2024
Tenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial
Xiong Y, Wang L, Pan Y, Wang M, Schwamm L, Duan C, Campbell B, Li S, Hao M, Wu N, Cao Z, Wu S, Li Z, Wang Y. Tenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial. Stroke And Vascular Neurology 2024, svn-2023-003048. PMID: 38858097, DOI: 10.1136/svn-2023-003048.Peer-Reviewed Original ResearchSymptomatic intracranial haemorrhageAcute ischaemic strokeModified Rankin ScaleElderly patientsPost hoc analysisAlteplase groupTenecteplase groupHoc analysisAlternative to alteplaseModified Rankin scale 0Ischaemic strokeRisk-benefit profileNon-inferiority clinical trialBenefit-risk profileEfficacy outcomesProportion of participantsReperfusion therapyIntracranial haemorrhageClinical trialsRankin ScaleSymptom onsetTenecteplaseAlteplaseIntravenous thrombolyticsSafety outcomesTenecteplase 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
2023
Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke
Lin D, Hardstone R, DiCarlo J, Mckiernan S, Snider S, Jacobs H, Erler K, Rishe K, Boyne P, Goldsmith J, Ranford J, Finklestein S, Schwamm L, Hochberg L, Cramer S. Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke. Neurology 2023, 101: e347-e357. PMID: 37268437, PMCID: PMC10435065, DOI: 10.1212/wnl.0000000000207417.Peer-Reviewed Original ResearchConceptsDistal motor controlUpper extremity motor deficitsAcute strokeBarthel IndexMotor deficitsMotor controlAcute stroke patientsUpper extremity hemiparesisUpper extremity motor controlRegion of injuryLesion-symptom mappingMotor systemHealthy CNSDays poststrokeDistal injuriesRankin ScaleStroke onsetConsecutive patientsStroke patientsMotor scoresClinical syndromeFunctional outcomeIntact CNSPosterior aspectPrecentral gyrusSMS-text messaging for collecting outcome measures after acute stroke
DiCarlo J, Erler K, Petrilli M, Emerson K, Gochyyev P, Schwamm L, Lin D. SMS-text messaging for collecting outcome measures after acute stroke. Frontiers In Digital Health 2023, 5: 1043806. PMID: 36910572, PMCID: PMC9996089, DOI: 10.3389/fdgth.2023.1043806.Peer-Reviewed Original ResearchModified Rankin ScaleAcute strokeOutcomes Measurement Information System (PROMIS) Global-10Acute stroke treatmentText messaging programsNIH Stroke ScaleOutcome data collectionHospitalization dischargeSMS text messagingHospital stayStroke ScaleMRS scoreRankin ScaleStroke treatmentFunctional outcomePROM scoresOutcome measuresWeighted Cohen's kappaPatientsSignificant associationStrokeTraditional followSMS textOutcomesParticipant satisfaction
2022
Functional status at 30 and 90 days after mild ischaemic stroke
Gardener H, Romano L, Smith E, Campo-Bustillo I, Khan Y, Tai S, Riley N, Sacco R, Khatri P, Alger H, Mac Grory B, Gulati D, Sangha N, Olds K, Benesch C, Kelly A, Brehaut S, Kansara A, Schwamm L, Romano J. Functional status at 30 and 90 days after mild ischaemic stroke. Stroke And Vascular Neurology 2022, 7: 375-380. PMID: 35474180, PMCID: PMC9614160, DOI: 10.1136/svn-2021-001333.Peer-Reviewed Original ResearchModified Rankin ScaleMild ischemic strokeIschemic strokeMRS 0Stroke severityStudy populationDisability statusGreater stroke severityIschemic stroke participantsAlteplase treatmentClinical characteristicsHealth StrokeHospital arrivalRankin ScaleStroke StudyMild strokeFunctional statusMedical recordsFunctional improvementStroke participantsMultivariable modelFunctional declineLong-term recoveryIdentifies predictorsStudy participantsAssociation of Modified Rankin Scale With Recovery Phenotypes in Patients With Upper Extremity Weakness After Stroke
Erler K, Wu R, DiCarlo J, Petrilli M, Gochyyev P, Hochberg L, Kautz S, Schwamm L, Cramer S, Finklestein S, Lin D. Association of Modified Rankin Scale With Recovery Phenotypes in Patients With Upper Extremity Weakness After Stroke. Neurology 2022, 98: e1877-e1885. PMID: 35277444, PMCID: PMC9109148, DOI: 10.1212/wnl.0000000000200154.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleUpper extremity weaknessMRS scoreStroke trialsFunctional outcomeOutcome measuresMRS levelsExtremity weaknessRankin ScaleMRS outcomesMotor impairmentFuture stroke trialsDaily living statusUpper extremity impairmentMeaningful changeGlobal outcome measuresMeaningful clinical changeIschemic strokeFugl-MeyerGrip strengthMotor phenotypeClinical changesClinical careDaily livingPatients
2021
Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Zhang S, Inohara T, Grau-Sepulveda M, Matsouaka RA, Peterson ED, Piccini JP, Smith EE, Sheth KN, Bhatt DL, Fonarow GC, Schwamm LH. Clinical Characteristics and Outcomes Associated With Oral Anticoagulant Use Among Patients Hospitalized With Intracerebral Hemorrhage. JAMA Network Open 2021, 4: e2037438. PMID: 33591368, PMCID: PMC7887660, DOI: 10.1001/jamanetworkopen.2020.37438.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsCase-Control StudiesCerebral HemorrhageCohort StudiesDependent AmbulationDrug Therapy, CombinationDual Anti-Platelet TherapyFactor Xa InhibitorsFemaleFunctional StatusHospicesHospital MortalityHumansMaleMiddle AgedOdds RatioPatient DischargePlatelet Aggregation InhibitorsRegistriesRisk FactorsWarfarinConceptsOral anticoagulant useOral anticoagulantsFXa inhibitorsHospital mortalityAnticoagulant useCohort studyIndependent ambulationMRS scoreIntracerebral hemorrhageGuidelines-Stroke registryCardiovascular risk factorsHospital mortality riskFactor Xa inhibitorsConcomitant warfarinOral anticoagulationAnticoagulation therapyAntiplatelet therapyHospital outcomesClinical characteristicsRankin ScaleSecondary outcomesPrimary outcomeRisk factorsWorse outcomesHigh prevalence
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
2019
The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design
Romano J, Gardener H, Campo-Bustillo I, Khan Y, Riley N, Tai S, Sacco R, Khatri P, Smith E, Schwamm L. The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design. International Journal Of Stroke 2019, 14: 983-986. PMID: 31496438, DOI: 10.1177/1747493019873595.Peer-Reviewed Original ResearchConceptsStroke symptomsStroke Impact Scale-16Actual treatment ratesMild ischemic strokePrimary safety outcomeSymptomatic hemorrhagic transformationProportion of patientsThird of patientsProspective observational studyEffect of alteplaseAcute stroke trialsLong-term outcomesPredictors of outcomeAlteplase treatmentHemorrhagic transformationIschemic strokeRankin ScaleSecondary outcomesBarthel IndexPrimary outcomeResidual disabilityStroke presentationRetrospective studyStroke StudyStroke trials
2018
Rates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care
Ali S, Fonarow G, Liang L, Xian Y, Smith E, Bhatt D, Schwamm L. Rates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care. Circulation Cardiovascular Quality And Outcomes 2018, 11: e003359. PMID: 30354551, DOI: 10.1161/circoutcomes.116.003359.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCentralized Hospital ServicesDisability EvaluationFemaleHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedPatient AdmissionPatient TransferRecovery of FunctionRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsSpecialized stroke centersStroke centersHospital mortalityAIS casesPrevious stroke/transient ischemic attackStroke/transient ischemic attackHealth Stroke Scale scoreHigher median National InstitutesWorse short-term outcomesAcute ischemic stroke careGuidelines-Stroke registryMedian National InstitutesOutcomes of patientsStroke Scale scoreTransient ischemic attackShort-term outcomesIschemic stroke careTransfer of patientsMidwest teaching hospitalInstitutional mortality ratesIschemic attackMultivariable adjustmentBaseline characteristicsRankin ScaleClinical outcomesIntravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results
Schwamm L, Wu O, Song S, Latour L, Ford A, Hsia A, Muzikansky A, Betensky R, Yoo A, Lev M, Boulouis G, Lauer A, Cougo P, Copen W, Harris G, Warach S, Investigators O. Intravenous thrombolysis in unwitnessed stroke onset: MR WITNESS trial results. Annals Of Neurology 2018, 83: 980-993. PMID: 29689135, PMCID: PMC6095471, DOI: 10.1002/ana.25235.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingSymptomatic intracranial hemorrhageLarge vessel occlusionIntravenous thrombolysisSymptom discoveryVessel occlusionAcute ischemic stroke patientsFluid-attenuated inversion recovery magnetic resonance imagingInversion recovery magnetic resonance imagingDiffusion-weighted magnetic resonance imagingIschemic stroke patientsStroke durationAnn NeurolSymptomatic edemaUnwitnessed onsetUnwitnessed strokeIntravenous alteplaseRankin ScaleSecondary outcomesStroke onsetSymptom onsetPrimary outcomeIntracranial hemorrhageProspective studyStroke patients
2017
Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke
Tokunboh I, Vales Montero M, Zopelaro Almeida M, Sharma L, Starkman S, Szeder V, Jahan R, Liebeskind D, Gonzalez N, Demchuk A, Froehler M, Goyal M, Lansberg M, Lutsep H, Schwamm L, Saver J. Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke. Stroke 2017, 49: 90-97. PMID: 29222229, DOI: 10.1161/strokeaha.117.018715.Peer-Reviewed Original ResearchConceptsAcute cerebral ischemiaEndovascular thrombectomyBetter disability outcomesCerebral ischemiaDisability outcomesTPA-eligible patientsAcute ischemic strokeLarge vessel occlusionReperfusion treatmentTerritory infarctsIschemic strokeRankin ScaleVessel occlusionThrombectomyPatientsPhysician's decisionHealthcare providersTrial dataAdverse effectsOutcomesTreatment effectsIschemiaVisual decision aidsTPADecision aidUse 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
2016
Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic
Moura L, Schwamm E, Moura Junior V, Seitz M, Hsu J, Cole A, Schwamm L. Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic. Neurology 2016, 87: 2435-2442. PMID: 27815405, PMCID: PMC5177682, DOI: 10.1212/wnl.0000000000003409.Peer-Reviewed Original ResearchConceptsPatient-reported outcome measuresT-scoreNeurology clinicAmbulatory neurology clinicMental health T-scoresGeneral neurology clinicPatient-reported outcomesMental health scoresUS general populationQuality of lifeMental health assessmentMean T-scoreQOLIE-10Rankin ScaleNeurology patientsEpilepsy scoresClinical dataOutcome measuresHealth scoresAdministrative claimsGeneral populationPatientsStudy periodVulnerable populationsDemographic characteristicsAssessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries
Fonarow G, Liang L, Thomas L, Xian Y, Saver J, Smith E, Schwamm L, Peterson E, Hernandez A, Duncan P, O'Brien E, Bushnell C, Prvu Bettger J. Assessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries. Stroke 2016, 47: 836-842. PMID: 26892279, DOI: 10.1161/strokeaha.115.011599.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleIschemic strokeMedicare beneficiariesIschemic stroke Longitudinal (AVAIL) registryMedian Modified Rankin ScaleAcute ischemic strokePatient-centered outcomesSkilled nursing facilitiesGuidelines-StrokeMRS 0Older patientsRankin ScaleStroke careInpatient rehabilitationStroke survivorsC-indexOutcome measuresNursing facilitiesFunctional independenceAdherence evaluationStrokePatientsSimilar findingsMeaningful outcomesPearson correlation coefficient
2014
Use of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke
Stein J, Bettger J, Sicklick A, Hedeman R, Magdon-Ismail Z, Schwamm L. Use of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke. Archives Of Physical Medicine And Rehabilitation 2014, 96: 210-217. PMID: 25102387, DOI: 10.1016/j.apmr.2014.07.403.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesInstitution-based rehabilitationPredictors of referralDischarge homeBarthel IndexBI scoreRehabilitation needsSociodemographic characteristicsShort Portable Mental Status QuestionnaireDischarge disposition locationGuidelines-Stroke registryHealth Stroke ScalePatients' sociodemographic characteristicsDaily living impairmentStandardized assessmentHigher BI scoreMental Status QuestionnaireProspective pilot projectPrestroke disabilityStroke ScaleAcute strokeClinical characteristicsOlder patientsRankin Scale
2013
A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Kidwell C, Jahan R, Gornbein J, Alger J, Nenov V, Ajani Z, Feng L, Meyer B, Olson S, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Guzy J, Starkman S, Saver J. A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke. New England Journal Of Medicine 2013, 368: 914-923. PMID: 23394476, PMCID: PMC3690785, DOI: 10.1056/nejmoa1212793.Peer-Reviewed Original ResearchConceptsFavorable penumbral patternAcute ischemic strokeStandard carePenumbral patternIschemic strokeRankin ScaleNinety-day mortalitySymptomatic intracranial hemorrhageAnterior circulation strokeModified Rankin ScaleMagnetic resonance imagingEligible patientsEmbolectomy groupMechanical embolectomyEndovascular thrombectomyEndovascular therapySuch patientsClinical outcomesEndovascular treatmentIntracranial hemorrhageMean ageImaging selectionImaging patternsEmbolectomyPatients
2012
Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy
Yoo A, Chaudhry Z, Nogueira R, Lev M, Schaefer P, Schwamm L, Hirsch J, González R. Infarct Volume Is a Pivotal Biomarker After Intra-Arterial Stroke Therapy. Stroke 2012, 43: 1323-1330. PMID: 22426317, DOI: 10.1161/strokeaha.111.639401.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkersBrain InfarctionCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingPredictive Value of TestsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTomography, X-Ray ComputedTreatment OutcomeConceptsFinal infarct volumeIntra-arterial therapyAcute ischemic strokeInfarct volumeFunctional outcomeBetter outcomesIschemic strokePoor outcomeAnterior circulation acute ischemic strokeScale scoreHealth Stroke Scale scoreMedian admission National InstitutesMedian final infarct volumesLong-term functional outcomeIntra-arterial stroke therapyAdmission National InstitutesProximal artery occlusionStroke Scale scoreOnly independent predictorRankin Scale scoreArtery occlusionProspective cohortRankin ScaleIndependent predictorsClinical outcomes
2010
Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield
2009
Number Needed to Treat to Benefit and to Harm for Intravenous Tissue Plasminogen Activator Therapy in the 3- to 4.5-Hour Window
Saver J, Gornbein J, Grotta J, Liebeskind D, Lutsep H, Schwamm L, Scott P, Starkman S. Number Needed to Treat to Benefit and to Harm for Intravenous Tissue Plasminogen Activator Therapy in the 3- to 4.5-Hour Window. Stroke 2009, 40: 2433-2437. PMID: 19498197, PMCID: PMC2724988, DOI: 10.1161/strokeaha.108.543561.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorRankin ScaleIntravenous tissue plasminogen activator therapyIntravenous tissue plasminogen activatorTissue plasminogen activator therapyPlasminogen activatorAcute cerebral ischemiaModified Rankin ScalePlasminogen activator therapyResults of therapyEffect sizeCerebral ischemiaPoststroke disabilityAdditional patientsActivator therapyWorse outcomesGlobal disabilityTreatment decisionsBetter outcomesClinical practicePatientsNNTBLikelihood of helpEffect size estimatesTable analysis