2024
Secondary 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 control
2023
A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association
Ndumele C, Neeland I, Tuttle K, Chow S, Mathew R, Khan S, Coresh J, Baker-Smith C, Carnethon M, Després J, Ho J, Joseph J, Kernan W, Khera A, Kosiborod M, Lekavich C, Lewis E, Lo K, Ozkan B, Palaniappan L, Patel S, Pencina M, Powell-Wiley T, Sperling L, Virani S, Wright J, Singh R, Elkind M, Rangaswami J, Association O. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association. Circulation 2023, 148: 1636-1664. PMID: 37807920, DOI: 10.1161/cir.0000000000001186.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseMetabolic risk factorsMetabolic syndromeRisk factorsKidney diseaseCardiovascular diseaseSocial determinantsEarly life preventionUnique management considerationsManagement of patientsInterdisciplinary care modelAmerican Heart AssociationBiological risk factorsScientific statementKidney outcomesLifestyle modificationHeart AssociationClinical managementCare modelClinical careSyndromeClinical phenotypeDiseaseMajor guidelinesWeight lossCardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association
Ndumele C, Rangaswami J, Chow S, Neeland I, Tuttle K, Khan S, Coresh J, Mathew R, Baker-Smith C, Carnethon M, Despres J, Ho J, Joseph J, Kernan W, Khera A, Kosiborod M, Lekavich C, Lewis E, Lo K, Ozkan B, Palaniappan L, Patel S, Pencina M, Powell-Wiley T, Sperling L, Virani S, Wright J, Singh R, Elkind M, Association O. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation 2023, 148: 1606-1635. PMID: 37807924, DOI: 10.1161/cir.0000000000001184.Peer-Reviewed Original ResearchConceptsMetabolic risk factorsMetabolic healthMetabolic syndromeRisk factorsPresidential AdvisorySocial determinantsCardiovascular disease eventsChronic kidney diseaseAdverse social determinantsAmerican Heart AssociationSignificant clinical impactMetabolic stagingSubspecialty guidelinesCardiovascular mortalityCardioprotective effectsKidney functionKidney diseaseTherapeutic optionsHeart AssociationInterdisciplinary careCardiovascular diseaseClinical impactHigh prevalenceCare fragmentationCare modelBaseline Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes and Coronary Disease Versus Stroke: Secondary Analysis of Cardiovascular Outcome Trials
Balasubramanian P, Kernan W, Sheth K, Ofstad A, Rosenstock J, Wanner C, Zinman B, Mattheus M, Marx N, Inzucchi S. Baseline Cardiovascular Risk Factor Control in Patients With Type 2 Diabetes and Coronary Disease Versus Stroke: Secondary Analysis of Cardiovascular Outcome Trials. Stroke 2023, 54: 2013-2021. PMID: 37449424, PMCID: PMC10358436, DOI: 10.1161/strokeaha.122.042053.Peer-Reviewed Original ResearchConceptsCardiovascular risk factor controlRisk factor controlCoronary artery diseaseEMPA-REG OUTCOMECardiovascular outcome trialsType 2 diabetesRisk factorsOutcome trialsBlood pressureOdds ratioAntiplatelet/anticoagulant medicationsAntiplatelet/anticoagulant therapyDiabetes cardiovascular outcome trialsSuboptimal risk factor controlCardiovascular risk factorsRecurrent ischemic eventsDiastolic blood pressureSystolic blood pressureRespective odds ratiosFactor controlCross-sectional analysisLogistic regression modelsMacrovascular complicationsStatin useAnticoagulant medication
2020
Adherence to study drug in a stroke prevention trial"?>
Kiran A, Viscoli CM, Furie KL, Gorman M, Kernan WN. Adherence to study drug in a stroke prevention trial"?>. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105048. PMID: 32912514, PMCID: PMC7487071, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105048.Peer-Reviewed Original ResearchConceptsRate of discontinuationStudy drugDrug holidayTreatment groupsActive study drugAdverse effectsInsulin Resistance InterventionPremature drug discontinuationRecent ischemic strokeStroke Prevention TrialDouble-blind trialTransient ischemic attackClinical trial researchPhases of adherenceDrug discontinuationIschemic attackStroke preventionDiscontinuation ratesIschemic strokeActive therapyMedical therapyPatient adherencePrevention trialsStroke trialsPharmacodynamic effects
2017
Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke
Yaghi S, Furie KL, Viscoli CM, Kamel H, Gorman M, Dearborn J, Young LH, Inzucchi SE, Lovejoy AM, Kasner SE, Conwit R, Kernan WN. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke. Circulation 2017, 137: 455-463. PMID: 29084736, DOI: 10.1161/circulationaha.117.030458.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeIschemic attackNondiabetic patientsStroke outcomeStroke eventsInsulin resistanceRecent transient ischemic attackCox proportional hazards modelQualifying ischemic strokeEffect of pioglitazoneFirst stroke eventProportional hazards modelPrevents strokeHemorrhagic eventsComposite outcomeSecondary preventionRecent strokeIRIS trialMyocardial infarctionTreatment groupsHazards modelPioglitazoneConsensus criteriaSurvival analysisEffects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial
Furie KL, Viscoli CM, Gorman M, Ford GA, Young LH, Inzucchi SE, Guarino PD, Lovejoy AM, Conwit R, Tanne D, Kernan WN. Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial. Journal Of Neurology Neurosurgery & Psychiatry 2017, 89: 21. PMID: 28939682, DOI: 10.1136/jnnp-2017-316361.Peer-Reviewed Original ResearchConceptsTransient ischemic attackRecent ischemic strokeIschemic strokeCognitive functionHomeostasis model assessment insulin resistance scoreModified Mini-Mental State Examination scoresAssessment-insulin resistance scoreMini-Mental State Examination scoreInsulin Resistance InterventionPoststroke cognitive functionVascular risk factorsEffect of pioglitazoneInsulin-resistant patientsState Examination scoreIschemic attackPioglitazone groupPlacebo groupIRIS trialStroke trialsCerebrovascular diseaseInsulin resistanceRisk factorsCognitive dysfunctionPatientsResistance Intervention
2016
Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial
Viscoli CM, Inzucchi SE, Young LH, Insogna KL, Conwit R, Furie KL, Gorman M, Kelly MA, Lovejoy AM, Kernan WN, Investigators F. Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial. The Journal Of Clinical Endocrinology & Metabolism 2016, 102: 914-922. PMID: 27935736, PMCID: PMC5460686, DOI: 10.1210/jc.2016-3237.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokeFracture riskBone fracturesRisk/benefit ratioAbsolute fracture riskInsulin Resistance InterventionPlacebo-treated patientsIschemic attackNondiabetic patientsPlacebo groupCardiovascular riskBone healthStroke trialsNondiabetic participantsPrevent fallsClinical trialsRelative riskSafety dataFracture classificationQuarterly interviewsPioglitazonePatientsResistance InterventionRisk incrementTaking care of volunteers in a stroke trial: a new assisted-management strategy
Stuart AC, Sico JJ, Viscoli CM, Tayal AH, Inzucchi SE, Ford GA, Furie KL, Cote R, Spence JD, Tanne D, Kernan WN. Taking care of volunteers in a stroke trial: a new assisted-management strategy. Stroke And Vascular Neurology 2016, 1: 108. PMID: 28959471, PMCID: PMC5435205, DOI: 10.1136/svn-2016-000029.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticholesteremic AgentsAntihypertensive AgentsBiomarkersBlood CoagulationBlood PressureCholesterol, LDLDouble-Blind MethodEuropeFemaleFibrinolytic AgentsHumansHypoglycemic AgentsInsulin ResistanceIschemic Attack, TransientIschemic StrokeIsraelMaleMiddle AgedNorth AmericaPioglitazoneRecurrenceRisk AssessmentRisk FactorsRisk Reduction BehaviorSecondary PreventionTime FactorsTreatment OutcomeConceptsPersonal healthcare providerBlood pressureStroke trialsPreventive careTrial participantsLow-density lipoprotein cholesterolPrevention goalsInsulin Resistance InterventionTransient ischemic attackPrevention of strokeSecondary prevention goalsEvidence-based careProportion of participantsIschemic attackAntithrombotic therapyIschemic strokeLipoprotein cholesterolSecondary preventionAntithrombotic useStroke therapyInsulin sensitisersMyocardial infarctionAnnual visitsHealthcare providersResistance Intervention
2012
Obesity
Kernan WN, Inzucchi SE, Sawan C, Macko RF, Furie KL. Obesity. Stroke 2012, 44: 278-286. PMID: 23111440, DOI: 10.1161/strokeaha.111.639922.Peer-Reviewed Original Research
2010
What Is the Future of Stroke Prevention?
Kernan WN, Launer LJ, Goldstein LB. What Is the Future of Stroke Prevention? Stroke 2010, 41: s35-s38. PMID: 20876501, PMCID: PMC4795938, DOI: 10.1161/strokeaha.110.592022.Peer-Reviewed Original ResearchConceptsRisk factorsPolypill approachDrug-related side effectsCardiovascular risk factorsFirst ischemic strokeStroke risk factorsMultiple risk factorsOlder adult populationStroke preventionIschemic strokeBlood pressureCholesterol levelsClinical trialsSide effectsAdult populationPolypillStrokeEntire populationRiskLarge populationPopulationCertain ageMedicationsPharmacodynamicsPharmacokinetics
2005
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive Sleep Apnea as a Risk Factor for Stroke and Death. New England Journal Of Medicine 2005, 353: 2034-2041. PMID: 16282178, DOI: 10.1056/nejmoa043104.Peer-Reviewed Original ResearchConceptsObstructive sleep apnea syndromeSleep apnea syndromeApnea-hypopnea indexMean apnea-hypopnea indexRisk of strokeApnea syndromeRisk factorsSleep apneaComposite end pointObservational cohort studyObstructive sleep apneaProportional hazards analysisComparison groupAlcohol consumption statusBody mass indexImportant risk factorCohort studyComposite outcomeConsecutive patientsDiabetes mellitusSmoking statusAtrial fibrillationUnadjusted analysesSyndromePatientsMajor Risk Factors for Intracerebral Hemorrhage in the Young Are Modifiable
Feldmann E, Broderick JP, Kernan WN, Viscoli CM, Brass LM, Brott T, Morgenstern LB, Wilterdink JL, Horwitz RI. Major Risk Factors for Intracerebral Hemorrhage in the Young Are Modifiable. Stroke 2005, 36: 1881-1885. PMID: 16081867, DOI: 10.1161/01.str.0000177480.62341.6b.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageIntracerebral hemorrhageMajor risk factorRisk factorsHemorrhagic strokeCase subjectsIndependent risk factorHistory of strokeCurrent cigarette smokingCase-control studyType of strokeMultivariate regression analysisCigarette smokingStroke ProjectControl subjectsStructural lesionsArteriovenous malformationsBrain lesionsEligibility criteriaStrokeYoung menAlcoholic drinksFurther studiesHemorrhageMenopauseAssociation between Impaired Insulin Sensitivity and Stroke
Bravata DM, Wells CK, Kernan WN, Concato J, Brass LM, Gulanski BI. Association between Impaired Insulin Sensitivity and Stroke. Neuroepidemiology 2005, 25: 69-74. PMID: 15947493, DOI: 10.1159/000086286.Peer-Reviewed Original ResearchConceptsHomeostasis model assessmentInsulin sensitivityGlycemic controlMultivariable logistic regression analysisStroke risk factorsLower insulin sensitivityThird National HealthImpaired insulin sensitivityLogistic regression analysisStroke historyInsulin resistancePlasma insulinPlasma glucoseRisk factorsNational HealthNutrition SurveyModel assessmentStrokeRegression analysisAssociationParticipantsClaudicationInsulinRacial Disparities in Stroke Risk Factors
Bravata DM, Wells CK, Gulanski B, Kernan WN, Brass LM, Long J, Concato J. Racial Disparities in Stroke Risk Factors. Stroke 2005, 36: 1507-1511. PMID: 15961710, DOI: 10.1161/01.str.0000170991.63594.b6.Peer-Reviewed Original ResearchConceptsStroke risk factorsRisk factorsStroke historyHigh prevalenceLow high-density lipoprotein cholesterolHigher C-reactive proteinHigh-density lipoprotein cholesterolCommunity-dwelling stroke survivorsC-reactive proteinThird National HealthSevere strokeLipoprotein cholesterolMyocardial infarctionNational HealthStroke survivorsNutrition SurveyHigh incidenceUS populationStrokeOlder ageCross-sectional samplePrevalenceRacial disparitiesEthnic differencesAssociationDecline in Physical Performance Among Women With a Recent Transient Ischemic Attack or Ischemic Stroke
Kernan WN, Viscoli CM, Brass LM, Gill TM, Sarrel PM, Horwitz RI. Decline in Physical Performance Among Women With a Recent Transient Ischemic Attack or Ischemic Stroke. Stroke 2005, 36: 630-634. PMID: 15677573, DOI: 10.1161/01.str.0000155728.42847.de.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic strokePhysical performance testsPhysical performanceIschemic attackRecent transient ischemic attackRecent ischemic strokeRecurrent neurological eventsAbsence of recurrenceLong-term disabilityEstrogen therapyRecurrent strokePostmenopausal womenNeurological eventsClinical trialsPPT scoresBaseline scoresFunctional independenceStrokeSpecific interventionsSubsequent strokeWomenSustained declineScoresBaseline
2003
Use of Ephedra-containing products and risk for hemorrhagic stroke
Kernan W, Brass L, Viscoli C, Broderick J, Brott T, Feldmann E, Wilterdink J, Morgenstern L. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology 2003, 61: 725. PMID: 12963785, DOI: 10.1212/wnl.61.5.724.Peer-Reviewed Original ResearchMajor Risk Factors for Aneurysmal Subarachnoid Hemorrhage in the Young Are Modifiable
Broderick JP, Viscoli CM, Brott T, Kernan WN, Brass LM, Feldmann E, Morgenstern LB, Wilterdink JL, Horwitz RI. Major Risk Factors for Aneurysmal Subarachnoid Hemorrhage in the Young Are Modifiable. Stroke 2003, 34: 1375-1381. PMID: 12764233, DOI: 10.1161/01.str.0000074572.91827.f4.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge DistributionBody Mass IndexCase-Control StudiesCocaine-Related DisordersCohort StudiesComorbidityCooperative BehaviorFemaleHumansHypertensionLogistic ModelsMaleMiddle AgedOdds RatioPhenylpropanolamineRisk FactorsSex DistributionSmokingStrokeSubarachnoid HemorrhageThinnessUnited StatesConceptsAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageRisk factorsLower body mass indexIndependent risk factorCurrent cigarette smokersPrevalent risk factorsBody mass indexMajor risk factorCase-control studyYears of ageRandom digit dialingWarrants further studyHemorrhagic strokeIntracerebral hemorrhageCigarette smokersMass indexPreventable diseaseWomen 18Multivariable modelFamily historyCase subjectsAssociation of caffeineCocaine useHemorrhageImpaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke. Neurology 2003, 60: 1447-1451. PMID: 12743229, DOI: 10.1212/01.wnl.0000063318.66140.a3.Peer-Reviewed Original ResearchConceptsImpaired insulin sensitivityIschemic strokeInsulin sensitivityRecent TIANondiabetic patientsMyocardial infarctionComposite insulin sensitivity indexInsulin sensitivity index valuesOral glucose tolerance testAge 45 yearsGlucose tolerance testInsulin sensitivity indexImportant therapeutic implicationsEligible patientsNondiabetic menStroke etiologyEligible subjectsMedian ageYounger patientsTolerance testHeart diseaseTherapeutic implicationsPatientsGlucose valuesStrokePioglitazone Improves Insulin Sensitivity Among Nondiabetic Patients With a Recent Transient Ischemic Attack or Ischemic Stroke
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Pioglitazone Improves Insulin Sensitivity Among Nondiabetic Patients With a Recent Transient Ischemic Attack or Ischemic Stroke. Stroke 2003, 34: 1431-1436. PMID: 12730556, DOI: 10.1161/01.str.0000071108.00234.0e.Peer-Reviewed Original ResearchConceptsRecent transient ischemic attackTransient ischemic attackGlucose tolerance testOral glucose tolerance testHistory of diabetesInsulin sensitivityTolerance testIschemic attackNondiabetic patientsEligible subjectsIschemic strokeMean C-reactive protein concentrationC-reactive protein concentrationsEffectiveness of pioglitazoneMonths of therapyGlucose blood levelsYears of ageMean proportional increaseIndex eventBlood levelsPatientsPlaceboPioglitazoneStrokeDiabetes