2020
Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era
Akbik F, Xu H, Xian Y, Shah S, Smith E, Bhatt D, Matsouaka R, Fonarow G, Schwamm L. Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era. JAMA Neurology 2020, 77: 1486-1495. PMID: 32955582, PMCID: PMC7506601, DOI: 10.1001/jamaneurol.2020.3362.Peer-Reviewed Original ResearchConceptsHospital stroke onsetHospital onsetIntravenous thrombolysisStroke onsetEndovascular therapyReperfusion therapyHospital strokeCohort studyIschemic strokeFunctional outcomeNational registryIn-Hospital Ischemic StrokeIntravenous thrombolysis treatmentLimited contemporary dataRetrospective cohort studyAcute ischemic strokeVascular risk factorsWorse functional outcomeEndovascular reperfusion therapyLonger median timeKey patient characteristicsTherapy eraThrombolysis treatmentHospital dischargePatient characteristics
2018
Incidence of Atrial Fibrillation in Patients With Recent Ischemic Stroke Versus Matched Controls
Witsch J, Merkler AE, Chen ML, Navi BB, Sheth KN, Freedman B, Schwamm LH, Kamel H. Incidence of Atrial Fibrillation in Patients With Recent Ischemic Stroke Versus Matched Controls. Stroke 2018, 49: 2529-2531. PMID: 30355110, PMCID: PMC6205716, DOI: 10.1161/strokeaha.118.022826.Peer-Reviewed Original ResearchConceptsAtrial fibrillation/flutterIschemic strokeHemorrhagic strokeAF incidenceAF diagnosisRisk factorsAF-free patientsNew AF diagnosisVascular risk factorsNonstroke diagnosisAutonomic dysfunctionCharlson comorbidityStroke cohortAtrial fibrillationCox regressionNinth RevisionOutpatient claimsIncidental findingClinical ModificationHigh riskInternational ClassificationMedicare beneficiariesSurvival statisticsMatched ControlsPatients
2016
Baseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis
Ali S, Siddiqui K, Ay H, Silverman S, Singhal A, Viswanathan A, Rost N, Lev M, Schwamm L. Baseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis. Stroke 2016, 47: 2986-2992. PMID: 27834750, DOI: 10.1161/strokeaha.116.014871.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorHealth Stroke ScaleTissue-type plasminogen activatorPoor outcomeIntravenous thrombolysisStroke ScaleMultivariable analysisPlasminogen activatorHigher median National InstitutesConsecutive stroke admissionsCurrent safety profileGuidelines-Stroke databaseInitial National InstitutesMedian National InstitutesThird of patientsVascular risk factorsNational InstituteSkilled nursing facilitiesMultifocal infarctionPoor collateralsStroke admissionsImaging predictorsInpatient rehabilitationSafety profileImaging featuresDistinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics
Romano J, Smith E, Liang L, Gardener H, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Distinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics. Stroke 2016, 47: 1278-1285. PMID: 26987870, DOI: 10.1161/strokeaha.115.011528.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleShort-term outcomesMild strokeHome dischargeIndependent ambulationStroke ScaleHealth Stroke Scale 0National InstituteGuidelines-Stroke registryVascular risk factorsLength of stayHospital mortalityHospital deathIschemic strokeSymptom onsetDischarge outcomesStroke presentationStroke symptomsHospital covariatesAdjusted outcomesRisk factorsWorse outcomesMultivariable modelRetrospective analysisGreater severity
2015
Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke
Ali S, Smith E, Reeves M, Zhao X, Xian Y, Hernandez A, Bhatt D, Fonarow G, Schwamm L. Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2015, 8: s73-s80. PMID: 26515213, DOI: 10.1161/circoutcomes.114.001244.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCoronary artery diseaseVascular risk factorsAdjusted odds ratioHospital mortalityRisk factorsIschemic strokeArtery diseaseOdds ratioProspective population-based studyPast-year smokersResidual unmeasured confoundingPopulation-based studyAge-stratified analysisPotent risk factorPast-year smokingConsecutive patientsMultivariable modelSmokersSmokingPatientsSignificant associationMortalitySubstantial confoundingUnmeasured confounding
2014
Guideline-Directed Low-Density Lipoprotein Management in High-Risk Patients With Ischemic Stroke
Saposnik G, Fonarow G, Pan W, Liang L, Hernandez A, Schwamm L, Smith E. Guideline-Directed Low-Density Lipoprotein Management in High-Risk Patients With Ischemic Stroke. Stroke 2014, 45: 3343-3351. PMID: 25300975, DOI: 10.1161/strokeaha.114.006736.Peer-Reviewed Original ResearchConceptsTransient ischemic attackCoronary artery diseaseHigh-risk patientsTIA/strokeIschemic attackIschemic strokeLDL targetsCardiovascular diseasePrevious stroke/transient ischemic attackStroke/transient ischemic attackConcomitant coronary artery diseasePreexistent coronary artery diseasePrevious TIA/strokePrior TIA/strokePrevious coronary artery diseaseMajor vascular risk factorsLow-density lipoprotein valuesGuidelines-Stroke registryAcute ischemic strokeManagement of dyslipidemiaVascular risk factorsCholesterol-lowering therapyLipoprotein managementRecurrent strokeStroke preventionThe TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network
Ali SF, Viswanathan A, Singhal AB, Rost NS, Forducey PG, Davis LW, Schindler J, Likosky W, Schlegel S, Solenski N, Schwamm LH, Network O. The TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network. Journal Of The American Heart Association 2014, 3: e000838. PMID: 24958778, PMCID: PMC4309074, DOI: 10.1161/jaha.114.000838.Peer-Reviewed Original ResearchConceptsStroke mimicsIschemic cerebrovascular diseaseTelestroke networkReceiver-operating characteristic curve analysisCurve analysisHealth Stroke ScaleVascular risk profileVascular risk factorsAcute stroke evaluationExternal validation cohortFinal clinical diagnosisLower mean ageROC curve analysisCharacteristic curve analysisStepwise logistic regressionTelestroke consultationStroke ScaleFacial weaknessConsecutive patientsDerivation cohortPrior seizuresStroke evaluationAlternate diagnosisCerebrovascular diseaseValidation cohort
2013
Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis
Ji R, Schwamm L, Pervez M, Singhal A. Ischemic Stroke and Transient Ischemic Attack in Young Adults: Risk Factors, Diagnostic Yield, Neuroimaging, and Thrombolysis. JAMA Neurology 2013, 70: 51-57. PMID: 23108720, DOI: 10.1001/jamaneurol.2013.575.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTertiary stroke centerIschemic strokeYoung adultsIschemic attackHospital dischargeStroke centersStroke etiologyRisk factorsIschemic stroke/transient ischemic attackBetter outcomesStroke/transient ischemic attackHealth Stroke Scale scoreTraditional vascular risk factorsDiagnostic testsGuidelines-Stroke databaseMedian National InstitutesSymptomatic brain hemorrhageUndetermined stroke etiologyStroke Scale scoreVascular risk factorsMiddle cerebral arteryShort-term outcomesAge 35 yearsInternal carotid artery
2011
Prestroke Dementia is Associated With Poor Outcomes After Reperfusion Therapy Among Elderly Stroke Patients
Busl K, Nogueira R, Yoo A, Hirsch J, Schwamm L, Rost N. Prestroke Dementia is Associated With Poor Outcomes After Reperfusion Therapy Among Elderly Stroke Patients. Journal Of Stroke And Cerebrovascular Diseases 2011, 22: 718-724. PMID: 22182760, PMCID: PMC3310930, DOI: 10.1016/j.jstrokecerebrovasdis.2011.11.005.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAged, 80 and overDementiaDisability EvaluationFemaleFibrinolytic AgentsHospicesHospital MortalityHumansInfusions, Intra-ArterialInfusions, IntravenousLogistic ModelsMaleMultivariate AnalysisOdds RatioPatient DischargeRehabilitation CentersRetrospective StudiesRisk FactorsSkilled Nursing FacilitiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial reperfusion therapyTissue plasminogen activatorReperfusion therapyPrestroke dementiaHospital mortalityDischarge destinationPoor outcomeStroke patientsElderly acute stroke patientsMultivariate logistic regression modelAcute reperfusion therapyGuidelines-Stroke databaseSymptomatic intracranial hemorrhageHealth Stroke ScaleHospital mortality rateAcute stroke patientsPowerful independent predictorVascular risk factorsElderly stroke patientsPresence of dementiaLikelihood of deathYears of ageLogistic regression modelsStroke ScaleSecondary outcomesOutcomes in Mild or Rapidly Improving Stroke Not Treated With Intravenous Recombinant Tissue-Type Plasminogen Activator
Smith E, Fonarow G, Reeves M, Cox M, Olson D, Hernandez A, Schwamm L. Outcomes in Mild or Rapidly Improving Stroke Not Treated With Intravenous Recombinant Tissue-Type Plasminogen Activator. Stroke 2011, 42: 3110-3115. PMID: 21903949, DOI: 10.1161/strokeaha.111.613208.Peer-Reviewed Original ResearchConceptsRecombinant tissue-type plasminogen activatorIntravenous recombinant tissue-type plasminogen activatorHealth Stroke Scale scoreStroke Scale scoreTissue-type plasminogen activatorHospital dischargePoor outcomeRisk factorsNationwide studyScale scorePoor short-term outcomePlasminogen activatorInitial National InstitutesHigher National InstitutesIschemic stroke patientsLipid-lowering medicationsVascular risk factorsMultivariable-adjusted analysesShort-term outcomesStroke-related disabilityLarge nationwide studyNational InstituteReperfusion therapyHome dischargeIndependent predictors