2024
StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierUse of a dedicated open transcarotid access system for neurovascular disease
Sujijantarat N, Renedo D, Antonios J, Koo A, Amllay A, Nowicki K, Cord B, Hebert R, de Havenon A, Sheth K, Petersen N, Matouk C. Use of a dedicated open transcarotid access system for neurovascular disease. Journal Of NeuroInterventional Surgery 2024, 17: jnis-2024-021599. PMID: 38719442, DOI: 10.1136/jnis-2024-021599.Peer-Reviewed Original ResearchExtracranial carotid stenosisTranscarotid artery revascularizationNeurovascular diseasesCarotid stenosisDatabase of consecutive patientsNeurovascular pathologyTreatment of neurovascular diseasesAccess-related complicationsTreatment of neurovascular pathologiesOff-label useCarotid flow reversalConsecutive patientsRetrospective reviewIntracranial atherosclerotic diseasePeriprocedural complicationsEndovascular treatmentArtery revascularizationProcedural characteristicsArterial sheathCarotid diseaseAcademic centersIntracranial aneurysmsPatientsTranscarotid approachTransradial approachAPOE 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 RevisionLipid-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 segmentationPolygenic Risk of Epilepsy and Poststroke Epilepsy
Clocchiatti-Tuozzo S, Rivier C, Misra S, Zelano J, Mazumder R, Sansing L, de Havenon A, Hirsch L, Liebeskind D, Gilmore E, Sheth K, Kim J, Worrall B, Falcone G, Mishra N. Polygenic Risk of Epilepsy and Poststroke Epilepsy. Stroke 2024, 55: 2835-2843. PMID: 39502073, PMCID: PMC11653790, DOI: 10.1161/strokeaha.124.047459.Peer-Reviewed Original ResearchParticipants of European ancestryRisk of poststroke epilepsyPolygenic riskPoststroke epilepsyEuropean ancestryGenome-wide association study meta-analysisPRS decileCase-control genetic association studyGenetic risk lociLowest decilePolygenic risk scoresGenetic association studiesMultivariate logistic regression modelStudy meta-analysisMultivariate logistic regression resultsHistory of strokeLogistic regression modelsRisk lociAssociation studiesStroke survivorsUK BiobankGenetic informationGenetic ancestryLogistic regression resultsGenetic variantsSex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage
Rivier C, Renedo D, Marini S, Magid‐Bernstein J, de Havenon A, Rosand J, Hanley D, Ziai W, Mayer S, Woo D, Sansing L, Sheth K, Anderson C, Falcone G. Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage. Annals Of Neurology 2024, 97: 232-241. PMID: 39499118, DOI: 10.1002/ana.27123.Peer-Reviewed Original ResearchRisk of hematoma expansionHighest risk of hematoma expansionRisk of poor outcomesIntracerebral hemorrhageHematoma expansionHigh riskMale sexPoor outcomeOutcome of spontaneous intracerebral hemorrhageClinical characteristics of patientsStudies of intracerebral hemorrhageNon-traumatic intracerebral hemorrhageIndividual patient data meta-analysisPatient data meta-analysisSpontaneous intracerebral hemorrhageSingle-center studyIntracerebral hemorrhage patientsHigh risk of expansionCharacteristics of patientsIntracerebral hemorrhage severityPoor functional outcomeRandomized clinical trialsData meta-analysisHemorrhage volumeClinical characteristicsLife'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 participantsSocioeconomic 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, 20: 7567-7579. PMID: 39351858, PMCID: PMC11567845, 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 minoritiesBrain 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 adultsWhite matter hyperintensity on MRI and plasma Aβ42/40 ratio additively increase the risk of cognitive impairment in hypertensive adults
de Havenon A, Gottesman R, Willamson J, Rost N, Sharma R, Li V, Littig L, Stulberg E, Falcone G, Prabhakaran S, Schneider A, Sheth K, Pajewski N, Brickman A. White matter hyperintensity on MRI and plasma Aβ42/40 ratio additively increase the risk of cognitive impairment in hypertensive adults. Alzheimer's & Dementia 2024, 20: 6810-6819. PMID: 39229896, PMCID: PMC11485393, DOI: 10.1002/alz.14126.Peer-Reviewed Original ResearchRisk of cognitive impairmentYears of follow-upCognitive impairmentExposure categoriesHigh-risk categoryWhite matter hyperintensitySystolic Blood Pressure Intervention TrialRates of cognitive impairmentSPRINT-MIND trialDementia preventionFollow-upLow-risk categoryMIND trialAdditional risk factorsDevelopment of cognitive impairmentIntervention trialsHypertensive adultsHazard ratioRisk factorsHigh riskLow riskVascular healthTertileRiskImpairmentCorrelations of Socioeconomic and Clinical Determinants with United States County‐Level Stroke Prevalence
Stulberg E, Lisabeth L, Schneider A, Skolarus L, Kershaw K, Zheutlin A, Harris B, Sarpong D, Wong K, Sheth K, de Havenon A. Correlations of Socioeconomic and Clinical Determinants with United States County‐Level Stroke Prevalence. Annals Of Neurology 2024, 96: 739-744. PMID: 39056317, DOI: 10.1002/ana.27039.Peer-Reviewed Original ResearchSocioeconomic statusStroke prevalenceCounty-level socioeconomic statusSocioeconomic status measuresHealth care accessCenters for Disease Control and PreventionRisk factor measurementsDisease Control and PreventionPrevalence of adultsFederal poverty levelControl and PreventionCare accessStroke metricsStroke riskPoverty levelObservational researchPrevalenceClinical determinantsCommunity estimatesEcological studiesStrokeFactor measurementsHealthInterventionAdultsDisability 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 deathDisabilityDiffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients
Sorby‐Adams A, Guo J, de Havenon A, Payabvash S, Sze G, Pinter N, Jaikumar V, Siddiqui A, Baldassano S, Garcia‐Guarniz A, Zabinska J, Lalwani D, Peasley E, Goldstein J, Nelson O, Schaefer P, Wira C, Pitts J, Lee V, Muir K, Nimjee S, Kirsch J, Iglesias J, Rosen M, Sheth K, Kimberly W. Diffusion‐Weighted Imaging Fluid‐Attenuated Inversion Recovery Mismatch on Portable, Low‐Field Magnetic Resonance Imaging Among Acute Stroke Patients. Annals Of Neurology 2024, 96: 321-331. PMID: 38738750, PMCID: PMC11293843, DOI: 10.1002/ana.26954.Peer-Reviewed Original ResearchStroke patientsAcute ischemic strokeCut-pointsIschemic strokeStroke patients <Diagnosis of acute ischemic strokeSignal intensity ratioFluid-attenuated inversion recoveryAcute stroke patientsOptimal cut-pointMagnetic resonance imagingDiffusion-weighted imagingDWI-FLAIR mismatchStroke onsetTrained assessorsNational InstituteStrokeThrombolytic interventionNegative predictive valueFLAIR hyperintensitiesPatientsInterobserver agreementHyperacute strokeDiffusion-weightedPredictive valueBlood Pressure and Cognitive Function in Older Adults
Littig L, Sheth K, Brickman A, Mistry E, de Havenon A. Blood Pressure and Cognitive Function in Older Adults. Clinics In Geriatric Medicine 2024, 40: 597-613. PMID: 39349034, PMCID: PMC11443062, DOI: 10.1016/j.cger.2024.04.003.Peer-Reviewed Original ResearchSecondary 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 controlImpact of sleep quality and physical activity on blood pressure variability
de Havenon A, Falcone G, Rivier C, Littig L, Petersen N, de Villele P, Prabhakaran S, Kimberly W, Mistry E, Sheth K. Impact of sleep quality and physical activity on blood pressure variability. PLOS ONE 2024, 19: e0301631. PMID: 38625967, PMCID: PMC11020843, DOI: 10.1371/journal.pone.0301631.Peer-Reviewed Original ResearchConceptsSleep qualityPhysical activityOdds ratioCohort of community-dwelling adultsCommunity-dwelling adultsExcess relative riskBlood pressure variabilityExamined sleep qualityPoor sleep qualitySystolic blood pressure standard deviationSleep interruptionBody mass indexPhysical inactivityPrimary study outcomeStep countsImpact of sleep qualityLowest tertileRelative riskHigh blood pressure variabilityHome measurement devicesActivity levelsExposure statusPoor sleepMass indexStudy outcomes
2023
Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia
Clocchiatti‐Tuozzo S, Rivier C, Renedo D, Lopez V, Geer J, Miner B, Yaggi H, de Havenon A, Payabvash S, Sheth K, Gill T, Falcone G. Suboptimal Sleep Duration Is Associated With Poorer Neuroimaging Brain Health Profiles in Middle‐Aged Individuals Without Stroke or Dementia. Journal Of The American Heart Association 2023, 13: e031514. PMID: 38156552, PMCID: PMC10863828, DOI: 10.1161/jaha.123.031514.Peer-Reviewed Original ResearchConceptsSuboptimal sleep durationWhite matter hyperintensitiesMiddle-aged individualsLong sleep durationLarger WMH volumeSleep durationMiddle-aged adultsHealth profileWMH volumeAmerican Heart Association's LifeAsymptomatic middle-aged adultsWMH presenceVolume of WMHOptimal sleepSelf-reported sleep durationModifiable risk factorsWhite matter tractsProspective magnetic resonanceSimple 7Cardiovascular healthRisk factorsShort sleepMatter hyperintensitiesHigh riskEarly intervention
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
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