2022
Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants
Das A, Gökçal E, Regenhardt R, Warren A, Biffi A, Goldstein J, Kimberly W, Viswanathan A, Schwamm L, Rosand J, Greenberg S, Gurol M. Clinical and neuroimaging risk factors associated with the development of intracerebral hemorrhage while taking direct oral anticoagulants. Journal Of Neurology 2022, 269: 6589-6596. PMID: 35997817, PMCID: PMC10947801, DOI: 10.1007/s00415-022-11333-2.Peer-Reviewed Original ResearchConceptsCortical superficial siderosisPrior ischemic strokeDOAC usersCerebral microbleedsWhite matter hyperintensitiesIschemic strokeSevere white matter hyperintensitiesOral anticoagulant usageDirect oral anticoagulantsSingle referral centerHigh hemorrhagic riskCoronary artery diseaseAge-matched controlsMultivariable regression modelsDOAC therapyICH cohortPrior strokeOral anticoagulantsSuperficial siderosisBaseline demographicsReferral centerSmoking historyArtery diseaseConclusionsRisk factorsHemorrhage risk
2020
Safety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months
Shah S, Liang L, Kosinski A, Hernandez A, Schwamm L, Smith E, Fonarow G, Bhatt D, Feng W, Peterson E, Xian Y. Safety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006031. PMID: 31903770, DOI: 10.1161/circoutcomes.119.006031.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleFibrinolytic AgentsHospital MortalityHumansInfusions, IntravenousIntracranial HemorrhagesMaleMedicareRecurrenceRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsAcute ischemic stroke patientsPrior ischemic strokeSymptomatic intracranial hemorrhageIschemic stroke patientsPrior strokeHospital mortalityIntravenous tPAIschemic strokeIntracranial hemorrhageStroke patientsGuidelines-Stroke hospitalsHigher stroke severityGood functional outcomeHistory of strokeRetrospective observational studyYears of ageCardiovascular comorbiditiesStroke providersStroke severityUnadjusted riskFunctional outcomeHigh prevalenceObservational studyMedicare claimsElevated risk
2019
Intravenous 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
Association 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
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 fibrillation
2014
Adherence to Third European Cooperative Acute Stroke Study 3- to 4.5-Hour Exclusions and Association With Outcome
Cronin CA, Sheth KN, Zhao X, Messé SR, Olson DM, Hernandez AF, Bhatt DL, Schwamm LH, Smith EE. Adherence to Third European Cooperative Acute Stroke Study 3- to 4.5-Hour Exclusions and Association With Outcome. Stroke 2014, 45: 2745-2749. PMID: 25104846, DOI: 10.1161/strokeaha.114.005443.Peer-Reviewed Original ResearchConceptsAdditional exclusion criteriaExclusion criteriaDiabetes mellitusAmerican Heart Association/American Stroke Association guidelinesEuropean Cooperative Acute Stroke StudyAmerican Stroke Association guidelinesSymptomatic intracranial hemorrhageWorse hospital outcomesHealth Stroke ScalePercent of patientsHistory of strokeOral anticoagulant treatmentCertain patient groupsAcute Stroke StudyTreatment time windowHour windowECASS IIIGuidelines-StrokePrior strokeAnticoagulant treatmentHospital outcomesStroke ScaleIschemic strokeSymptom onsetIncreased risk
2011
Timeliness of Tissue-Type Plasminogen Activator Therapy in Acute Ischemic Stroke
Fonarow G, Smith E, Saver J, Reeves M, Bhatt D, Grau-Sepulveda M, Olson D, Hernandez A, Peterson E, Schwamm L. Timeliness of Tissue-Type Plasminogen Activator Therapy in Acute Ischemic Stroke. Circulation 2011, 123: 750-758. PMID: 21311083, DOI: 10.1161/circulationaha.110.974675.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overAmerican Heart AssociationBrain IschemiaEmergency Medical ServicesFemaleFibrinolytic AgentsGuideline AdherenceHumansMaleMiddle AgedOutcome Assessment, Health CarePractice Guidelines as TopicRisk FactorsStrokeTime FactorsTissue Plasminogen ActivatorUnited StatesConceptsAcute ischemic strokeIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorIschemic stroke patientsNeedle timeIschemic strokeStroke patientsAcute ischemic stroke patientsGuidelines-Stroke programSimilar stroke severitySymptomatic intracranial hemorrhageTimeliness of reperfusionProportion of patientsPlasminogen activator therapyTreatment initiation timeMinute doorPrior strokeHospital mortalityHospital factorsStroke severitySymptom onsetPatient factorsActivator therapyIntracranial hemorrhageHospital characteristics
2008
Advance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator
Abdullah A, Smith E, Biddinger P, Kalenderian D, Schwamm L. Advance Hospital Notification by EMS in Acute Stroke Is Associated with Shorter Door-to-Computed Tomography Time andIncreased Likelihood of Administration of Tissue-Plasminogen Activator. Prehospital Emergency Care 2008, 12: 426-431. PMID: 18924004, DOI: 10.1080/10903120802290828.Peer-Reviewed Original ResearchConceptsEmergency medical servicesTissue plasminogen activatorAcute stroke patientsStroke patientsTertiary care stroke centerIntravenous tissue plasminogen activatorCatheter-based thrombolysisED arrival timeHospital time intervalsIntra-arterial thrombolysisMedian National InstitutesHealth Stroke ScaleUse of thrombolysisEmergency department arrivalTerms of ageHigher baseline ratesPrior strokeTPA useAcute strokeStroke centersStroke ScaleSymptom onsetStroke databaseMild strokeHospital notification