2024
Twenty 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 Research
2023
Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke
Mac Grory B, Holmes D, Matsouaka R, Shah S, Chang C, Rison R, Jindal J, Holmstedt C, Logan W, Corral C, Mackey J, Gee J, Bonovich D, Walker J, Gropen T, Benesch C, Dissin J, Pandey H, Wang D, Unverdorben M, Hernandez A, Reeves M, Smith E, Schwamm L, Bhatt D, Saver J, Fonarow G, Peterson E, Xian Y. Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke. JAMA 2023, 329: 2038-2049. PMID: 37338878, PMCID: PMC10282891, DOI: 10.1001/jama.2023.8073.Peer-Reviewed Original ResearchConceptsRisk of sICHSymptomatic intracranial hemorrhageVitamin K antagonistsAcute ischemic strokeSecondary end pointsEndovascular thrombectomyVKA useIschemic strokeHospital mortalityEnd pointIntracranial hemorrhageOral vitamin K antagonistsVitamin K antagonist useGuidelines-Stroke programPrior VKA usePrimary end pointObservational cohort studyLarge vessel occlusionRisk of complicationsAmerican Heart AssociationUse of anticoagulantsSignificant differencesHospital presentationSICH riskAntagonist use
2022
Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke
Xian Y, Xu H, Matsouaka R, Laskowitz D, Maisch L, Hannah D, Smith E, Fonarow G, Bhatt D, Schwamm L, Mac Grory B, Feng W, Fosbøl E, Peterson E, Johnson M. Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke. JAMA Network Open 2022, 5: e2224157. PMID: 35900761, PMCID: PMC9335137, DOI: 10.1001/jamanetworkopen.2022.24157.Peer-Reviewed Original ResearchConceptsAHA/ASA guidelinesAcute ischemic strokeMinor ischemic strokeUse of DAPTDual antiplatelet therapyIschemic strokeMinor strokeHospital-level variationAntiplatelet therapyASA guidelinesDAPT useCohort studySecondary preventionOdds ratioAmerican Heart Association/American Stroke AssociationMinor acute ischemic strokeMulticenter retrospective cohort studyMultivariable logistic regression analysisSubstantial hospital-level variationAHA/ASAGuidelines-Stroke programIdentical clinical featuresRetrospective cohort studyAmerican Stroke AssociationEvidence-based guidelinesTrends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients
Adcock A, Schwamm L, Smith E, Fonarow G, Reeves M, Xu H, Matsouaka R, Xian Y, Saver J. Trends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients. JAMA Network Open 2022, 5: e2215869. PMID: 35671055, PMCID: PMC9175073, DOI: 10.1001/jamanetworkopen.2022.15869.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeYounger patientsHospital mortalityCohort studyIschemic strokeOlder patientsIntracranial hemorrhageAmerican Heart Association/American Stroke AssociationFunctional independenceHealth Stroke Scale scoreSymptomatic intracranial hemorrhage rateNationwide retrospective cohort studyGuidelines-Stroke programGWTG-Stroke hospitalsIntracranial hemorrhage rateStroke Scale scoreFavorable functional outcomeRetrospective cohort studyAmerican Stroke AssociationQuality improvement registryMeeting study criteriaEVT rateEVT useThrombectomy trialsAssociation of Recent Use of Non–Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase
Kam W, Holmes D, Hernandez A, Saver J, Fonarow G, Smith E, Bhatt D, Schwamm L, Reeves M, Matsouaka R, Khan Y, Unverdorben M, Birmingham M, Lyden P, Asimos A, Altschul D, Schoonover T, Jumaa M, Nomura J, Suri M, Moore S, Lafranchise E, Olson D, Peterson E, Xian Y. Association of Recent Use of Non–Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase. JAMA 2022, 327: 760-771. PMID: 35143601, PMCID: PMC8832308, DOI: 10.1001/jama.2022.0948.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeSymptomatic intracranial hemorrhageSecondary functional outcomesSecondary safety outcomesProportion of patientsIntravenous alteplaseIntracranial hemorrhageIschemic strokeFunctional outcomeOral anticoagulantsInpatient mortalitySafety outcomesNon-Vitamin K Antagonist Oral AnticoagulantsK Antagonist Oral AnticoagulantsBaseline clinical factorsGuidelines-Stroke programIntravenous alteplase administrationLong-term anticoagulantsUse of NOACsRetrospective cohort studyUse of anticoagulantsSignificant differencesAlteplase administrationCardiovascular comorbiditiesNOAC group
2019
Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke
Song S, Liang L, Fonarow G, Smith E, Bhatt D, Matsouaka R, Xian Y, Schwamm L, Saver J. Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke. JAMA Neurology 2019, 76: 430-439. PMID: 30667466, PMCID: PMC6459126, DOI: 10.1001/jamaneurol.2018.4410.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAsianBrain IschemiaFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntracranial HemorrhagesLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient DischargeQuality of Health CareRetrospective StudiesSeverity of Illness IndexStrokeStroke RehabilitationThrombolytic TherapyTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeAsian American patientsIschemic strokeWhite patientsAmerican patientsClinical outcomesHospital mortalityStroke severityAmerican Heart Association/American Stroke AssociationIntravenous tissue plasminogen activator administrationTissue plasminogen activator administrationMultivariable logistic regression modelGreater stroke severityGuidelines-Stroke programGWTG-Stroke hospitalsIntensive statin therapyOverall stroke incidenceIn-Hospital OutcomesSevere ischemic strokeWorse functional outcomeAmerican Stroke AssociationQuality improvement registryLogistic regression modelsRace/ethnicityStatin therapy
2018
Absence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes
Gonzalez‐Castellon M, Ju C, Xian Y, Hernandez A, Fonarow G, Schwamm L, Smith E, Bhatt D, Reeves M, Willey J. Absence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes. Journal Of The American Heart Association 2018, 7: e007685. PMID: 29386207, PMCID: PMC5850252, DOI: 10.1161/jaha.117.007685.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaClinical CompetenceFemaleHealth StatusHospitals, TeachingHumansInternship and ResidencyMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient DischargePersonnel Staffing and SchedulingQuality Indicators, Health CareRegistriesStrokeTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsGuidelines-Stroke programProportion of patientsAcute ischemic strokeIschemic strokeJuly phenomenonHospital outcomesAcute ischemic stroke care qualityMultivariable logistic regression modelCare qualityDefect-free careStroke care qualityStroke performance measuresSymptomatic intracranial hemorrhageHours of admissionLower care qualityLogistic regression modelsNeedle timeIntracranial hemorrhageMultivariable analysisAdverse outcomesNonteaching hospitalsTomography timePatientsClinical metricsHospital
2017
Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials
Smith E, Saver J, Cox M, Liang L, Matsouaka R, Xian Y, Bhatt D, Fonarow G, Schwamm L. Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials. Circulation 2017, 136: 2303-2310. PMID: 28982689, DOI: 10.1161/circulationaha.117.031097.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyEVT useEligible patientsIschemic strokePivotal trialsCase volumeStroke systemsHealth Stroke Scale scoreGuidelines-Stroke programStroke Scale scoreMean case volumeGuidelines-StrokeEndovascular therapyMore patientsPatient eligibilityPatientsClinical practiceScale scoreHospitalStrokeTrialsNational InstituteStroke durationLinear regressionThrombectomyProfessional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English
Erfe B, Siddiqui K, Schwamm L, Kirwan C, Nunes A, Mejia N. Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English. Journal Of The American Heart Association 2017, 6: e006175. PMID: 28935679, PMCID: PMC5634277, DOI: 10.1161/jaha.117.006175.Peer-Reviewed Original ResearchConceptsProfessional medical interpretersMedical interpretersAcute ischemic stroke careIschemic stroke careAcute ischemic stroke patientsIschemic stroke patientsStroke carePMI servicesCommon languageEnglishLanguageStroke patientsInterpretersGuidelines-Stroke programAmerican Heart AssociationAppropriate health careLogistic regression modelsQuality patient careHospital stayMultivariable analysisPatient receiptHeart AssociationLower oddsPatientsMedical careAssociation of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation
Xian Y, O’Brien E, Liang L, Xu H, Schwamm L, Fonarow G, Bhatt D, Smith E, Olson D, Maisch L, Hannah D, Lindholm B, Lytle B, Pencina M, Hernandez A, Peterson E. Association of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation. JAMA 2017, 317: 1057-1067. PMID: 28291892, DOI: 10.1001/jama.2017.1371.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHistory of AFAntithrombotic therapyAntiplatelet therapyAntithrombotic treatmentAtrial fibrillationHospital mortalityTherapeutic warfarinTherapeutic anticoagulationSevere strokeIschemic strokeStroke severityLower oddsSubtherapeutic warfarinUnadjusted ratesAcute ischemic stroke severityGuidelines-Stroke programHealth Stroke ScaleIn-Hospital OutcomesHigh-risk patientsPrevalence of patientsRetrospective observational studyTime of strokeIschemic stroke severityHospital outcomesImpact of an Expanded Hospital Recognition Program for Stroke Quality of Care
Heidenreich P, Zhao X, Hernandez A, Schwamm L, Smith E, Reeves M, Peterson E, Fonarow G. Impact of an Expanded Hospital Recognition Program for Stroke Quality of Care. Journal Of The American Heart Association 2017, 6: e004278. PMID: 28110310, PMCID: PMC5523627, DOI: 10.1161/jaha.116.004278.Peer-Reviewed Original Research
2016
Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke
Medford‐Davis L, Fonarow G, Bhatt D, Xu H, Smith E, Suter R, Peterson E, Xian Y, Matsouaka R, Schwamm L. Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2016, 5: e004282. PMID: 27930356, PMCID: PMC5210352, DOI: 10.1161/jaha.116.004282.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulancesAnticholesteremic AgentsAntihypertensive AgentsBrain IschemiaDiabetes MellitusFemaleGuideline AdherenceHospital MortalityHumansHypercholesterolemiaHypertensionHypoglycemic AgentsInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicSkilled Nursing FacilitiesStrokeStroke RehabilitationTime FactorsUnited StatesConceptsAcute ischemic strokeIschemic strokeInsurance statusHospital mortalityGuidelines-Stroke programIschemic stroke patientsMultivariable logistic regressionPatient insurance statusGovernment-sponsored insuranceSkilled nursing facilitiesGuidelines-StrokeInpatient rehabPostdischarge destinationHospital outcomesPatient demographicsSymptom onsetAcute treatmentControl medicationDiabetes mellitusStroke patientsHospital characteristicsUninsured patientsHigh cholesterolNursing facilitiesPreventative care
2015
Drip and Ship Thrombolytic Therapy for Acute Ischemic Stroke
Sheth KN, Smith EE, Grau-Sepulveda MV, Kleindorfer D, Fonarow GC, Schwamm LH. Drip and Ship Thrombolytic Therapy for Acute Ischemic Stroke. Stroke 2015, 46: 732-739. PMID: 25672784, DOI: 10.1161/strokeaha.114.007506.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorSymptomatic intracranial hemorrhageTPA useAcute strokeIschemic strokeIntracranial hemorrhageHealth Stroke Scale scoreReal-world practice patternsGuidelines-Stroke programStroke Scale scoreAcute ischemic strokeCharacteristics of patientsLower National InstitutesPatient selection biasConventional thrombolysisHospital mortalityHospital outcomesSymptom onsetInterhospital transferThrombolytic therapyHospital characteristicsPractice patternsShip paradigmMAIN OUTCOME
2014
Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke
Ovbiagele B, Smith E, Schwamm L, Grau-Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2014, 7: 929-935. PMID: 25249561, DOI: 10.1161/circoutcomes.114.001144.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedBrain IschemiaFemaleFibrinolytic AgentsFollow-Up StudiesGlomerular Filtration RateHemorrhageHospital MortalityHumansIncidenceInjections, IntravenousMaleOdds RatioRegistriesRenal Insufficiency, ChronicRetrospective StudiesThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorUnited StatesConceptsChronic kidney diseaseSerious systemic hemorrhageSymptomatic intracranial hemorrhagePresence of CKDIntravenous tissue-type plasminogen activatorIntracranial hemorrhageSystemic hemorrhageTissue-type plasminogen activatorKidney diseaseFunctional statusTissue-type plasminogen activator administrationPlasminogen activatorAdmission serum creatinineGuidelines-Stroke programIndependent functional statusIntravenous thrombolytic therapyPrimary end pointAcute ischemic strokeIschemic stroke patientsGlomerular filtration rateNormal kidney functionDischarge functional statusHigher unadjusted oddsTissue-type plasminogenHospital mortalityHospitalized Hemorrhagic Stroke Patients with Renal Insufficiency: Clinical Characteristics, Care Patterns, and Outcomes
Ovbiagele B, Schwamm L, Smith E, Grau-Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Hospitalized Hemorrhagic Stroke Patients with Renal Insufficiency: Clinical Characteristics, Care Patterns, and Outcomes. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2265-2273. PMID: 25158677, DOI: 10.1016/j.jstrokecerebrovasdis.2014.04.016.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseNormal renal functionICH patientsClinical characteristicsRenal functionKidney diseaseCare patternsDeep venous thrombosis prophylaxisGuidelines-Stroke programGWTG-Stroke programVenous thrombosis prophylaxisThird of patientsGlomerular filtration rateHemorrhagic stroke patientsNormal kidney functionIntracerebral hemorrhage patientsSmoking cessation interventionHospital mortalityThrombosis prophylaxisHospital outcomesRenal dysfunctionRenal insufficiencyInpatient mortalityClinical outcomesComorbid conditionsPatterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease
Ovbiagele B, Schwamm L, Smith E, Grau‐Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Patterns of Care Quality and Prognosis Among Hospitalized Ischemic Stroke Patients With Chronic Kidney Disease. Journal Of The American Heart Association 2014, 3: e000905. PMID: 24904017, PMCID: PMC4309090, DOI: 10.1161/jaha.114.000905.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseIschemic stroke patientsSevere renal dysfunctionGlomerular filtration rateStroke patientsRenal dysfunctionQuality of careKidney diseaseHospitalized ischemic stroke patientsGuideline-based therapyGuideline-recommended therapiesGuidelines-Stroke programGWTG-Stroke programStroke performance measuresHospital mortality rateNormal kidney functionHospital mortalityHospital prognosisInpatient mortalityIschemic strokeCare complianceKidney functionModerate dysfunctionKidney failureFiltration rate
2013
Review of Stroke Center Effectiveness and Other Get with the Guidelines Data
Silva G, Schwamm L. Review of Stroke Center Effectiveness and Other Get with the Guidelines Data. Current Atherosclerosis Reports 2013, 15: 350. PMID: 23892766, DOI: 10.1007/s11883-013-0350-8.Peer-Reviewed Original ResearchConceptsStroke systemsAcute careAcute stroke-ready hospitalGuidelines-Stroke programSpectrum of strokeStroke-ready hospitalsComprehensive stroke centerBest evidence-based careEvidence-based careAmerican Heart AssociationEmergency medical servicesSecondary preventionStroke centersStroke carePrimary preventionHeart AssociationCoordinated careCare processesPatient accessCareCare comprisesStrokeMedical servicesPreventionGuideline dataTime to Treatment With Intravenous Tissue Plasminogen Activator and Outcome From Acute Ischemic Stroke
Saver J, Fonarow G, Smith E, Reeves M, Grau-Sepulveda M, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Time to Treatment With Intravenous Tissue Plasminogen Activator and Outcome From Acute Ischemic Stroke. JAMA 2013, 309: 2480-2488. PMID: 23780461, DOI: 10.1001/jama.2013.6959.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeSymptomatic intracranial hemorrhageTissue-type plasminogen activatorIschemic strokeIntracranial hemorrhageIndependent ambulationHospital mortalityThrombolytic treatmentClinical practiceIntravenous tissue-type plasminogen activatorMedian pretreatment National InstitutesIntravenous tissue plasminogen activatorPlasminogen activatorGreater stroke severityGuidelines-Stroke programPretreatment National InstitutesHealth Stroke ScaleUS clinical practiceRandomized clinical trialsTissue plasminogen activatorHospital presentationShorter OTTAmbulatory statusHospital deathStroke ScaleRacial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Qian F, Fonarow G, Smith E, Xian Y, Pan W, Hannan E, Shaw B, Glance L, Peterson E, Eapen Z, Hernandez A, Schwamm L, Bhatt D. Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2013, 6: 284-292. PMID: 23680966, DOI: 10.1161/circoutcomes.113.000211.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBlack or African AmericanBrain IschemiaEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansLogistic ModelsMaleMedicareMultivariate AnalysisOdds RatioPatient ReadmissionRacial GroupsRegistriesRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeLong-term outcomesRace/ethnicityCause rehospitalizationOlder patientsIschemic strokeUnadjusted mortalityHispanic patientsGuidelines-Stroke programGuidelines-Stroke registryHealth Stroke ScaleOlder Medicare beneficiariesAmerican Heart AssociationAsian American patientsYears of ageStroke ScaleStroke severityHigher median scoresAsian patientsHeart AssociationHospital characteristicsAmerican patientsUS CentersPrognostic variablesLower odds
2012
Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program
Bettger J, Kaltenbach L, Reeves M, Smith E, Fonarow G, Schwamm L, Peterson E. Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program. Archives Of Physical Medicine And Rehabilitation 2012, 94: 38-45. PMID: 22858797, DOI: 10.1016/j.apmr.2012.06.029.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programStroke patientsAcute hospitalizationAcute strokeAcute hospitalsGWTG-Stroke programAcute stroke patientsProspective cohortStroke unitMultivariable analysisNonwhite raceRehabilitation careAcute assessmentMAIN OUTCOMEStroke diagnosisPatientsRehabilitation servicesHospitalizationRehabilitationHospitalStrokeUnited StatesAssessmentAdmissionCohort