2025
Bidirectional relationship between epigenetic age and stroke, dementia, and late-life depression
Rivier C, Szejko N, Renedo D, Clocchiatti-Tuozzo S, Huo S, de Havenon A, Zhao H, Gill T, Sheth K, Falcone G. Bidirectional relationship between epigenetic age and stroke, dementia, and late-life depression. Nature Communications 2025, 16: 1261. PMID: 39893209, PMCID: PMC11787333, DOI: 10.1038/s41467-024-54721-0.Peer-Reviewed Original ResearchThis study shows a bidirectional link between accelerated epigenetic aging and brain health events like stroke, dementia, and depression, supporting new prevention strategies for aging-related conditions.A failure to launch: blood pressure control after stroke in a regional health system
Forman R, Xin X, Kim C, Kernan W, Sheth K, Krumholz H, de Havenon A, Spatz E, Lu Y. A failure to launch: blood pressure control after stroke in a regional health system. Journal Of Hypertension 2025, 43: 715-718. PMID: 39995224, DOI: 10.1097/hjh.0000000000003961.Peer-Reviewed Original ResearchConceptsYale New Haven Health SystemRegional health systemHealth systemSystolic blood pressureDiastolic blood pressureMonths post strokeAverage proportion of patientsBP controlPost strokeBlood pressureProfessional visitsPrimary outcomeBlood pressure controlProportion of patientsAverage proportionVisitsSBP valuesEpic systemPressure controlStrokePatientsGlobal budget
2024
Lipid-Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity.
Gordon-Kundu B, Peyravi R, Garg A, Baker A, Salas S, Levien M, Faridi K, de Havenon A, Krumholz H, Sheth K, Forman R, Sharma R. Lipid-Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity. Journal Of The American Heart Association 2024, 14: e033365. PMID: 39699007, DOI: 10.1161/jaha.123.033365.Peer-Reviewed Original ResearchConceptsPrescribed lipid-lowering therapyNational Institutes of Health Stroke Scale scoreAcute ischemic strokeLipid-lowering therapyStroke Scale scoreStroke severityGuidelines-Stroke registryAtherosclerotic cardiovascular disease eventsCardiovascular disease eventsScale scoreGuideline-recommended criteriaSevere stroke symptomsStudy assessed usePropensity score subclassificationLipid-lowering therapy useNational InstituteLogistic regression modelsCholesterol management guidelinesPoststroke disabilityElevated low-density lipoprotein cholesterolInstitutional GetSmall vessel diseaseTime of acute ischemic strokeLarge-artery atherosclerosisLow-density lipoprotein cholesterolPortable, low-field magnetic resonance imaging for evaluation of Alzheimer’s disease
Sorby-Adams A, Guo J, Laso P, Kirsch J, Zabinska J, Garcia Guarniz A, Schaefer P, Payabvash S, de Havenon A, Rosen M, Sheth K, Gomez-Isla T, Iglesias J, Kimberly W. Portable, low-field magnetic resonance imaging for evaluation of Alzheimer’s disease. Nature Communications 2024, 15: 10488. PMID: 39622805, PMCID: PMC11612292, DOI: 10.1038/s41467-024-54972-x.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMachine learning pipelineMild cognitive impairmentAlzheimer's diseaseWhite matter hyperintensities volumeLearning pipelineAssessment of patientsIncrease accessCognitive impairmentEvaluation of Alzheimer's diseaseDementiaLF-MRIPoint-of-care assessmentMagnetic resonance imagingHippocampal volumeResonance imagingImage qualityDiseaseReduce costsAnisotropic counterpartIncreasing availabilityManual segmentationOutcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry
Al Kasab S, Almallouhi E, Jumaa M, Inoa V, Capasso F, Nahhas M, Starke R, Fragata I, Bender M, Moldovan K, Yaghi S, Maier I, Grossberg J, Jabbour P, Psychogios M, Samaniego E, Burkhardt J, Jankowitz B, Abdalkader M, Hassan A, Altschul D, Mascitelli J, Regenhardt R, Wolfe S, Ezzeldin M, Limaye K, Grandhi R, Al Jehani H, Niazi M, Goyal N, Tjoumakaris S, Alawieh A, Abdelsalam A, Guada L, Ntoulias N, El-Ghawanmeh R, Batra V, Choi A, Zohdy Y, Nguyen S, Essibayi M, Naamani K, Koo A, Almekhlafi M, Raz E, Miller S, Mierzwa A, Zaidi S, Gudino A, Alsarah A, Azeem H, Mattingly T, Schartz D, Nelson A, Pinheiro C, Spiotta A, Kicielinski K, Lena J, Lajthia O, Hubbard Z, Zaidat O, Derdeyn C, Klein P, Nguyen T, de Havenon A. Outcomes of Adjunct Emergent Stenting Versus Mechanical Thrombectomy Alone: The RESCUE-ICAS Registry. Stroke 2024, 56: 390-400. PMID: 39576761, DOI: 10.1161/strokeaha.124.049038.Peer-Reviewed Original ResearchConceptsPatients treated with mechanical thrombectomyStent groupMechanical thrombectomySymptomatic hemorrhageEmergency stentingConsecutive patients treated with mechanical thrombectomyIntracranial stenosisRate of symptomatic hemorrhageRisk of symptomatic hemorrhageModified Rankin Scale scoreAssociated with better functional outcomesInverse probability of treatment weightingProbability of treatment weightingRankin Scale scoreInternational cohort studyLarge vessel occlusionAcute ischemic strokeThrombectomy-capable centersComplication rateResidual stenosisCohort studyIncreased riskInfarct volumePrimary outcomeFunctional outcomesLife's Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults
Clocchiatti-Tuozzo S, Rivier C, Renedo D, Huo S, Hawkes M, de Havenon A, Schwamm L, Sheth K, Gill T, Falcone G. Life's Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults. Neurology 2024, 103: e209990. PMID: 39442069, PMCID: PMC11498939, DOI: 10.1212/wnl.0000000000209990.Peer-Reviewed Original ResearchConceptsLife's Essential 8Poor cardiovascular healthCardiovascular healthBrain healthLife's Essential 8 scoreUnadjusted riskEssential 8Determinants of cardiovascular healthUK Biobank (UKBCardiovascular health profileModifiable cardiovascular risk factorsBrain health outcomesRisk factorsComposite outcomePublic health constructsPopulation studiesMiddle-aged adultsCox modelLate-life depressionCox proportional hazards modelsBrain health benefitsMultivariate Cox modelCardiovascular risk factorsFollow-up timeAoU participantsRecent trends in GLP-1 RA and SGLT2i use among people with type 2 diabetes and atherosclerotic cardiovascular disease in the USA
King A, Tan X, Dhopeshwarkar N, Bohn R, Dea K, Leonard C, de Havenon A. Recent trends in GLP-1 RA and SGLT2i use among people with type 2 diabetes and atherosclerotic cardiovascular disease in the USA. BMJ Open Diabetes Research & Care 2024, 12: e004431. PMID: 39366717, PMCID: PMC11459310, DOI: 10.1136/bmjdrc-2024-004431.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsGLP-1 RAsAtherosclerotic cardiovascular diseaseGLP-1Type 2 diabetesIncident useGlucagon-like peptide-1 receptor agonistsPeptide-1 receptor agonistsCardiovascular diseasePrevalence of atherosclerotic cardiovascular diseaseASCVD diagnosisProportion of patientsRetrospective observational studyNested cohort studyReceptor agonistsSGLT2i useAnalysis of cross-sectional dataSodium-glucoseCohort studyPatient numbersObservational studyPatientsPrevalent useCross-sectional dataT2DBrain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program.
Huo S, Rivier C, Clocchiatti-Tuozzo S, Renedo D, Sunmonu N, de Havenon A, Sarpong D, Rosendale N, Sheth K, Falcone G. Brain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program. Neurology 2024, 103: e209863. PMID: 39321407, DOI: 10.1212/wnl.0000000000209863.Peer-Reviewed Original ResearchConceptsBrain health outcomesSexual minoritiesGender minoritiesSGM groupHealth outcomesSGM personsLate-life depressionGender identitySexual orientationHigher odds of dementiaUS population-based studyElectronic health record dataOdds of dementiaHealth record dataGender minority groupsPopulation-based studyOdds of strokeCross-sectional studyMultivariate logistic regressionHealth disparitiesBaseline questionnaireNon-SGMSubgroups of genderTransgender womenUS adultsIntravenous Thrombolysis in Patients With Cervical Artery Dissection
Shu L, Akpokiere F, Mandel D, Field T, Leon Guerrero C, Henninger N, Muppa J, Affan M, Haq Lodhi O, Heldner M, Antonenko K, Seiffge D, Arnold M, Salehi Omran S, Crandall R, Lester E, López-Mena D, Arauz A, Nehme A, Boulanger M, Touzé E, Sousa J, Sargento-Freitas J, Barata V, Castro-Chaves P, Brito M, Khan M, Mallick D, Rothstein A, Khazaal O, Kaufmann J, Engelter S, Traenka C, Aguiar de Sousa D, Soares M, Rosa S, Zhou L, Gandhi P, Mancini S, Metanis I, Leker R, Pan K, Dantu V, Baumgartner K, Burton T, Von Rennenberg R, Nolte C, Choi R, MacDonald J, Bavarsad Shahripour R, Guo X, Ghannam M, Almajali M, Samaniego E, Rioux B, Zine-Eddine F, Poppe A, Fonseca A, Baptista M, Cruz D, Romoli M, De Marco G, Longoni M, Keser Z, Griffin K, Kuohn L, Frontera J, Amar J, Giles J, Zedde M, Pascarella R, Grisendi I, Nzwalo H, Liebeskind D, Molaie A, Cavalier A, Kam W, Mac Grory B, Al Kasab S, Anadani M, Kicielinski K, Eltatawy A, Chervak L, Chulluncuy Rivas R, Aziz Y, Mistry E, Bakradze E, Tran T, Rodrigo-Gisbert M, Requena M, Saleh Velez F, Garcia J, Muddasani V, de Havenon A, Sanchez S, Vishnu V, Yaddanapudi S, Adams L, Browngoehl A, Ranasinghe T, Dunston R, Lynch Z, Penckofer M, Siegler J, Mayer S, Willey J, Zubair A, Cheng Y, Sharma R, Marto J, Krupka D, Klein P, Nguyen T, Asad S, Sarwat Z, Balabhadra A, Patel S, Secchi T, Martins S, Mantovani G, Kim Y, Krishnaiah B, Elangovan C, Lingam S, Qureshi A, Fridman S, Alvarado A, Khasiyev F, Linares G, Mannino M, Terruso V, Tountopoulou A, Tentolouris-Piperas V, Martinez-Marino M, Carrasco Wall V, Indraswari F, El Jamal S, Liu S, Zhou M, Alvi M, Ali F, Sarvath M, Morsi R, Kass-Hout T, Shi F, Zhang J, Sokhi D, Said J, Mongare N, Simpkins A, Gomez R, Sen S, Ghani M, Elnazeir M, Wangqin R, Xiao H, Kala N, Khan F, Stretz C, Mohammadzadeh N, Goldstein E, Furie K, Yaghi S. Intravenous Thrombolysis in Patients With Cervical Artery Dissection. Neurology 2024, 103: e209843. PMID: 39298709, PMCID: PMC11415265, DOI: 10.1212/wnl.0000000000209843.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke symptomsCervical artery dissectionFunctional independenceIntravenous thrombolysisIschemic stroke symptomsStroke symptomsArtery dissectionIncidence of symptomatic intracranial hemorrhageIschemic strokeSymptomatic intracranial hemorrhageSuspected ischemic strokeClass III evidenceMedian ageSymptomatic ICHIntracranial hemorrhageSecondary analysisGuideline recommendationsICH riskIII evidenceFunctional outcomesPatientsThrombolysisCeADYoung adultsDissectionDisability 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 deathDisabilityPrediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research.
de Havenon A, Ayodele I, Alhanti B, Mac Grory B, Xian Y, Fonarow G, Smith E, Worrall B. Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research. Neurology 2024, 102: e209424. PMID: 38759133, PMCID: PMC11175650, DOI: 10.1212/wnl.0000000000209424.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionNIH Stroke ScaleConsistent with previous studiesAdult acute ischemic stroke patientsCross-sectional cohort analysisAcute ischemic stroke patientsLarge vessel occlusion strokePosterior circulation strokeDiagnosis of ischemic strokeReceiver operating curveNeuroimagingGWTG-StrokeIschemic stroke patientsVascular neuroimagingAdult patientsAtrial fibrillationCirculation strokeCohort analysisClinical covariatesStroke patientsOcclusion strokeVessel occlusionPrevious studiesCut-pointsStroke ScaleSecondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts
Rivier C, Acosta J, Leasure A, Forman R, Sharma R, de Havenon A, Spatz E, Inzucchi S, Kernan W, Falcone G, Sheth K. Secondary Prevention in Patients With Stroke Versus Myocardial Infarction: Analysis of 2 National Cohorts. Journal Of The American Heart Association 2024, 13: e033322. PMID: 38639369, PMCID: PMC11179946, DOI: 10.1161/jaha.123.033322.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsBlood PressureCross-Sectional StudiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsPractice Guidelines as TopicRisk AssessmentRisk FactorsSecondary PreventionStrokeUnited KingdomUnited StatesConceptsMyocardial infarctionPrevention scoreSecondary preventionImplementation of preventive therapyNational cohortUK BiobankAntiplatelet therapy useGuideline-directed therapyPrevention profilesBlood pressure controlAdherence to guideline-directed therapyLow-density lipoprotein controlNeighborhood deprivation levelHistory of strokeVascular risk profileStatin useAntiplatelet useTherapy usePreventive therapyComparison to participantsPrevention criteriaCross-sectional analysisBlood pressurePatientsPressure controlExternal validation of the SI2NCAL2C score for outcomes following cerebral venous thrombosis
Klein P, Shu L, Lindgren E, de Winter M, Siegler J, Simpkins A, Omran S, Heldner M, de Havenon A, Abdalkader M, Al Kasab S, Stretz C, Wu T, Wilson D, Asad S, Almallouhi E, Frontera J, Kuohn L, Rothstein A, Bakradze E, Henninger N, Zubair A, Sharma R, Kerrigan D, Aziz Y, Mistry E, van Kammen M, Tatlisumak T, Krzywicka K, Aguiar de Sousa D, Jood K, Field T, Yaghi S, Coutinho J, Nguyen T. External validation of the SI2NCAL2C score for outcomes following cerebral venous thrombosis. Journal Of Stroke And Cerebrovascular Diseases 2024, 33: 107720. PMID: 38614162, DOI: 10.1016/j.jstrokecerebrovasdis.2024.107720.Peer-Reviewed Original ResearchConceptsCerebral venous thrombosisArea under the receiver operating characteristic curvePoor outcomeVenous thrombosisCentral nervous system infectionInternational retrospective studyNervous system infectionExternal validation cohortFocal neurological deficitsReceiver operating characteristic curvePoor outcome dataLevels of hemoglobinLack of follow-upPoorer outcome scoresConsecutive patientsClinical presentationRetrospective studyValidation cohortIntracerebral hemorrhageNeurological deficitsFollow-upOutcome scoresSystemic infectionLevels of glucoseInternational cohortBurden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization.
de Havenon A, Callaghan B, Xu Y, Connor M, Hill C, Ney J, Esper G. Burden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization. Neurology 2024, 102: e209248. PMID: 38507675, PMCID: PMC11383855, DOI: 10.1212/wnl.0000000000209248.Peer-Reviewed Original ResearchConceptsHealth care encountersNeurological diagnosisCare encountersHealth careCollection of electronic health recordsHospital-based careHealth Research NetworkElectronic health recordsEmergency department visitsCohort of adultsYears of follow-upGlobal health research networkPatient-level dataElixhauser comorbidity scorePropensity score matchingHealth recordsMovement disordersDepartment visitsEMR dataPatient's residenceMarital statusAnalysis of patient-level dataNearest neighbor propensity score matchingIncident eventsHazard ratioAPOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation
Renedo D, Rivier C, Koo A, Sujijantarat N, Clocchiatti-Tuozzo S, Wu K, Torres-Lopez V, Huo S, Gunel M, de Havenon A, Sheth K, Matouk C, Falcone G. APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation. JAMA Network Open 2024, 7: e2355368. PMID: 38363572, PMCID: PMC10873768, DOI: 10.1001/jamanetworkopen.2023.55368.Peer-Reviewed Original ResearchConceptsApolipoprotein E e4Participants of European ancestryRisk of intracerebral hemorrhageHigh risk of intracerebral hemorrhageCross-sectional studyUK BiobankEuropean ancestryHigh riskUs Research ProgramUK Biobank participantsInternational Classification of DiseasesAssociated with higher risk of ICHCross-sectional study of patientsAPOE e4 statusClassification of DiseasesApolipoprotein ENinth Revision and Tenth RevisionAssociated with higher riskIndividual-level dataMultivariate logistic regressionIntracerebral hemorrhage riskBrain arteriovenous malformationsIntracerebral hemorrhageBiobank participantsTenth RevisionGenome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke
Aldridge C, Braun R, Lohse K, de Havenon A, Cole J, Cramer S, Lindgren A, Keene K, Hsu F, Worrall B. Genome-Wide Association Studies of 3 Distinct Recovery Phenotypes in Mild Ischemic Stroke. Neurology 2024, 102: e208011. PMID: 38181310, PMCID: PMC11023036, DOI: 10.1212/wnl.0000000000208011.Peer-Reviewed Original Research
2023
Association of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank.
Rivier C, Renedo D, de Havenon A, Sunmonu N, Gill T, Payabvash S, Sheth K, Falcone G. Association of Poor Oral Health With Neuroimaging Markers of White Matter Injury in Middle-Aged Participants in the UK Biobank. Neurology 2023, 102: e208010. PMID: 38165331, PMCID: PMC10870735, DOI: 10.1212/wnl.0000000000208010.Peer-Reviewed Original ResearchConceptsPoor oral healthOral healthBrain healthRisk factorsNeuroimaging markerWMH volumeHealth profileMD scoreSelf-reported poor oral healthCross-sectional neuroimaging studiesFractional anisotropyWhite matter hyperintensity volumeModifiable risk factorsWhite matter injuryPresence of denturesMendelian randomizationMiddle-aged personsFA scoreMiddle-aged participantsLoose teethCardiovascular diseaseHyperintensity volumeBrain MRIModifiable processEarly interventionDisability Status and Secondary Prevention Among Survivors of Stroke: A Cross‐Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey
Zhou T, de Havenon A, Sheth K, Ross J. Disability Status and Secondary Prevention Among Survivors of Stroke: A Cross‐Sectional Analysis of the 2011 to 2018 National Health and Nutrition Examination Survey. Journal Of The American Heart Association 2023, 12: e030869. PMID: 38014672, PMCID: PMC10727323, DOI: 10.1161/jaha.123.030869.Peer-Reviewed Original ResearchImprovement 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 testStrokePerioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation
Shu L, Jiang W, Xiao H, Henninger N, Nguyen T, Siegler J, de Havenon A, Goldstein E, Mandel D, Rana M, Al‐Mufti F, Frontera J, Furie K, Yaghi S. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation. Annals Of Neurology 2023, 94: 321-329. PMID: 37183768, DOI: 10.1002/ana.26678.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAtrial fibrillationPerioperative acute ischemic strokeDiagnosis-related groupsRisk factors-VASc scoreActive cancerHigher CHA<sub>2</sub> DS<sub>2</sub> VASc score. TheElective proceduresInternational Classification of DiseasesRisk factors of acute ischemic strokeScoring systemIschemic strokeClassification of DiseasesNeurological surgeryDays of dischargeLogistic regression modelsNationwide Readmissions DatabaseElective surgical proceduresAnticoagulant therapyInternational ClassificationPeriprocedural periodRenal failureSurgical typeAdult patients
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