2024
Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021.
Skajaa N, Laugesen K, Lauffenburger J, Schwamm L, Sørensen H, Patorno E. Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021. Neurology 2024, 102: e209309. PMID: 38648572, PMCID: PMC11226314, DOI: 10.1212/wnl.0000000000209309.Peer-Reviewed Original ResearchConceptsMedication useOral anticoagulant medicationsGlucose-lowering medication useFactors associated with medication useLipid-lowering medication useSevere strokeIschemic stroke hospitalizationsAntihypertensive medication useAnticoagulant medicationOlder patientsCare of patientsSodium-glucose cotransporter-2 inhibitorsGlucagon-like peptide-1 receptor agonistsStroke preventionAnticoagulant medication useLipid-loweringPeptide-1 receptor agonistsGlucose-loweringReduced life expectancyIschemic strokeCotransporter-2 inhibitorsStroke careCohort of patientsStroke hospitalizationsSecondary ischemic stroke prevention
2022
Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation
Sharma R, Silverman S, Patel S, Schwamm LH, Sanborn DY. Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation. Stroke And Vascular Neurology 2022, 7: 482-492. PMID: 35697387, PMCID: PMC9811598, DOI: 10.1136/svn-2021-001170.Peer-Reviewed Original ResearchConceptsStroke risk factorsAcute ischemic strokeStroke hospitalisationsTransthoracic echocardiographyRisk factorsClinical utilityAbnormal transthoracic echocardiographyHigh stroke riskCardiac event riskCoronary artery diseaseTransthoracic echocardiographic findingsNet reclassification improvementCategory ICardioembolic sourceRecurrent strokeTTE findingsCardiovascular outcomesEchocardiographic findingsCardiac eventsIschemic strokeOlder patientsStroke riskArtery diseaseSingle centerAtrial fibrillationTrends 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 trials
2021
Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure
Lusk J, Xu H, Peterson E, Bhatt D, Fonarow G, Smith E, Matsouaka R, Schwamm L, Xian Y. Antithrombotic Therapy for Stroke Prevention in Patients With Ischemic Stroke With Aspirin Treatment Failure. Stroke 2021, 52: e777-e781. PMID: 34702067, PMCID: PMC8608737, DOI: 10.1161/strokeaha.121.034622.Peer-Reviewed Original ResearchConceptsAspirin treatment failureDual antiplatelet therapyIschemic strokeAspirin monotherapyClopidogrel monotherapyAntiplatelet therapyAntithrombotic therapyTreatment failureAntithrombotic treatment patternsAspirin/dipyridamoleGuidelines-Stroke registryIschemic stroke survivorsAcute ischemic strokeHalf of patientsAmerican Heart AssociationComplex clinical scenariosNonvitamin KOral anticoagulantsStroke preventionStroke RegistryOlder patientsPreventive therapyTreatment patternsHeart AssociationStroke survivorsOral Anticoagulation and Adverse Outcomes after Ischemic Stroke in Heart Failure Patients without Atrial Fibrillation
Saeed O, Zhang S, Patel S, Jorde U, Garcia M, Bulcha N, Gupta T, Xian Y, Matsouaka R, Shah S, Smith E, Schwamm L, Fonarow G. Oral Anticoagulation and Adverse Outcomes after Ischemic Stroke in Heart Failure Patients without Atrial Fibrillation. Journal Of Cardiac Failure 2021, 27: 857-864. PMID: 33975786, PMCID: PMC8355019, DOI: 10.1016/j.cardfail.2021.02.017.Peer-Reviewed Original ResearchConceptsOral anticoagulationRecurrent ischemic strokeAcute ischemic strokeIschemic strokeHeart failureAtrial fibrillationOlder patientsHistory of HFInitiation of OACCox proportional hazard ratiosProportional hazard ratiosHeart failure patientsKaplan-Meier curvesClinical registry dataCause bleedingEligible patientsAdverse eventsCumulative incidenceFailure patientsHazard ratioSuch patientsYear mortalityAdverse outcomesClinical covariatesRegistry data
2019
Thrombolysis in young adults with stroke: Findings from Get With The Guidelines-Stroke.
Dodds J, Xian Y, Sheng S, Fonarow G, Bhatt D, Matsouaka R, Schwamm L, Peterson E, Smith E. Thrombolysis in young adults with stroke: Findings from Get With The Guidelines-Stroke. Neurology 2019, 92: e2784-e2792. PMID: 31092622, DOI: 10.1212/wnl.0000000000007653.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTissue plasminogen activatorIschemic strokeOlder patientsYounger patientsYears of ageSymptomatic intracranial hemorrhage rateYoung adultsGuidelines-Stroke registryIntracranial hemorrhage rateGuidelines-StrokeHospital mortalityHospital arrivalHemorrhage rateIntracranial hemorrhageMultivariable modelPatientsBetter outcomesStrokePlasminogen activatorTPA treatmentTreatmentAdultsAgeOutcomes
2016
Why are acute ischemic stroke patients not receiving IV tPA?
Messé S, Khatri P, Reeves M, Smith E, Saver J, Bhatt D, Grau-Sepulveda M, Cox M, Peterson E, Fonarow G, Schwamm L. Why are acute ischemic stroke patients not receiving IV tPA? Neurology 2016, 87: 1565-1574. PMID: 27629092, PMCID: PMC5067546, DOI: 10.1212/wnl.0000000000003198.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overBrain IschemiaDatasets as TopicFemaleFibrinolytic AgentsHealthcare DisparitiesHumansLogistic ModelsMaleMultivariate AnalysisRegistriesRetrospective StudiesSeverity of Illness IndexStrokeThrombolytic TherapyTissue Plasminogen ActivatorUnited StatesConceptsAcute ischemic strokeTissue plasminogen activatorHours of onsetEligible patientsAcute ischemic stroke patientsNIH Stroke Scale scoreStroke center certificationRetrospective cohort studyStroke Scale scoreIschemic stroke patientsEarlier calendar yearsEquation logistic regressionProsthetic heart valvesEmergency medical servicesGuidelines-StrokePrior strokeCohort studyIschemic strokeOlder patientsStroke onsetStroke severityDiabetes mellitusCenter HospitalStroke patientsAtrial fibrillationAssessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries
Fonarow G, Liang L, Thomas L, Xian Y, Saver J, Smith E, Schwamm L, Peterson E, Hernandez A, Duncan P, O'Brien E, Bushnell C, Prvu Bettger J. Assessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries. Stroke 2016, 47: 836-842. PMID: 26892279, DOI: 10.1161/strokeaha.115.011599.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleIschemic strokeMedicare beneficiariesIschemic stroke Longitudinal (AVAIL) registryMedian Modified Rankin ScaleAcute ischemic strokePatient-centered outcomesSkilled nursing facilitiesGuidelines-StrokeMRS 0Older patientsRankin ScaleStroke careInpatient rehabilitationStroke survivorsC-indexOutcome measuresNursing facilitiesFunctional independenceAdherence evaluationStrokePatientsSimilar findingsMeaningful outcomesPearson correlation coefficient
2014
Use of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke
Stein J, Bettger J, Sicklick A, Hedeman R, Magdon-Ismail Z, Schwamm L. Use of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke. Archives Of Physical Medicine And Rehabilitation 2014, 96: 210-217. PMID: 25102387, DOI: 10.1016/j.apmr.2014.07.403.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesInstitution-based rehabilitationPredictors of referralDischarge homeBarthel IndexBI scoreRehabilitation needsSociodemographic characteristicsShort Portable Mental Status QuestionnaireDischarge disposition locationGuidelines-Stroke registryHealth Stroke ScalePatients' sociodemographic characteristicsDaily living impairmentStandardized assessmentHigher BI scoreMental Status QuestionnaireProspective pilot projectPrestroke disabilityStroke ScaleAcute strokeClinical characteristicsOlder patientsRankin Scale
2013
Racial 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 oddsPatterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment
Ekundayo O, Saver J, Fonarow G, Schwamm L, Xian Y, Zhao X, Hernandez A, Peterson E, Cheng E. Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment. Circulation Cardiovascular Quality And Outcomes 2013, 6: 262-269. PMID: 23633218, DOI: 10.1161/circoutcomes.113.000089.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overChi-Square DistributionEmergency Medical ServicesEmergency Service, HospitalEthnicityFemaleGuideline AdherenceHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMinority GroupsOdds RatioOutcome and Process Assessment, Health CarePatient Acceptance of Health CarePatient Education as TopicPractice Guidelines as TopicRegistriesRisk FactorsStrokeTime FactorsTime-to-TreatmentTransportation of PatientsTreatment OutcomeUnited StatesConceptsEmergency medical servicesStroke patientsEMS useEmergency medical services useMinority raceHealth Stroke ScoreMedical service useTreatment of strokeTissue-type plasminogen activatorEligible patientsGuidelines-StrokeSevere strokeStroke ScoreHospital arrivalOlder patientsYounger patientsHemorrhagic strokeStroke treatmentMedicare insuranceInsurance statusEMS activationDecreased oddsEMS transportService usePatientsAge Differences in the Use of Implantable Cardioverter‐Defibrillators Among Older Patients Hospitalized with Heart Failure
HESS P, GRAU‐SEPULVEDA M, HERNANDEZ A, PETERSON E, BHATT D, SCHWAMM L, YANCY C, FONAROW G, AL‐KHATIB S, Committee and Hospitals F. Age Differences in the Use of Implantable Cardioverter‐Defibrillators Among Older Patients Hospitalized with Heart Failure. Journal Of Cardiovascular Electrophysiology 2013, 24: 664-671. PMID: 23437793, PMCID: PMC4076932, DOI: 10.1111/jce.12100.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionHeart failureAge groupsPatient ageGuideline-eligible patientsGuidelines-HF ProgramAbsence of contraindicationsVentricular ejection fractionAmerican Heart AssociationUse of ICDsImplantable cardioverter defibrillatorOlder age groupsSame age groupOlder patientsEjection fractionICD useICD placementHeart AssociationAge-related differencesPractice guidelinesCardioverter defibrillatorPatientsHospitalizationICDAge
2012
Age and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction
Bangalore S, Fonarow G, Peterson E, Hellkamp A, Hernandez A, Laskey W, Peacock W, Cannon C, Schwamm L, Bhatt D, Committee and Investigators G. Age and Gender Differences in Quality of Care and Outcomes for Patients with ST-segment Elevation Myocardial Infarction. The American Journal Of Medicine 2012, 125: 1000-1009. PMID: 22748404, DOI: 10.1016/j.amjmed.2011.11.016.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overCohort StudiesFemaleGuideline AdherenceHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionOutcome and Process Assessment, Health CarePractice Guidelines as TopicPrognosisQuality Indicators, Health CareRegistriesRisk FactorsSex FactorsUnited StatesConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionQuality of careYounger patientsMyocardial infarctionHospital outcomesOlder patientsST-segment elevation myocardial infarction casesGuidelines-Coronary Artery Disease registryTraditional cardiovascular risk factorsCoronary Artery Disease registryCardiovascular risk factorsAmerican Heart AssociationMyocardial infarction casesOlder counterpartsYounger cohortsTime trend analysisHospital mortalityHospital deathHeart AssociationRisk factorsWorse outcomesInfarction casesThrombolytic timeDisease Registry
2011
Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke
Lewis W, Fonarow G, Grau-Sepulveda M, Smith E, Bhatt D, Hernandez A, Olson D, Peterson E, Schwamm L. Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke. American Heart Journal 2011, 162: 692-699.e2. PMID: 21982662, DOI: 10.1016/j.ahj.2011.07.019.Peer-Reviewed Original ResearchConceptsTransient ischemic attackUse of anticoagulationAtrial fibrillationAnticoagulation therapyGWTG-StrokeEligible patientsStroke patientsIschemic stroke/transient ischemic attackJoint Commission Primary Stroke CentersStroke/transient ischemic attackEligible AF patientsGuidelines-Stroke programIschemic stroke patientsPrimary stroke centerHospital-level characteristicsAnticoagulation useGuidelines-StrokeIschemic attackThromboembolic eventsHospital dischargeIschemic strokeOlder patientsStroke centersAF patientsHispanic patients
2010
Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients With Ischemic Stroke
Fonarow G, Reeves M, Zhao X, Olson D, Smith E, Saver J, Schwamm L. Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients With Ischemic Stroke. Circulation 2010, 121: 879-891. PMID: 20142445, DOI: 10.1161/circulationaha.109.892497.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsOlder patientsIschemic strokeAge-related differencesAge groupsClinical characteristicsStroke patientsTreatment gapGuideline-recommended therapiesGuidelines-Stroke programWorse poststroke outcomesEarly clinical outcomesAcute ischemic strokeLarge contemporary cohortIschemic stroke admissionsHospital mortalityHospital outcomesStroke admissionsYounger patientsClinical outcomesContemporary cohortRecent smokersAtrial fibrillationMean agePoststroke outcomes
2001
Ischemic Stroke: Effects of Etiology and Patient Age on the Time Course of the Core Apparent Diffusion Coefficient
Copen W, Schwamm L, González R, Wu O, Harmath C, Schaefer P, Koroshetz W, Sorensen A. Ischemic Stroke: Effects of Etiology and Patient Age on the Time Course of the Core Apparent Diffusion Coefficient. Radiology 2001, 221: 27-34. PMID: 11568317, DOI: 10.1148/radiol.2211001397.Peer-Reviewed Original ResearchConceptsPatient ageApparent diffusion coefficientInfarct etiologyYounger patientsTime courseMagnetic resonance imaging examinationsRelative ADCEffect of etiologyRelative apparent diffusion coefficientLesion apparent diffusion coefficientNormal-appearing brainSignificant age-related differencesEtiology of lesionsStroke onsetIschemic strokeMedian ageOlder patientsSubgroup analysisAge-related differencesImaging examinationsPatientsADC progressionEtiologyLacunesAge