outcomesPoor outcomeIntravenous recombinant tissue plasminogen activatorTemporal improvementRecombinant tissue plasminogen activatorAdverse cardiovascular eventsIn-Hospital OutcomesUse of anticoagulantsComposite scoreImprovement studyTissue plasminogen activatorMean composite scoreHealth care systemHospital complicationsTIA admissionsTIA care'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model
Regenhardt R, Rosenthal J, Awad A, Martinez-Gutierrez J, Nolan N, McIntyre J, Whitney C, Alotaibi N, Dmytriw A, Vranic J, Stapleton C, Patel A, Rost N, Schwamm L, Leslie-Mazwi T. 'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model. Journal Of NeuroInterventional Surgery 2021, 14: 650-653. PMID: 34326197, PMCID: PMC8799754, DOI: 10.1136/neurintsurg-2021-017819.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyIntravenous thrombolysisIntracerebral hemorrhageDay mRSEVT candidatesFunctional independenceHealth Stroke Scale scoreEmergent large vessel occlusionRisk of ICHMedian National InstitutesStroke Scale scoreLarge vessel occlusionOutcomes of interestAlteplase useDischarge mRSTelestroke modelThrombectomy candidatesEligible patientsIntravenous alteplaseTICI 2bAdequate reperfusionMedian ageSpoke hospitalsCT scoreVessel occlusionClinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Zhang S, Inohara T, Grau-Sepulveda M, Matsouaka RA, Peterson ED, Piccini JP, Smith EE, Sheth KN, Bhatt DL, Fonarow GC, Schwamm LH. Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage. JAMA Network Open 2021, 4: e2037438. PMID: 33591368, PMCID: PMC7887660, DOI: 10.1001/jamanetworkopen.2020.37438.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsCase-Control StudiesCerebral HemorrhageCohort StudiesDependent AmbulationDrug Therapy, CombinationDual Anti-Platelet TherapyFactor Xa InhibitorsFemaleFunctional StatusHospicesHospital MortalityHumansMaleMiddle AgedOdds RatioPatient DischargePlatelet Aggregation InhibitorsRegistriesRisk FactorsWarfarinConceptsOral anticoagulant useOral anticoagulantsFXa inhibitorsHospital mortalityAnticoagulant useCohort studyIndependent ambulationMRS scoreIntracerebral hemorrhageGuidelines-Stroke registryCardiovascular risk factorsHospital mortality riskFactor Xa inhibitorsConcomitant warfarinOral anticoagulationAnticoagulation therapyAntiplatelet therapyHospital outcomesClinical characteristicsRankin ScaleSecondary outcomesPrimary outcomeRisk factorsWorse outcomesHigh prevalence
2020
Cerebral Small Vessel Diseases and Sleep Related Strokes
Lauer A, Ay H, Bianchi M, Charidimou A, Boulouis G, Ayres A, Vashkevich A, Schwab K, Singhal A, Viswanathan A, Rost N, Goldstein J, Rosand J, Schwamm L, Greenberg S, Gurol M. Cerebral Small Vessel Diseases and Sleep Related Strokes. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 104606. PMID: 31937490, DOI: 10.1016/j.jstrokecerebrovasdis.2019.104606.Peer-Reviewed Original ResearchConceptsSmall vessel diseaseCerebral small vessel diseaseSmall artery occlusionIntracerebral hemorrhageIschemic strokeHemorrhagic strokeICH patientsVessel diseasePresence of SVDCerebral amyloid angiopathyLobar intracerebral hemorrhageICH cohortArtery occlusionSymptom onsetAmyloid angiopathyHemodynamic changesIS cohortRisk factorsStroke systemsCausative ClassificationStrokePatientsCohortDeep locationDisease
2019
Resource utilisation among patients transferred for intracerebral haemorrhage
Zachrison K, Aaronson E, Mahmood S, Rosand J, Viswanathan A, Schwamm L, Goldstein J. Resource utilisation among patients transferred for intracerebral haemorrhage. Stroke And Vascular Neurology 2019, 4: 223. PMID: 32030206, PMCID: PMC6979870, DOI: 10.1136/svn-2019-000255.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAge FactorsAgedAged, 80 and overCerebral HemorrhageCritical CareFemaleGlasgow Coma ScaleHumansIntensive Care UnitsMaleMiddle AgedNeurosurgical ProceduresPatient AdmissionPatient TransferProspective StudiesRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsGlasgow Coma ScoreIntracerebral hemorrhageSurgical interventionICH scoreAcademic hospitalBaseline Glasgow Coma ScoreIntensive care unit admissionCare unit admissionSingle academic hospitalPrimary intracerebral hemorrhageUrban academic hospitalLess frequent useCollected registryICU stayUnit admissionComa ScoreConsecutive patientsIntraventricular hemorrhagePrimary outcomePrimary patientsPatientsHospitalLogistic regressionHemorrhageResource utilisationIntravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus
Ehrlich M, Liang L, Xu H, Kosinski A, Hernandez A, Schwamm L, Smith E, Fonarow G, Bhatt D, Peterson E, Xian Y. Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus. Stroke 2019, 50: 1497-1503. PMID: 31035901, PMCID: PMC6538420, DOI: 10.1161/strokeaha.118.024172.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorSymptomatic intracerebral hemorrhageAcute ischemic strokeHistory of strokeTissue-type plasminogen activatorIschemic stroke patientsDiabetes mellitusIschemic strokeIntracerebral hemorrhagePlasminogen activatorStroke patientsUnadjusted ratesAcute ischemic stroke patientsBaseline clinical factorsConcomitant diabetes mellitusECASS III trialGuidelines-Stroke registryPrior ischemic strokeCardiovascular risk factorsHospital mortalityPrior strokeSevere strokeIII trialsClinical factorsRisk factors
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 InstituteAssociation of Intracerebral Hemorrhage Among Patients Taking Non–Vitamin K Antagonist vs Vitamin K Antagonist Oral Anticoagulants With In-Hospital Mortality
Inohara T, Xian Y, Liang L, Matsouaka R, Saver J, Smith E, Schwamm L, Reeves M, Hernandez A, Bhatt D, Peterson E, Fonarow G. Association of Intracerebral Hemorrhage Among Patients Taking Non–Vitamin K Antagonist vs Vitamin K Antagonist Oral Anticoagulants With In-Hospital Mortality. JAMA 2018, 319: 463-473. PMID: 29372247, PMCID: PMC5839299, DOI: 10.1001/jama.2017.21917.Peer-Reviewed Original ResearchConceptsHospital mortalityDual antiplatelet agentsIntracerebral hemorrhagePrior useOral anticoagulantsAntiplatelet agentsLower riskVitamin K Antagonist Oral AnticoagulantsK Antagonist Oral AnticoagulantsNon-vitamin K antagonistsGuidelines-Stroke hospitalsPrior antiplatelet therapyHospital mortality rateOral anticoagulant useRetrospective cohort studyWarfarin-treated patientsUse of OACInteraction p valuePrior strokeAnticoagulation therapyAntiplatelet therapyK antagonistsAnticoagulant useCohort studyHospital arrival
2017
Association Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes
Khan N, Siddiqui F, Goldstein J, Cox M, Xian Y, Matsouaka R, Heidenreich P, Peterson E, Bhatt D, Fonarow G, Schwamm L, Smith E. Association Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes. Stroke 2017, 48: 1810-1817. PMID: 28596454, DOI: 10.1161/strokeaha.117.016290.Peer-Reviewed Original ResearchConceptsAntiplatelet therapyIntracerebral hemorrhageHospital mortalityPrevious useDiagnosis of ICHCombination antiplatelet therapyGuidelines-Stroke hospitalsPrestroke antiplatelet therapyTerms of comorbiditiesOral anticoagulant therapyIntracerebral hemorrhage outcomesAPT groupHigh-risk profileHospital presentationAnticoagulant therapyBaseline characteristicsAntiplatelet agentsHospital characteristicsHigh riskPatientsRisk profileMortalityTherapyAPT useComorbiditiesEarly transition to comfort measures only in acute stroke patients
Prabhakaran S, Cox M, Lytle B, Schulte P, Xian Y, Zahuranec D, Smith E, Reeves M, Fonarow G, Schwamm L. Early transition to comfort measures only in acute stroke patients. Neurology Clinical Practice 2017, 7: 194-204. PMID: 28680764, PMCID: PMC5490382, DOI: 10.1212/cpj.0000000000000358.Peer-Reviewed Original ResearchIntracerebral hemorrhageIschemic strokeStroke patientsHospital characteristicsComfort measuresCMO orderGuidelines-Stroke registryHospital days 0Acute stroke patientsMultivariable logistic regressionRisk-adjusted mortalityLife-sustaining interventionsLife-sustaining treatmentAcute strokeNonambulatory statusHospital factorsMultivariable analysisStudy criteriaFemale sexStroke typeWhite racePatientsDay 0Older ageLogistic regression