2024
Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection
Albers G, Jumaa M, Purdon B, Zaidi S, Streib C, Shuaib A, Sangha N, Kim M, Froehler M, Schwartz N, Clark W, Kircher C, Yang M, Massaro L, Lu X, Rippon G, Broderick J, Butcher K, Lansberg M, Liebeskind D, Nouh A, Schwamm L, Campbell B. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. New England Journal Of Medicine 2024, 390: 701-711. PMID: 38329148, DOI: 10.1056/nejmoa2310392.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSymptomatic intracranial hemorrhageInternal carotid arteryMiddle cerebral arteryRankin ScalePlacebo groupTenecteplase groupIntracranial hemorrhageIncidence of symptomatic intracranial hemorrhageCerebral arteryIncidence of symptomatic intracerebral hemorrhageCarotid arteryPlacebo-controlled trialSymptomatic intracerebral hemorrhageEvidence of occlusionSafety populationDouble-blindPerfusion-imagingMedian timeClinical outcomesIntracerebral hemorrhagePlaceboPerfusion imagingPrimary outcomeOdds ratio
2022
Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry
Demel S, Reeves M, Xu H, Xian Y, Mac Grory B, Fonarow G, Matsouaka R, Smith E, Saver J, Schwamm L. Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry. Stroke 2022, 53: 3099-3106. PMID: 35880521, DOI: 10.1161/strokeaha.122.038491.Peer-Reviewed Original ResearchConceptsEndovascular therapyIschemic strokeHealth Stroke Scale scoreTreatment ratesGuidelines-Stroke hospitalsGuidelines-Stroke registryStroke Scale scoreAcute ischemic strokeSex differencesLarge vessel occlusionMultivariable regression analysisIschemic stroke dischargesEVT useHospital deathHospital mortalityASA guidelinesVessel occlusionOdds ratioScale scoreStroke dischargesSignificant sex differencesWomenNational InstituteMenStatistical adjustmentAnalysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke
Xian Y, Xu H, Matsouaka R, Laskowitz D, Maisch L, Hannah D, Smith E, Fonarow G, Bhatt D, Schwamm L, Mac Grory B, Feng W, Fosbøl E, Peterson E, Johnson M. Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke. JAMA Network Open 2022, 5: e2224157. PMID: 35900761, PMCID: PMC9335137, DOI: 10.1001/jamanetworkopen.2022.24157.Peer-Reviewed Original ResearchConceptsAHA/ASA guidelinesAcute ischemic strokeMinor ischemic strokeUse of DAPTDual antiplatelet therapyIschemic strokeMinor strokeHospital-level variationAntiplatelet therapyASA guidelinesDAPT useCohort studySecondary preventionOdds ratioAmerican Heart Association/American Stroke AssociationMinor acute ischemic strokeMulticenter retrospective cohort studyMultivariable logistic regression analysisSubstantial hospital-level variationAHA/ASAGuidelines-Stroke programIdentical clinical featuresRetrospective cohort studyAmerican Stroke AssociationEvidence-based guidelines
2021
Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage
Leifer D, Fonarow G, Hellkamp A, Baker D, Hoh B, Prabhakaran S, Schoeberl M, Suter R, Washington C, Williams S, Xian Y, Schwamm L. Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage. Journal Of The American Heart Association 2021, 10: e018373. PMID: 34325522, PMCID: PMC8475679, DOI: 10.1161/jaha.120.018373.Peer-Reviewed Original ResearchConceptsAnnual case volumeComprehensive Stroke Center (CSC) certificationStroke center certificationNational Inpatient SampleSubarachnoid hemorrhageNontraumatic subarachnoid hemorrhageCase volumeHospital mortalityClinical outcomesPoor outcomeCenter certificationSAH casesBetter outcomesVolume thresholdHospital annual case volumeHospital case volumeCases/yearBackground Previous studiesLogistic regression modelsSAH hospitalizationsHospital volumeAneurysm obliterationInpatient SampleOdds ratioImproved outcomes
2020
Missing outcome data management in acute stroke trials testing iv thrombolytics. Is there risk of bias?
Fernandez-Ferro J, Schwamm L, Descalzo M, MacIsaac R, Lyden P, Lees K. Missing outcome data management in acute stroke trials testing iv thrombolytics. Is there risk of bias? European Stroke Journal 2020, 5: 148-154. PMID: 32637648, PMCID: PMC7313360, DOI: 10.1177/2396987320905457.Peer-Reviewed Original ResearchAcute stroke trialsStroke trialsOdds ratioOutcome dataRankin ScaleNon-thrombolysed patientsRankin Scale 90Ischemic stroke patientsInternational Stroke TrialRisk of biasMultiple imputationLast observationOdds ratio estimatesTreatment odds ratiosStroke patientsClinical trialsOutcome comparisonsPatientsTrials
2017
Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke
Xian Y, Thomas L, Liang L, Federspiel J, Webb L, Bushnell C, Duncan P, Schwamm L, Stein J, Fonarow G, Hoenig H, Montalvo C, George M, Lutz B, Peterson E, Bettger J. Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke. Stroke 2017, 48: 2836-2842. PMID: 28830975, DOI: 10.1161/strokeaha.117.016904.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute ischemic strokeHospital-level variationIschemic strokeNursing facilitiesGuidelines-Stroke hospitalsMultilevel logistic regression modelsMedian odds ratioGeographic availabilityLogistic regression modelsIRF patientsHospital complicationsSNF patientsClinical characteristicsComorbid conditionsInpatient rehabilitationHospital characteristicsClinical registryOdds ratioRehabilitation facilityHospital useMedicare beneficiariesPatientsHospitalUse of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non–Vitamin K Antagonist Oral Anticoagulants Before Stroke
Xian Y, Federspiel J, Hernandez A, Laskowitz D, Schwamm L, Bhatt D, Smith E, Fonarow G, Peterson E. Use of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non–Vitamin K Antagonist Oral Anticoagulants Before Stroke. Circulation 2017, 135: 1024-1035. PMID: 28119380, DOI: 10.1161/circulationaha.116.023940.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overAnticoagulantsDabigatranFemaleFibrinolytic AgentsHemorrhageHospital MortalityHumansInternational Normalized RatioMalePyrazolesPyridonesRecombinant ProteinsRegistriesRetrospective StudiesRisk FactorsRivaroxabanStrokeTime FactorsTissue Plasminogen ActivatorTreatment OutcomeWarfarinConceptsIntravenous rt-PASymptomatic intracranial hemorrhageIschemic strokeRt-PAIntracranial hemorrhageOdds ratioNon-Vitamin K Antagonist Oral AnticoagulantsIntravenous recombinant tissue plasminogen activatorK Antagonist Oral AnticoagulantsRecombinant tissue plasminogen activatorGuidelines-Stroke registrySerious systemic hemorrhageAcute ischemic strokeAdjusted odds ratioAmerican Heart AssociationTissue plasminogen activatorOutcomes of useHospital mortalityRegistry hospitalsOral anticoagulantsSevere strokeAdverse eventsProhibitive riskRankin ScaleThrombolytic therapy
2015
Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke
Ali S, Smith E, Reeves M, Zhao X, Xian Y, Hernandez A, Bhatt D, Fonarow G, Schwamm L. Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2015, 8: s73-s80. PMID: 26515213, DOI: 10.1161/circoutcomes.114.001244.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCoronary artery diseaseVascular risk factorsAdjusted odds ratioHospital mortalityRisk factorsIschemic strokeArtery diseaseOdds ratioProspective population-based studyPast-year smokersResidual unmeasured confoundingPopulation-based studyAge-stratified analysisPotent risk factorPast-year smokingConsecutive patientsMultivariable modelSmokersSmokingPatientsSignificant associationMortalitySubstantial confoundingUnmeasured confoundingAssociation of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke
Masrur S, Cox M, Bhatt D, Smith E, Ellrodt G, Fonarow G, Schwamm L. Association of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2015, 4: e002193. PMID: 26408015, PMCID: PMC4845108, DOI: 10.1161/jaha.115.002193.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overBiomarkersBlood GlucoseBrain IschemiaChi-Square DistributionChronic DiseaseFemaleFibrinolytic AgentsGlycated HemoglobinGuideline AdherenceHospital MortalityHumansHyperglycemiaLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicPractice Patterns, Physicians'RegistriesRetrospective StudiesRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorAssociation of acuteAcute ischemic strokeHistory of diabetesWorse clinical outcomesChronic hyperglycemiaClinical outcomesGuidelines-StrokeHospital mortalityAIS patientsBlood glucoseGlucose levelsPlasma glucose levelsBlood glucose levelsAdmission glucoseNondiabetic patientsPost thrombolysisIschemic strokeAcute hyperglycemiaDL increaseAcute correctionPoor outcomeAdverse outcomesOdds ratioHyperglycemia
2014
Outcomes of intravenous tissue plasminogen activator for acute ischaemic stroke in HIV‐infected adults
Sweeney E, Thakur K, Lyons J, Smith B, Willey J, Cervantes‐Arslanian A, Hickey M, Uchino K, Haussen D, Koch S, Schwamm L, Elkind M, Shinohara R, Mateen F. Outcomes of intravenous tissue plasminogen activator for acute ischaemic stroke in HIV‐infected adults. European Journal Of Neurology 2014, 21: 1394-1399. PMID: 25040336, DOI: 10.1111/ene.12506.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNationwide Inpatient SampleIntravenous tissue plasminogen activatorIV-tPA useIV-tPATissue plasminogen activatorUninfected patientsIschemic strokeAIS patientsUS Nationwide Inpatient SampleSex-adjusted odds ratiosPlasminogen activatorShort-term outcomesRisk of deathIV-tPA administrationProportion of deathsHospital mortalityHospital deathHIV serostatusIntracerebral hemorrhageInpatient SampleOdds ratioHIVAIS casesPatients
2013
Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry
Hsich E, Grau-Sepulveda M, Hernandez A, Eapen Z, Xian Y, Schwamm L, Bhatt D, Fonarow G. Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry. American Heart Journal 2013, 166: 1063-1071.e3. PMID: 24268222, DOI: 10.1016/j.ahj.2013.08.029.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptide levelsMedian BNP levelNatriuretic peptide levelsEjection fractionInhospital mortalityHeart failureBNP levelsHF patientsPeptide levelsPlasma B-type natriuretic peptide (BNP) levelsGuidelines-Heart Failure registryGuidelines-Heart FailurePrimary end pointInhospital outcomesBNP valuesHospital clusteringPrognostic significanceClinical variablesLarge registriesOdds ratioPatientsBNPHigh mortalityEnd pointMortalityInsurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke
James M, Grau-Sepulveda M, Olson D, Smith E, Hernandez A, Peterson E, Schwamm L, Bhatt D, Fonarow G. Insurance Status and Outcome after Intracerebral Hemorrhage: Findings from Get With The Guidelines-Stroke. Journal Of Stroke And Cerebrovascular Diseases 2013, 23: 283-292. PMID: 23537567, DOI: 10.1016/j.jstrokecerebrovasdis.2013.02.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCerebral HemorrhageChi-Square DistributionFemaleGuideline AdherenceHealth Services AccessibilityHealthcare DisparitiesHumansInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Private SectorQuality of Health CareRegistriesRetrospective StudiesRisk FactorsTreatment OutcomeUnited StatesConceptsInsurance statusIntracerebral hemorrhageCare measuresOdds ratioND groupHospital mortality rateProspective stroke registryPrivate insurance groupHigher mortality riskHigher odds ratioEvidence-based qualityInsurance groupsHospital-specific variablesGuidelines-StrokeHospital outcomesStroke RegistryDischarge destinationIndependent ambulationComorbid conditionsStroke databaseAdjusted analysisICH patientsFunctional statusCare indicatorsMedicare patients
2012
Achievement of Guideline-Concordant Care and In-Hospital Outcomes in Patients With Coronary Artery Disease in Teaching and Nonteaching Hospitals
Tam L, Fonarow G, Bhatt D, Grau-Sepulveda M, Hernandez A, Peterson E, Schwamm L, Giugliano R. Achievement of Guideline-Concordant Care and In-Hospital Outcomes in Patients With Coronary Artery Disease in Teaching and Nonteaching Hospitals. Circulation Cardiovascular Quality And Outcomes 2012, 6: 58-65. PMID: 23233750, DOI: 10.1161/circoutcomes.112.965525.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmerican Heart AssociationCoronary Artery DiseaseDrug Therapy, CombinationEvidence-Based PracticeFemaleGuideline AdherenceGuidelines as TopicHospital MortalityHospitalsHospitals, TeachingHumansInpatientsMaleMiddle AgedOutcome Assessment, Health CareQuality Assurance, Health CareRetrospective StudiesSecondary PreventionTreatment OutcomeUnited StatesConceptsGuideline-concordant careGuidelines-Coronary Artery Disease programSecondary prevention therapiesCoronary artery diseaseTeaching hospitalHospital mortalityArtery diseasePrevention therapyAngiotensin-converting enzyme inhibitors/angiotensin receptor blockersEnzyme inhibitors/angiotensin receptor blockersEvidence-based secondary prevention therapiesDisease programsGuideline-recommended therapiesAngiotensin receptor blockersIn-Hospital OutcomesLength of stayLow-density lipoproteinGreatest incremental improvementReceptor blockersSystolic dysfunctionPrimary outcomeSmoking cessationLipid therapyOdds ratioNonteaching hospitals