2024
Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis
Mac Grory B, Sun J, Alhanti B, Lusk J, Li F, Adeoye O, Furie K, Hasan D, Messe S, Sheth K, Schwamm L, Smith E, Bhatt D, Fonarow G, Saver J, Xian Y, Grotta J. Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis. JAMA Neurology 2024, 81 PMID: 39466286, DOI: 10.1001/jamaneurol.2024.3659.Peer-Reviewed Original ResearchEmergency medical servicesEmergency medical service managementMobile stroke unitPrehospital managementSymptomatic intracranial hemorrhageHospital dischargeGlobal disabilityIn-hospital mortalityEfficacy end pointUtility-weighted modified Rankin scaleStroke unit managementAcute ischemic strokeIschemic strokePrimary analytic cohortDiagnosis of ischemic strokeIntravenous thrombolysisAmerican Heart AssociationEnd pointsGuidelines-StrokeUW-mRSSecondary efficacy end pointsMain OutcomesMedical servicesStroke unitAmbulation statusTwenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program
Xian Y, Li S, Jiang T, Beon C, Poudel R, Thomas K, Reeves M, Smith E, Saver J, Sheth K, Messé S, Schwamm L, Fonarow G. Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program. Stroke 2024, 55: 2599-2610. PMID: 39429153, PMCID: PMC11518659, DOI: 10.1161/strokeaha.124.048174.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programEvidence-based stroke careDoor-to-needle timeTransient ischemic attackGuidelines-Stroke hospitalsEvidence-based careQuality of careSmoking cessation counselingSustained improvementQuality improvement initiativesSkilled nursing facilityIndependence of patientsAcute ischemic strokeIschemic strokeRelevant to patientsIschemic attackDoor-to-puncture timeCessation counselingGuidelines-StrokeAssociated with sustained improvementStroke careDysphagia screeningNursing facilitiesHospital characteristicsImprovement initiativesNanotechnology approaches to drug delivery for the treatment of ischemic stroke
Peng B, Mohammed F, Tang X, Liu J, Sheth K, Zhou J. Nanotechnology approaches to drug delivery for the treatment of ischemic stroke. Bioactive Materials 2024, 43: 145-161. PMID: 39386225, PMCID: PMC11462157, DOI: 10.1016/j.bioactmat.2024.09.016.Peer-Reviewed Original ResearchBlood-brain barrierClinical translationClinical trialsFDA-approved pharmacotherapiesReview therapeutic agentsIschemic strokeTherapeutic agentsEffective treatment optionDrug deliveryTreatment of ischemic strokePotential clinical translationGlobal public health concernImprove delivery efficiencyTreatment optionsTreatment strategiesIschemic brainPublic health concernStroke pharmacotherapyEngineered nanoparticlesStroke treatment strategiesDelivery efficiencyNanotechnological approachesDrugPharmacotherapyStrokeDiffusion‐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 valueImpact 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 differenceBurden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019
Renedo D, Acosta J, Leasure A, Sharma R, Krumholz H, de Havenon A, Alahdab F, Aravkin A, Aryan Z, Bärnighausen T, Basu S, Burkart K, Coberly K, Criqui M, Dai X, Desai R, Dharmaratne S, Doshi R, Elgendy I, Feigin V, Filip I, Gad M, Ghozy S, Hafezi-Nejad N, Kalani R, Karaye I, Kisa A, Krishnamoorthy V, Lo W, Mestrovic T, Miller T, Misganaw A, Mokdad A, Murray C, Natto Z, Radfar A, Ram P, Roth G, Seylani A, Shah N, Sharma P, Sheikh A, Singh J, Song S, Sotoudeh H, Vervoort D, Wang C, Xiao H, Xu S, Zand R, Falcone G, Sheth K. Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019. JAMA Neurology 2024, 81: 394-404. PMID: 38436973, PMCID: PMC10913004, DOI: 10.1001/jamaneurol.2024.0190.Peer-Reviewed Original ResearchBurden of strokeHemorrhagic strokeBurden trendsGlobal burdenGlobal Burden of Disease StudyBurden of Disease StudyAge-standardized ratesAge-standardized estimatesPublic health policiesStroke-related outcomesIschemic strokeCross-sectional studyPublic health challengeCross-sectional analysisStroke mortalityStroke burdenHealth policyOlder adultsMain OutcomesStroke incidenceStroke casesIntracerebral hemorrhageEscalating burdenHealth challengesSignificant disparitiesEndovascular Treatment of Acute Ischemic Stroke After Cardiac Interventions in the United States
de Havenon A, Zhou L, Koo A, Matouk C, Falcone G, Sharma R, Ney J, Shu L, Yaghi S, Kamel H, Sheth K. Endovascular Treatment of Acute Ischemic Stroke After Cardiac Interventions in the United States. JAMA Neurology 2024, 81: 264-272. PMID: 38285452, PMCID: PMC10825786, DOI: 10.1001/jamaneurol.2023.5416.Peer-Reviewed Original ResearchNational Institutes of Health Stroke ScaleNational Institutes of Health Stroke Scale scoreOdds of discharge homeDischarged homeIschemic strokeRate of endovascular thrombectomyMultivariate logistic regressionNational Inpatient Sample databaseHealth Stroke ScaleIntervention patientsInpatient Sample databaseMain OutcomesIntervention statusHospitalization of patientsPotential confoundersUS hospitalsEndovascular thrombectomyStroke patientsCohort studySecondary outcomesLogistic regressionCardiac interventionsStroke severityStroke ScaleGroup of hospitalized patientsAssociation Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient data
2023
Code ICH: A Call to Action
Li Q, Yakhkind A, Alexandrov A, Alexandrov A, Anderson C, Dowlatshahi D, Frontera J, Hemphill J, Ganti L, Kellner C, May C, Morotti A, Parry-Jones A, Sheth K, Steiner T, Ziai W, Goldstein J, Mayer S. Code ICH: A Call to Action. Stroke 2023, 55: 494-505. PMID: 38099439, DOI: 10.1161/strokeaha.123.043033.Peer-Reviewed Original ResearchIntracerebral hemorrhageHematoma expansionNeurological outcomeEarly aggressive careAcute ischemic strokeBlood pressure controlPoor functional outcomeMultiple simultaneous interventionsBundled careAggressive careIschemic strokeIndependent predictorsPrimary outcomeAcute phaseEmergency reversalFunctional recoveryRandomized trialsFunctional outcomeWorse outcomesConsensus statementCurrent evidenceTreatment opportunitiesSingle interventionEarly interventionPressure controlPriorities for Advancements in Neuroimaging in the Diagnostic Workup of Acute Stroke
Samaniego E, Boltze J, Lyden P, Hill M, Campbell B, Silva G, Sheth K, Fisher M, Hillis A, Nguyen T, Carone D, Favilla C, Deljkich E, Albers G, Heit J, Lansberg M, Aksoy D, Broderick J, Castonguay A, Ghosh S, Grotta J, Harston G, Houser G, Kuchenbecker K, Latour L, Liebeskind D, Kylan Lynch J, Maier C, Mistry E, Mocco J, Nogueira R, Saver J, van Vlimmeren M, Wakhloo A, Wechsler L. Priorities for Advancements in Neuroimaging in the Diagnostic Workup of Acute Stroke. Stroke 2023, 54: 3190-3201. PMID: 37942645, PMCID: PMC10841844, DOI: 10.1161/strokeaha.123.044985.Peer-Reviewed Original ResearchConceptsAcute strokeDiagnostic workupAcute ischemic stroke treatmentAcute ischemic strokeComprehensive stroke centerHigh-resolution vessel wallCerebral Infarction (TICI) scaleIschemic stroke treatmentMobile stroke unitIschemic strokeStroke centersStroke treatmentStroke unitReperfusion outcomesPatient outcomesEarly ischemiaCone beamStrokeVessel wallWorkupAcademic investigatorsOutcomesTomographyThrombolysisReperfusionRacial and Ethnic Differences in the Risk of Ischemic Stroke After Nontraumatic Intracerebral Hemorrhage
Simonetto M, Sheth K, Ziai W, Iadecola C, Zhang C, Murthy S. Racial and Ethnic Differences in the Risk of Ischemic Stroke After Nontraumatic Intracerebral Hemorrhage. Stroke 2023, 54: 2401-2408. PMID: 37462054, PMCID: PMC10529487, DOI: 10.1161/strokeaha.123.043160.Peer-Reviewed Original ResearchConceptsNon-Hispanic white patientsNon-Hispanic blacksIschemic strokeIntracerebral hemorrhageHispanic patientsWhite patientsAtrial fibrillationICH patientsHigh riskNon-Hispanic black patientsCox proportional hazards modelIncident ischemic strokeRetrospective cohort studyNontraumatic intracerebral hemorrhageValvular heart diseaseTime of dischargeLarge heterogeneous cohortProportional hazards modelNon-Hispanic whitesICH hospitalizationsCardiovascular comorbiditiesMedian followCohort studyVascular comorbiditiesConcomitant diagnosisAnalysis of brain edema in RHAPSODY
Schleicher R, Vorasayan P, McCabe M, Bevers M, Davis T, Griffin J, Hinduja A, Jadhav A, Lee J, Sawyer R, Zlokovic B, Sheth K, Fedler J, Lyden P, Kimberly W, Investigators O. Analysis of brain edema in RHAPSODY. International Journal Of Stroke 2023, 19: 68-75. PMID: 37382409, PMCID: PMC10789908, DOI: 10.1177/17474930231187268.Peer-Reviewed Original ResearchConceptsNet water uptakeMidline shiftCerebral edemaMarkers of edemaImaging markerClinical outcomesBrain magnetic resonance imaging (MRI) scansMass effectMagnetic resonance imaging (MRI) scansSupratentorial ischemic lesionsAcute ischemic strokeBaseline stroke volumeProtein C treatmentResonance imaging scansCerebrospinal fluid volumeTime courseIschemic strokeBaseline visitIschemic lesionsTrial cohortBrain edemaTreatment armsSecondary complicationsFuture trialsImaging scansNeighborhood Deprivation and Race Synergistically Contribute to Undiagnosed Hypertension Leading to Acute Ischemic Stroke: Results from the All of Us Research Program (P6-9.001)
Torres-Lopez V, Renedo D, Acosta J, Gill T, Sheth K, Falcone G, Rivier C. Neighborhood Deprivation and Race Synergistically Contribute to Undiagnosed Hypertension Leading to Acute Ischemic Stroke: Results from the All of Us Research Program (P6-9.001). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000202154.Peer-Reviewed Original ResearchNeighborhood Deprivation and Polygenic Contribution to Acute Ischemic Stroke: Results from the All of Us Research Program (S49.007)
Rivier C, Acosta J, Renedo D, Gill T, Sheth K, Falcone G. Neighborhood Deprivation and Polygenic Contribution to Acute Ischemic Stroke: Results from the All of Us Research Program (S49.007). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000202793.Peer-Reviewed Original ResearchInvestigating the Relationship Between Oximetry Trends During Endovascular Therapy and Neurological Worsening for Patients with Acute Ischemic Stroke (S24.006)
Olexa M, Begunova Y, Bartolome D, Peng T, Matouk C, Sheth K, Petersen N. Investigating the Relationship Between Oximetry Trends During Endovascular Therapy and Neurological Worsening for Patients with Acute Ischemic Stroke (S24.006). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000202997.Peer-Reviewed Original ResearchHemorrhagic Conversion of Acute Ischemic Stroke
Zubair A, Sheth K. Hemorrhagic Conversion of Acute Ischemic Stroke. Neurotherapeutics 2023, 20: 705-711. PMID: 37085684, PMCID: PMC10275827, DOI: 10.1007/s13311-023-01377-1.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHemorrhagic conversionIschemic strokeTreatment of patientsHemorrhagic transformationEndovascular thrombectomySerious complicationsThrombolytic therapyTreatment optionsRisk factorsLeading causePatient outcomesCurrent treatmentTimely managementStrokePatientsTreatmentThrombectomyMorbidityComplicationsReviewPathophysiologyTherapyMortalityDiagnosisEffect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample
de Havenon A, Zhou L, Yaghi S, Frontera J, Sheth K. Effect of COVID-19 on Acute Ischemic Stroke Severity and Mortality in 2020: Results From the 2020 National Inpatient Sample. Stroke 2023, 54: e194-e198. PMID: 37021563, PMCID: PMC10121243, DOI: 10.1161/strokeaha.122.041929.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleStroke ScaleStroke severityLowest quartileCOVID-19Acute ischemic stroke outcomesAcute ischemic stroke severityHigher stroke severityHospital stroke mortalityIschemic stroke outcomeHigher National InstitutesNational Inpatient SampleCross-sectional cohortIschemic stroke severityCOVID-19 statusNational InstituteHospital mortalityAdjusted riskHospital dischargeIschemic strokeStroke outcomeStroke mortalityAIS severityInpatient SampleExposure statusEffect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity
de Havenon A, Abbasi M, Yaghi S, Delic A, Bangad A, Johnston K, Tirschwell D, Sheth K. Effect of Alteplase on Ischemic Stroke Mortality Is Dependent on Stroke Severity. Annals Of Neurology 2023, 93: 1106-1116. PMID: 36852919, DOI: 10.1002/ana.26621.Peer-Reviewed Original ResearchConceptsIV-tPAHigher NIHSSIschemic strokeAtrial fibrillationNational Inpatient Sample (NIS) 2016Non-Hispanic white raceOlder ageBaseline National InstitutesDEFUSE-3 trialsHealth Stroke ScalePost-stroke mortalityIschemic stroke mortalityEffect of alteplaseRisk of mortalityLogistic regression modelsAnn NeurolFAST-MAGIMS IIISevere ISHospital mortalityIntravenous alteplaseSevere strokeStroke ScaleStroke severityFunctional outcomeChange 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
Cholesterol-Lowering Medication Use Prior to Ischemic Strokes Secondary to Large Artery Atherosclerosis or Small Vessel Disease: A Single Center Study (S35.009)
Garg A, Baker A, Faridi K, De Havenon A, Sheth K, Forman R, Sharma R. Cholesterol-Lowering Medication Use Prior to Ischemic Strokes Secondary to Large Artery Atherosclerosis or Small Vessel Disease: A Single Center Study (S35.009). Neurology 2022, 98 DOI: 10.1212/wnl.98.18_supplement.3531.Peer-Reviewed Original Research