2024
Polygenic 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, 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 variantsImpact 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 difference
2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatientsImprovement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity
de Havenon A, Smith E, Sharma R, Falcone G, Bangad A, Prabhakaran S, Sheth K. Improvement in the Prediction of Cerebrovascular Events With White Matter Hyperintensity. Journal Of The American Heart Association 2023, 12: e029374. PMID: 37345754, PMCID: PMC10356061, DOI: 10.1161/jaha.123.029374.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesIncident strokePrimary outcomeHypertensive individualsMatter hyperintensitiesAtherosclerotic cardiovascular disease risk scoreCognitive impairmentCardiovascular disease risk scoreVascular risk factorsCurrent cigarette smokingDisease risk scoreMagnetic resonance imagingLogistic regression modelsRandomization armCerebrovascular eventsVascular riskCigarette smokingPrognostic informationRisk factorsPrognostic abilityRisk scoreCognitive declineResonance imagingDeLong testStrokePerioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation
Shu L, Jiang W, Xiao H, Henninger N, Nguyen T, Siegler J, de Havenon A, Goldstein E, Mandel D, Rana M, Al‐Mufti F, Frontera J, Furie K, Yaghi S. Perioperative Acute Ischemic Stroke in Patients with Atrial Fibrillation. Annals Of Neurology 2023, 94: 321-329. PMID: 37183768, DOI: 10.1002/ana.26678.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAtrial fibrillationPerioperative acute ischemic strokeDiagnosis-related groupsRisk factors-VASc scoreActive cancerHigher CHA<sub>2</sub> DS<sub>2</sub> VASc score. TheElective proceduresInternational Classification of DiseasesRisk factors of acute ischemic strokeScoring systemIschemic strokeClassification of DiseasesNeurological surgeryDays of dischargeLogistic regression modelsNationwide Readmissions DatabaseElective surgical proceduresAnticoagulant therapyInternational ClassificationPeriprocedural periodRenal failureSurgical typeAdult patientsEffect 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 outcome
2022
Borderzone infarction and recurrent stroke in intracranial atherosclerosis
Kvernland A, Torres J, Raz E, Nossek E, de Havenon A, Gebregziabher M, Khatri P, Prabhakaran S, Liebeskind D, Yaghi S. Borderzone infarction and recurrent stroke in intracranial atherosclerosis. Journal Of Stroke And Cerebrovascular Diseases 2022, 32: 106897. PMID: 36402094, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106897.Peer-Reviewed Original ResearchConceptsRecurrent cerebrovascular eventsIntracranial stenosisBorderzone infarctsInfarct patternsIschemic strokeBorderzone infarctionRetrospective single-center studyAcute ischemic strokeRecurrent ischemic strokeSingle-center studySymptomatic intracranial stenosisHigh-risk cohortBinary logistic regression analysisDistal blood flowAlternative treatment strategiesLogistic regression analysisLogistic regression modelsCerebrovascular eventsRecurrent strokeIntracranial atherosclerosisPrimary outcomeCenter studyMean ageSurrogate markerTreatment strategiesMutation of breast cancer susceptibility genes increases cerebral microbleeds: A pilot study
Pope B, Wolcott Z, Castillo M, Jin J, Wong KH, Havenon A, Yaghi S, Goldstein ED. Mutation of breast cancer susceptibility genes increases cerebral microbleeds: A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2022, 31: 106729. PMID: 36116220, DOI: 10.1016/j.jstrokecerebrovasdis.2022.106729.Peer-Reviewed Original ResearchConceptsCerebral small vessel diseaseCerebrovascular risk factorsBRCA mutationsCerebral microbleedsRisk factorsOdds ratioMarkers of CSVDBreast cancer susceptibility gene mutationsRetrospective cross-sectional analysisCancer susceptibility gene mutationsAdjusted odds ratioSmall vessel diseaseHosmer-Lemeshow testSusceptibility gene mutationsCross-sectional analysisLogistic regression modelsBreast cancer susceptibility genesVessel diseaseWildtype individualsBrain MRICancer susceptibility genesStudent's t-test analysisT-test analysisMalignancy evaluationClinical implications
2021
Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control
de Havenon A, Muddasani V, Castillo M, Sheth KN, Delic A, Herman A, Conaway M, Johnston KC, Investigators F. Black Patients with Ischemic Stroke and Hyperglycemia have Worse outcome than Whites if given Intensive Glucose Control. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106065. PMID: 34455151, PMCID: PMC8511272, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106065.Peer-Reviewed Original ResearchConceptsIntensive glucose controlAcute ischemic strokeWorse functional outcomeBlack patientsGlucose controlIschemic strokeWhite patientsExcellent outcomesFunctional outcomeTreatment armsWorse outcomesAcute ischemic stroke patientsStroke Hyperglycemia Insulin Network Effort (SHINE) trialIntensive treatment armStandard treatment armIschemic stroke patientsExcellent functional outcomeMixed effects logistic regression modelsLogistic regression modelsPrimary outcomeStroke patientsPotential confoundersOdds ratioFunctional impairmentPatientsInvestigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke
Grandhi R, Ravindra VM, Ney JP, Zaidat O, Taussky P, de Havenon A. Investigating the “Weekend Effect” on Outcomes of Patients Undergoing Endovascular Mechanical Thrombectomy for Ischemic Stroke. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106013. PMID: 34375859, PMCID: PMC8511062, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106013.Peer-Reviewed Original ResearchMeSH KeywordsAfter-Hours CareAgedAged, 80 and overCross-Sectional StudiesDatabases, FactualEndovascular ProceduresFemaleHospital CostsHospital MortalityHumansInpatientsIschemic StrokeLength of StayMaleMiddle AgedPatient DischargeRetrospective StudiesRisk AssessmentRisk FactorsThrombectomyTime FactorsTreatment OutcomeUnited StatesConceptsAcute ischemic strokeEndovascular thrombectomyIschemic strokeLarge vessel occlusion ischemic strokeHealth Stroke Scale scoreNationwide Inpatient Sample dataStroke Scale scoreExtended hospital stayWorse clinical outcomesCross-sectional analysisLogistic regression modelsHospital deathHospital staySecondary outcomesPrimary outcomeClinical outcomesAIS patientsNormal working hoursPatientsScale scoreFavorable dischargeExposure variablesStrokeWeekends/National InstituteThe association between transthoracic echocardiogram parameters and white matter hyperintensities
Navarro KS, Wong KH, Ibrahim MM, de Havenon AH, Goldstein ED. The association between transthoracic echocardiogram parameters and white matter hyperintensities. Clinical Neurology And Neurosurgery 2021, 206: 106672. PMID: 33979694, DOI: 10.1016/j.clineuro.2021.106672.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingBrain magnetic resonance imagingCerebral small vessel diseaseVentricular ejection fractionCardiac chamber sizeTransthoracic echocardiogramFazekas scoreEjection fractionAtrial areaTricuspid annular plane systolic excursionAnnular plane systolic excursionRight ventricular ejection fractionRight ventricular internal diameterRetrospective chart reviewRight atrial areaSmall vessel diseaseVentricular internal diameterMultivariate ordinal logistic regression modelWhite matter hyperintensitiesChamber sizeLogistic regression modelsOrdinal logistic regression modelsMore WMHChart reviewSystolic excursionImpact of COVID-19 on the hospitalization, treatment, and outcomes of intracerebral and subarachnoid hemorrhage in the United States
Ravindra VM, Grandhi R, Delic A, Hohmann S, Shippey E, Tirschwell D, Frontera JA, Yaghi S, Majersik JJ, Anadani M, de Havenon A. Impact of COVID-19 on the hospitalization, treatment, and outcomes of intracerebral and subarachnoid hemorrhage in the United States. PLOS ONE 2021, 16: e0248728. PMID: 33852591, PMCID: PMC8046225, DOI: 10.1371/journal.pone.0248728.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCerebral HemorrhageChildChild, PreschoolCohort StudiesCOVID-19EthnicityFemaleHospital MortalityHospitalizationHumansInfantLength of StayMaleMiddle AgedMinority GroupsPatient DischargeRetrospective StudiesSARS-CoV-2Subarachnoid HemorrhageTreatment OutcomeUnited StatesConceptsAdjusted odds ratioHospital death rateIntensive care stayOutcome of deathIntracerebral hemorrhageSubarachnoid hemorrhageFavorable dischargeCOVID-19Vizient Clinical Data BaseDeath rateLonger hospital lengthIntensive care lengthLength of hospitalLonger hospital stayCohort of patientsMixed-effects logistic regression modelSpontaneous intracerebral hemorrhageCOVID-19 infectionClinical data baseLogistic regression modelsICH controlsHospital deathHospital stayHospital lengthSecondary outcomesMagnitude of blood pressure change and clinical outcomes after thrombectomy in stroke caused by large artery occlusion
Anadani M, Matusevicius M, Tsivgoulis G, Peeters A, Nunes A, Mancuso M, Roffe C, de Havenon A, Ahmed N. Magnitude of blood pressure change and clinical outcomes after thrombectomy in stroke caused by large artery occlusion. European Journal Of Neurology 2021, 28: 1922-1930. PMID: 33682232, DOI: 10.1111/ene.14807.Peer-Reviewed Original ResearchConceptsSystolic blood pressureAssociated with unfavorable outcomesRestricted cubic spline modelsUnfavorable outcomeLow systolic blood pressureRestricted cubic splinesCubic spline modelsLogistic regression modelsMixed logistic regression modelsArtery occlusion strokeMultivariable mixed logistic regression modelsMechanical thrombectomyAssociated with poor functional outcomeSBP increaseAdmission systolic blood pressureHigher SBPPoor functional outcomeMagnitude of blood pressure changesPredictors of unfavorable outcomeIncreased risk of unfavorable outcomeOcclusion strokePrimary outcomeSBP changeRisk of unfavorable outcomeStudy populationDuration of symptomatic stroke and successful reperfusion with endovascular thrombectomy for anterior circulation large vessel occlusive stroke
de Havenon A, Alexander MD, Nogueira RG, Haussen DC, Castonguay AC, Linfante I, Johnson MA, Nguyen TN, Mokin M, Zaidat OO. Duration of symptomatic stroke and successful reperfusion with endovascular thrombectomy for anterior circulation large vessel occlusive stroke. Journal Of NeuroInterventional Surgery 2021, 13: 1128-1131. PMID: 33526478, PMCID: PMC8325713, DOI: 10.1136/neurintsurg-2020-016961.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsIschemic stroke patientsSymptomatic strokeSuccessful reperfusionLogistic regression modelsAcute strokeEndovascular therapyStroke patientsLarge vessel occlusive strokeAnterior circulation occlusionCerebral Infarction scoreReal-world cohortLarge vessel occlusionBalloon guide catheterMiddle cerebral arteryIndividual patient dataInternal carotid arteryProbability of reperfusionLower ratesOcclusive strokeEndovascular thrombectomyMechanical thrombectomySecondary outcomesStroke onsetPrimary outcome
2020
Impact of Intracranial Pressure Monitor–Guided Therapy on Neurologic Outcome After Spontaneous Nontraumatic Intracranial Hemorrhage
Menacho ST, Grandhi R, Delic A, Anadani M, Ziai WC, Awad IA, Hanley DF, de Havenon A. Impact of Intracranial Pressure Monitor–Guided Therapy on Neurologic Outcome After Spontaneous Nontraumatic Intracranial Hemorrhage. Journal Of Stroke And Cerebrovascular Diseases 2020, 30: 105540. PMID: 33360250, PMCID: PMC8080544, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105540.Peer-Reviewed Original ResearchMeSH KeywordsAgedClinical Trials, Phase III as TopicDatabases, FactualFemaleHumansIntracranial HemorrhagesIntracranial PressureMaleMiddle AgedMonitoring, PhysiologicPredictive Value of TestsRandomized Controlled Trials as TopicRecovery of FunctionRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsICP monitor placementNontraumatic intracranial hemorrhageIntracranial hemorrhageIntracranial pressure monitorPoor outcomeNeurologic outcomePressure monitorPropensity score-matched cohortMonitor placementIdentification of patientsSpontaneous intracranial hemorrhageExternal ventricular drainInvasive ICP monitoringLogistic regression modelsIntraparenchymal monitorsIII trialsSecondary outcomesPrimary outcomeBalanced cohortVentricular drainICP monitorICP monitoringPatientsSecondary analysisGreater riskBenefit of endovascular thrombectomy for M2 middle cerebral artery occlusion in the ARISE II study
de Havenon A, Narata AP, Amelot A, Saver JL, Bozorgchami H, Mattle HP, Ribo M, Andersson T, Zaidat OO, investigators A. Benefit of endovascular thrombectomy for M2 middle cerebral artery occlusion in the ARISE II study. Journal Of NeuroInterventional Surgery 2020, 13: 779-783. PMID: 33219148, PMCID: PMC8134506, DOI: 10.1136/neurintsurg-2020-016427.Peer-Reviewed Original ResearchConceptsMiddle cerebral artery occlusionM2 occlusionsCerebral artery occlusionM1 occlusionEndovascular thrombectomyAdverse eventsBetter outcomesArtery occlusionIschemic strokeReperfusion ratesM2-segment middle cerebral artery occlusionM2 middle cerebral artery occlusionsScale scoreHealth Stroke Scale scoreBaseline National InstitutesStroke Scale scoreAcute ischemic strokeMajor adverse eventsRankin Scale scorePaucity of dataLogistic regression modelsII trialSuccessful reperfusionII studyPrespecified analysisFactors associated with therapeutic anticoagulation status in patients with ischemic stroke and atrial fibrillation
Yaghi S, Liberman AL, Henninger N, Grory BM, Nouh A, Scher E, Giles J, Liu A, Nagy M, Kaushal A, Azher I, Fakhri H, Espaillat KB, Asad SD, Pasupuleti H, Martin H, Tan J, Veerasamy M, Esenwa C, Cheng N, Moncrieffe K, Moeini-Naghani I, Siddu M, Trivedi T, Ishida K, Frontera J, Lord A, Furie K, Keyrouz S, de Havenon A, Mistry E, Leon Guerrero CR, Khan M. Factors associated with therapeutic anticoagulation status in patients with ischemic stroke and atrial fibrillation. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 104888. PMID: 32414583, PMCID: PMC8207529, DOI: 10.1016/j.jstrokecerebrovasdis.2020.104888.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsAtrial FibrillationBlood CoagulationBrain IschemiaDrug MonitoringFemaleHumansInternational Normalized RatioIntracranial ArteriosclerosisMaleRecurrenceRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesWarfarinConceptsStroke prevention strategiesIschemic strokeAtrial fibrillationAnticoagulation statusMore narrowingStroke sizeStroke mechanismPrevention strategiesSetting of AFInitiation of anticoagulationComprehensive stroke centerAcute ischemic strokeDirect oral anticoagulantsIschemic stroke mechanismLogistic regression modelsBinary logistic regression modelIndex strokeSubtherapeutic INRTherapeutic anticoagulationOral anticoagulantsStroke RegistryAnticoagulant statusStroke centersConsecutive patientsLuminal narrowing
2019
Increased blood pressure variability after acute ischemic stroke increases the risk of death: A secondary analysis of the Virtual International Stroke Trial Archive
de Havenon A, Stoddard G, Saini M, Wong KH, Tirschwell D, Bath P, . Increased blood pressure variability after acute ischemic stroke increases the risk of death: A secondary analysis of the Virtual International Stroke Trial Archive. JRSM Cardiovascular Disease 2019, 8: 2048004019856496. PMID: 31217966, PMCID: PMC6560789, DOI: 10.1177/2048004019856496.Peer-Reviewed Original ResearchBlood pressure variabilityVirtual International Stroke Trials ArchiveAcute ischemic strokePressure variabilityIschemic strokeStudy enrollmentAcute ischemic stroke patientsDiastolic blood pressure variabilitySystolic blood pressure variabilityIschemic stroke patientsOutcome of deathWorse neurologic outcomeDiastolic blood pressureRisk of deathBlood pressure readingsLogistic regression modelsNeurologic outcomeRankin ScaleStroke onsetBlood pressurePrimary outcomeClinical outcomesStroke patientsRetrospective analysisLarge cohort
2018
Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome
Bennett AE, Wilder MJ, McNally JS, Wold JJ, Stoddard GJ, Majersik JJ, Ansari S, de Havenon A. Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome. Journal Of NeuroInterventional Surgery 2018, 10: 823. PMID: 29352059, DOI: 10.1136/neurintsurg-2017-013473.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleBlood pressure variabilityIntra-arterial therapyIntravenous tissue plasminogen activatorPressure variabilityTissue plasminogen activatorLogistic regression modelsOrdinal logistic regression modelsIschemic strokeWorse outcomesMean age 63.2 yearsMedian admission National InstitutesMultivariable ordinal logistic regression modelsSystolic blood pressure variabilityPlasminogen activatorAdmission National InstitutesWorse neurologic outcomeWorse clinical outcomesLogistic regression analysisOrdinal logistic regression analysisIndependent predictive abilitySuccessive variationAcute strokeEndovascular thrombectomyNeurologic outcome
2017
Association of Collateral Blood Vessels Detected by Arterial Spin Labeling Magnetic Resonance Imaging With Neurological Outcome After Ischemic Stroke
de Havenon A, Haynor DR, Tirschwell DL, Majersik JJ, Smith G, Cohen W, Andre JB. Association of Collateral Blood Vessels Detected by Arterial Spin Labeling Magnetic Resonance Imaging With Neurological Outcome After Ischemic Stroke. JAMA Neurology 2017, 74: 453-458. PMID: 28192548, PMCID: PMC5470363, DOI: 10.1001/jamaneurol.2016.4491.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeArterial spin labeling magnetic resonance imagingCollateral blood vesselsNeurologic outcomeMRS scoreMagnetic resonance imagingNeurological outcomeIschemic strokeScale scoreHealth Stroke Scale scoreResonance imagingMultivariable ordinal logistic regression modelsTertiary academic medical centerBlood vesselsAdmission National InstitutesPremorbid mRS scoreGood neurologic outcomeGood neurological outcomeRetrospective cohort studyStroke Scale scoreRankin Scale scorePresence of collateralsAcademic medical centerLogistic regression modelsOrdinal logistic regression models