2024
Socioeconomic and medical determinants of state‐level subjective cognitive decline in the United States
de Havenon A, Stulberg E, Littig L, Wong K, Sarpong D, Li V, Sharma R, Falcone G, Williamson J, Pajewski N, Gottesman R, Brickman A, Sheth K. Socioeconomic and medical determinants of state‐level subjective cognitive decline in the United States. Alzheimer's & Dementia 2024 PMID: 39351858, DOI: 10.1002/alz.14220.Peer-Reviewed Original ResearchSubjective cognitive declinePrevalence of diabetesPrevalence of povertyMedical determinantsBehavioral Risk Factor Surveillance SystemRisk Factor Surveillance SystemCognitive declinePrevalence of subjective cognitive declineBurden of cognitive declinePopulation levelState-level prevalenceMedical risk factorsFunctional impairmentState-level associationsPhysician densityUnited StatesMedical factorsRates of povertyState-level analysisHousehold incomePrimary outcomeCollege educationSurveillance systemRisk factorsEthnic minoritiesDisability and Recurrent Stroke Among Participants in Stroke Prevention Trials
de Havenon A, Viscoli C, Kleindorfer D, Sucharew H, Delic A, Becker C, Robinson D, Yaghi S, Li V, Lansberg M, Cramer S, Mistry E, Sarpong D, Kasner S, Kernan W, Sheth K. Disability and Recurrent Stroke Among Participants in Stroke Prevention Trials. JAMA Network Open 2024, 7: e2423677. PMID: 39028666, PMCID: PMC11259901, DOI: 10.1001/jamanetworkopen.2024.23677.Peer-Reviewed Original ResearchConceptsPrevention trialsPoststroke disabilityRecurrent stroke ratesRecurrent strokeCohort studyRate of recurrent strokeStroke Prevention TrialIncreased hazardInsulin Resistance InterventionSecondary prevention trialsBaseline disabilityAssociated with increased ratesStroke rateMain OutcomesFunctional statusResistance InterventionStudy baselineSecondary outcomesPrimary outcomeWorsening heart failureModified Rankin ScaleProfession's participationLong-term followVascular deathDisabilityImpact of Procedure Time on First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke
Koo A, Reeves B, Renedo D, Maier I, Al Kasab S, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Shaban A, Arthur A, Yoshimura S, Cuellar H, Grossberg J, Alawieh A, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Osbun J, Crosa R, Park M, Levitt M, Brinjikji W, Moss M, Dumont T, Williamson R, Navia P, Kan P, Spiotta A, Sheth K, de Havenon A, Matouk C. Impact of Procedure Time on First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke. Neurosurgery 2024, 95: 128-136. PMID: 38483158, DOI: 10.1227/neu.0000000000002900.Peer-Reviewed Original ResearchAnterior circulation large vessel occlusion acute ischemic strokeAcute ischemic strokeLarge vessel occlusion acute ischemic strokeProcedure timeMechanical thrombectomyExcellent reperfusionClinical benefitIschemic strokeAnterior circulation acute ischemic strokeSuccess of mechanical thrombectomyModified Rankin Scale scoreRankin Scale scoreLogistic regression modelsNo significant differencePrimary study exposuresPrimary outcomeFunctional outcomesPotential confoundersStudy exposureThrombectomy devicesScale scoreThrombectomyReperfusionPatientsSignificant difference
2023
Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity
de Havenon A, Smith E, Sharma R, Falcone G, Bangad A, Prabhakaran S, Sheth K. Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity. Journal Of The American Heart Association 2023, 12: e029374. PMID: 37345754, PMCID: PMC10356061, DOI: 10.1161/jaha.123.029374.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesIncident strokePrimary outcomeHypertensive individualsMatter hyperintensitiesAtherosclerotic cardiovascular disease risk scoreCognitive impairmentCardiovascular disease risk scoreVascular risk factorsCurrent cigarette smokingDisease risk scoreMagnetic resonance imagingLogistic regression modelsRandomization armCerebrovascular eventsVascular riskCigarette smokingPrognostic informationRisk factorsPrognostic abilityRisk scoreCognitive declineResonance imagingDeLong testStrokeComplications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis
Rose D, Cavalier A, Kam W, Cantrell S, Lusk J, Schrag M, Yaghi S, Stretz C, de Havenon A, Saldanha I, Wu T, Ranta A, Barber P, Marriott E, Feng W, Kosinski A, Laskowitz D, Poli S, Mac Grory B. Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Stroke 2023, 54: 1192-1204. PMID: 36951049, PMCID: PMC10133185, DOI: 10.1161/strokeaha.122.042335.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeIntracranial hemorrhageIschemic strokeSystematic reviewIntravenous tenecteplaseRelative riskHigh-dose groupRisk of complicationsPrior systematic reviewsTenecteplase-treated patientsFull-text articlesWeb of ScienceGastrointestinal hemorrhageAdult patientsExtracranial hemorrhageNoncomparative studySecondary outcomesPooled riskPrimary outcomeTreatment complicationsAbsolute riskCochrane LibraryInterventional studyMedium doseChange in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial
Anadani M, Turan T, Yaghi S, Spiotta A, Gory B, Sharma R, Sheth K, de Havenon A. Change in Smoking Behavior and Outcome After Ischemic Stroke: Post-Hoc Analysis of the SPS3 Trial. Stroke 2023, 54: 921-927. PMID: 36876480, PMCID: PMC10050138, DOI: 10.1161/strokeaha.121.038202.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsAdverse cardiovascular eventsAcute ischemic strokeIschemic strokeCardiovascular eventsPersistent smokersPersistent smokingSPS3 trialSmoking statusMyocardial infarctionMajor adverse cardiovascular events outcomesCardiovascular event outcomesMajor cardiovascular outcomesSubsequent cardiovascular eventsHistory of hypertensionRisk of strokeEnd of studyPost Hoc AnalysisPrior smokersRandomization armCardiovascular outcomesFormer smokersMonth 3Primary outcomeTotal cohort
2022
CGRP, Migraine, and Brain MRI in CADASIL
Goldstein E, Gopal N, Badi M, Hodge D, de Havenon A, Glover P, Durham P, Huang J, Lin M, Baradaran H, Majersik J, Meschia J. CGRP, Migraine, and Brain MRI in CADASIL. The Neurologist 2022, 28: 231-236. PMID: 36729391, PMCID: PMC10277309, DOI: 10.1097/nrl.0000000000000478.Peer-Reviewed Original ResearchConceptsCalcitonin gene-related peptideMigraine-related disabilitySerum calcitonin gene-related peptideSerum CGRP levelsCGRP levelsBrain magnetic resonance imagingCerebral autosomal dominant arteriopathyGene-related peptideAutosomal dominant arteriopathyMagnetic resonance imagingCross-sectional analysisRadiographic associationRadiographic implicationsPrimary outcomeT2 hyperintensityCerebral microbleedsDisability ScaleSubcortical infarctsMigraine pathophysiologyVasoactive peptidesBrain MRIMigraine pathologyMigraineResonance imagingCADASILTechnical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly.
Forman R, Viscoli C, Meurer K, Sheth K, Sansing L, de Havenon A, Sharma R, Mariscal M, Kernan W. Technical Dissonance in Home Blood Pressure Monitoring After Stroke: Having the Machine, but Not Using Correctly. American Journal Of Hypertension 2022, 36: 195-200. PMID: 36520024, PMCID: PMC10016067, DOI: 10.1093/ajh/hpac129.Peer-Reviewed Original ResearchConceptsHome blood pressure monitoringBlood pressure monitoringBlood pressurePressure monitoringNon-Hispanic white patientsProportion of patientsCross-sectional studyNon-Hispanic white participantsStroke recurrenceRate of useMost patientsPrimary outcomeWhite patientsRate of possessionPatientsUnderrepresented patientsArm cuffHypertensionStrokeCorrect useWhite participantsSignificant disparitiesEthnic groupsParticipantsQuality of techniqueBorderzone infarction and recurrent stroke in intracranial atherosclerosis
Kvernland A, Torres J, Raz E, Nossek E, de Havenon A, Gebregziabher M, Khatri P, Prabhakaran S, Liebeskind D, Yaghi S. Borderzone infarction and recurrent stroke in intracranial atherosclerosis. Journal Of Stroke And Cerebrovascular Diseases 2022, 32: 106897. PMID: 36402094, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106897.Peer-Reviewed Original ResearchConceptsRecurrent cerebrovascular eventsIntracranial stenosisBorderzone infarctsInfarct patternsIschemic strokeBorderzone infarctionRetrospective single-center studyAcute ischemic strokeRecurrent ischemic strokeSingle-center studySymptomatic intracranial stenosisHigh-risk cohortBinary logistic regression analysisDistal blood flowAlternative treatment strategiesLogistic regression analysisLogistic regression modelsCerebrovascular eventsRecurrent strokeIntracranial atherosclerosisPrimary outcomeCenter studyMean ageSurrogate markerTreatment strategiesDirect cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**
de Havenon A, Orlando C, Delic A, McNally JS, Majersik JJ, Harman T, Alexander M, Reddy V, Lyden S, Anzai Y. Direct cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**. The Neuroradiology Journal 2022, 36: 142-147. PMID: 35701745, PMCID: PMC10034695, DOI: 10.1177/19714009221108681.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHospital lengthIschemic strokeBrain attackRapid MRIAIS patientsEmergency departmentCT perfusionMRI cohortRapid MRI protocolTotal hospital lengthEmergency department evaluationDirect costsNeurologic symptom onsetTotal direct costsDirect cost analysisHospital LOSSequential patientsSymptom onsetDepartment evaluationED LOSPrimary outcomeDischarge diagnosisPatientsMRI protocol
2021
Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke
de Havenon A, Castonguay A, Nogueira R, Nguyen TN, English J, Satti SR, Veznedaroglu E, Saver JL, Mocco J, Khatri P, Mistry E, Zaidat OO. Prestroke Disability and Outcome After Thrombectomy for Emergent Anterior Circulation Large Vessel Occlusion Stroke. Neurology 2021, 97: e1914-e1919. PMID: 34544817, PMCID: PMC8601211, DOI: 10.1212/wnl.0000000000012827.Peer-Reviewed Original ResearchConceptsPremorbid mRS scoreAnterior circulation acute ischemic strokeLarge vessel occlusion strokeAcute ischemic strokeEndovascular thrombectomyMRS scoreIschemic strokePrimary outcomeOcclusion strokeOdds ratioAnterior circulation large vessel occlusion strokeMiddle cerebral artery occlusionAcute Stroke RegistryCerebral artery occlusionClass II evidenceStudy of patientsPrestroke disabilityStroke RegistryArtery occlusionConsecutive patientsEndovascular therapyPremorbid disabilityFurther disabilityTrevo deviceMore disabilityIncreased Blood Pressure Variability and the Risk of Probable Dementia or Mild Cognitive Impairment: A Post Hoc Analysis of the SPRINT MIND Trial
de Havenon A, Anadani M, Prabhakaran S, Wong K, Yaghi S, Rost N. Increased Blood Pressure Variability and the Risk of Probable Dementia or Mild Cognitive Impairment: A Post Hoc Analysis of the SPRINT MIND Trial. Journal Of The American Heart Association 2021, 10: e022206. PMID: 34533059, PMCID: PMC8649507, DOI: 10.1161/jaha.121.022206.Peer-Reviewed Original ResearchConceptsBlood pressure controlBlood pressure variabilityMild cognitive impairmentCognitive impairmentProbable dementiaMIND trialBlood pressurePressure variabilityExcellent blood pressure controlPressure controlSuboptimal blood pressure controlSystolic blood pressure variabilityCox proportional hazards modelRisk of dementiaBlood pressure measurementsProportional hazards modelRate of dementiaPost Hoc AnalysisLowest tertileHighest tertilePrimary outcomeCardiovascular diseaseHoc AnalysisCox modelHazards modelBlack Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control
de Havenon A, Muddasani V, Castillo M, Sheth KN, Delic A, Herman A, Conaway M, Johnston KC, Investigators F. Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106065. PMID: 34455151, PMCID: PMC8511272, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106065.Peer-Reviewed Original ResearchConceptsIntensive glucose controlAcute ischemic strokeWorse functional outcomeBlack patientsGlucose controlIschemic strokeWhite patientsExcellent outcomesFunctional outcomeTreatment armsWorse outcomesAcute ischemic stroke patientsStroke Hyperglycemia Insulin Network Effort (SHINE) trialIntensive treatment armStandard treatment armIschemic stroke patientsExcellent functional outcomeMixed effects logistic regression modelsLogistic regression modelsPrimary outcomeStroke patientsPotential confoundersOdds ratioFunctional impairmentPatientsIntracranial Pressure and Cerebral Perfusion Pressure in Large Spontaneous Intracranial Hemorrhage and Impact of Minimally Invasive Surgery
Al-Kawaz MN, Li Y, Thompson RE, Avadhani R, de Havenon A, Gruber J, Awad I, Hanley DF, Ziai W. Intracranial Pressure and Cerebral Perfusion Pressure in Large Spontaneous Intracranial Hemorrhage and Impact of Minimally Invasive Surgery. Frontiers In Neurology 2021, 12: 729831. PMID: 34512537, PMCID: PMC8427275, DOI: 10.3389/fneur.2021.729831.Peer-Reviewed Original ResearchCerebral perfusion pressureLong-term mortalityHigh intracranial pressureIntracranial pressureCPP readingsTerm mortalityPerfusion pressureIntracerebral hemorrhageMIS groupControl groupLarge Spontaneous Intracerebral HemorrhageICP readingsInvasive surgeryHematoma volume reductionBlinded outcome assessmentShort-term mortalitySpontaneous intracerebral hemorrhageSpontaneous intracranial hemorrhageMultiple logistic regressionMIS patientsMISTIE IIISecondary outcomesPrimary outcomeHigher proportionIntracranial hemorrhageInvestigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke
Grandhi R, Ravindra VM, Ney JP, Zaidat O, Taussky P, de Havenon A. Investigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106013. PMID: 34375859, PMCID: PMC8511062, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106013.Peer-Reviewed Original ResearchMeSH KeywordsAfter-Hours CareAgedAged, 80 and overCross-Sectional StudiesDatabases, FactualEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansInpatientsIschemic StrokeLength of StayMaleMiddle AgedPatient DischargeRetrospective StudiesRisk AssessmentRisk FactorsThrombectomyTime FactorsTreatment OutcomeUnited StatesConceptsAcute ischemic strokeEndovascular thrombectomyIschemic strokeLarge vessel occlusion ischemic strokeHealth Stroke Scale scoreNationwide Inpatient Sample dataStroke Scale scoreExtended hospital stayWorse clinical outcomesCross-sectional analysisLogistic regression modelsHospital deathHospital staySecondary outcomesPrimary outcomeClinical outcomesAIS patientsNormal working hoursPatientsScale scoreFavorable dischargeExposure variablesStrokeWeekends/National InstituteMidlife Blood Pressure Variability and Risk of All-Cause Mortality and Cardiovascular Events During Extended Follow-up
de Havenon A, Delic A, Yaghi S, Wong KH, Majersik JJ, Stulberg E, Tirschwell D, Anadani M. Midlife Blood Pressure Variability and Risk of All-Cause Mortality and Cardiovascular Events During Extended Follow-up. American Journal Of Hypertension 2021, 34: 1269-1275. PMID: 34240111, PMCID: PMC8643578, DOI: 10.1093/ajh/hpab106.Peer-Reviewed Original ResearchConceptsBlood pressure variabilityLong-term blood pressure variabilityCardiovascular eventsHazard ratioPressure variabilityCardiovascular disease-free participantsMean systolic blood pressureVisit blood pressure variabilityCox proportional hazards modelCardiovascular risk factorsCorresponding hazard ratiosCongestive heart failureDisease-free patientsSystolic blood pressureDisease-free participantsProportional hazards modelPrior strokeCause mortalitySecondary outcomesBlood pressureHeart failureIndependent predictorsPrimary outcomeVisit 4Mean agePenumbra Consumption Rates Based on Time-to-Maximum Delay and Reperfusion Status: A Post Hoc Analysis of the DEFUSE 3 Trial
Yaghi S, Raz E, Dehkharghani S, Riina H, McTaggart R, Jayaraman M, Prabhakaran S, Liebeskind DS, Khatri P, Mac Grory B, Al-Mufti F, Lansberg M, Albers G, de Havenon A. Penumbra Consumption Rates Based on Time-to-Maximum Delay and Reperfusion Status: A Post Hoc Analysis of the DEFUSE 3 Trial. Stroke 2021, 52: 2690-2693. PMID: 34157865, DOI: 10.1161/strokeaha.120.033806.Peer-Reviewed Original ResearchConceptsDEFUSE-3 trialsLarge vessel occlusionPenumbral tissueVessel occlusionMismatch volumeAcute large vessel occlusionAnterior circulation occlusionEndovascular thrombectomy patientsAcute ischemic strokePost Hoc AnalysisReperfusion statusThrombectomy patientsTICI 0Cerebral infarctionEndovascular thrombectomyIschemic strokeUntreated patientsPrimary outcomeSalvageable tissueTreatment modalitiesHoc AnalysisPerfusion timePatientsNatural historyOcclusionVariability of the Modified Rankin Scale Score Between Day 90 and 1 Year After Ischemic Stroke
de Havenon A, Tirschwell DL, Heitsch L, Cramer SC, Braun R, Cole J, Reddy V, Majersik JJ, Lindgren A, Worrall BB. Variability of the Modified Rankin Scale Score Between Day 90 and 1 Year After Ischemic Stroke. Neurology Clinical Practice 2021, 11: e239-e244. PMID: 34484897, PMCID: PMC8382369, DOI: 10.1212/cpj.0000000000000954.Peer-Reviewed Original ResearchModified Rankin ScaleTrial's primary outcomePrimary outcomeIschemic strokeDay 90Stroke onsetStroke trialsStroke (NINDS) rt-PA Stroke StudyModified Rankin Scale scoreAcute ischemic strokeProportion of patientsIschemic stroke onsetRankin Scale scoreClinical trial designTraditional outcome measuresMRS improvementMRS shiftStroke IIIRecurrent strokeRankin ScaleInterventional managementClinical evolutionStroke StudyRehabilitative therapyAlbumin treatmentEvaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial
de Havenon A, Johnston SC, Easton JD, Kim AS, Sheth KN, Lansberg M, Tirschwell D, Mistry E, Yaghi S. Evaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial. JAMA Network Open 2021, 4: e2112551. PMID: 34086033, PMCID: PMC8178708, DOI: 10.1001/jamanetworkopen.2021.12551.Peer-Reviewed Original ResearchConceptsBaseline systolic blood pressureDual antiplatelet therapySystolic blood pressureTransient ischemic attackMinor Ischemic Stroke (POINT) trialNew transient ischemic attackAcute ischemic strokeIschemic strokeIschemic stroke trialsStroke recurrenceHazard ratioBlood pressurePrimary outcomeStroke trialsElevated baseline systolic blood pressureFit Cox proportional hazards modelsHigher baseline systolic blood pressureElevated systolic blood pressureCox proportional hazards modelDays of randomizationFuture stroke riskIschemic stroke recurrenceUse of aspirinSubgroup of patientsProportional hazards modelCarotid Stenosis and Recurrent Ischemic Stroke
Yaghi S, de Havenon A, Rostanski S, Kvernland A, Mac Grory B, Furie KL, Kim AS, Easton JD, Johnston SC, Henninger N. Carotid Stenosis and Recurrent Ischemic Stroke. Stroke 2021, 52: 2414-2417. PMID: 33940954, PMCID: PMC8268075, DOI: 10.1161/strokeaha.121.034089.Peer-Reviewed Original ResearchConceptsHigh-risk transient ischemic attackTransient ischemic attackEffect of clopidogrelMinor ischemic strokeIschemic strokeIschemic stroke riskCarotid stenosisIschemic attackStroke riskCervical internal carotid arteryAddition of clopidogrelDual antiplatelet therapyRecurrent ischemic strokeCox regression modelInternal carotid arteryAntiplatelet therapyPrimary outcomePoint trialCarotid arteryInclusion criteriaClopidogrelAdjusted modelStenosisPatientsStroke