Search results for "stroke"

New Strategy to Reduce the Global Burden of Stroke

2015

The socioeconomic and health effect of stroke and other noncommunicable disorders (NCDs) that share many of the same risk factors with stroke, such as heart attack, dementia, and diabetes mellitus, is huge and increasing.1–4 Collectively, NCDs account for 34.5 million deaths (66% of deaths from all causes)3 and 1344 million disability-adjusted life years lost worldwide in 2010.2 The burden of NCDs is likely to burgeon given the aging of the world’s population and the epidemiological transition currently observed in many low- to middle-income countries (LMICs).5,6 In addition, there is low awareness in the population about these NCDs and their risk factors,7–10 particularly in LMICs.11 These…

Response by Uphaus et al to Letter Regarding Article, “NfL (Neurofilament Light Chain) Levels as a Predictive Marker for Long-Term Outcome After Isch…

2019

Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion

2020

Background and Purpose: Because of several methodological limitations, previous studies focusing on the prevalence of large vessel occlusion in ischemic stroke (IS) patients provided conflicting results. We evaluated the incidence of IS with a visible arterial occlusion using a comprehensive population-based registry. Methods: Patients with acute IS were prospectively identified among residents of Dijon, France, using a population-based registry (2013–2017). All arterial imaging exams were reviewed to assess arterial occlusion. Annual incidence rates of IS (first-ever and recurrent events) and IS with a visible occlusion were calculated. Results: One thousand sixty cases of IS were recorde…

Therapy of Early Poststroke Depression With Venlafaxine: Safety, Tolerability, and Efficacy as Determined in an Open, Uncontrolled Clinical Trial

1999

To the Editor: The development of persistent depressive symptoms is a severe and frequent complication of ischemic or hemorrhagic stroke.1 The etiology of poststroke depression is not well understood. Only few placebo-controlled, double-blind studies have been carried out, all reporting various degrees of superiority of standard antidepressants over placebos.1 2 On the other hand, serious side effects have been reported.3 4 In most of these studies, patients were examined whose stroke had occurred several weeks to several months before the antidepressive therapy was started. Antidepressive therapy in the first weeks after stroke has not yet been attempted in studies. Drug-induced improvemen…

Brain Natriuretic Peptide and Discovery of Atrial Fibrillation After Stroke

2020

Background and Purpose— Diagnosing paroxysmal atrial fibrillation (pAF) can be challenging after acute ischemic stroke. Enhanced and prolonged Holter-ECG monitoring (EPM) improves the detection rate but is not feasible for all patients. We hypothesized that brain natriuretic peptide (BNP) may help to identify patients with stroke at high risk for pAF to select patients for EPM more effectively. Methods— Patients with acute cerebral ischemia ≥60 years presenting in sinus rhythm and without history of AF were included into a prospective, randomized multicenter study to receive either EPM (3× 10-day Holter-ECG) or usual stroke care diagnostic work-up. BNP plasma levels were measured on random…

Evidence-Based Practice Needs Stronger Prognostic Scores for the Prediction of Recurrent Stroke

2010

To the Editor: The article by Weimer et al1 is of great interest for internists and neurologists that have to prognostically stratify patients with acute or subacute cerebrovascular disease based on risk scores. However, we have to comprehend the actual and pragmatic value of the study findings for clinical practice. We previously underscored the …

Abstract WP201: Stroke Patients With Atrial Fibrillation Detected by 72 hour- versus Prolonged ECG-monitoring

2018

Background: Detecting concealed paroxysmal atrial fibrillation (pAF) is a major focus in the workup of ischemic-stroke-patients. The minimal ECG-monitoring for stroke patients was recently expanded from 24 to 72 hours. However, it has been shown that even more prolonged monitoring reveals further pAF-cases. Our aim was to determine, whether known predictors for underlying pAF differ between stroke patients with AF that occurs on shorter (72h) or more prolonged ECG-monitoring (>72h). Methods: The Find-AF RANDOMISED -trial (NCT01855035) evaluated 3x10-day Holter-ECG vs. standard-care in patients > 60 years with acute ischemic strokes with the primary endpoint of novel pAF after 6 month…

Response by Béjot and Duloquin to Letter Regarding Article, "Incidence of Acute Ischemic Stroke With Visible Arterial Occlusion: A Population-Based S…

2020

2019

Background and Purpose— Prevalence of atrial fibrillation (AF) is increasing, but the impact on overall burden of stroke is uncertain, as is the proportion that could be attributed to under anticoagulation. We did a population-based study of AF-associated stroke and a systematic review of time trends in other stroke incidence studies and of rates of premorbid anticoagulation. Methods— The proportion of incident strokes with associated AF was determined in the OXVASC (Oxford Vascular Study; 2002–2017) and in other prospective, population-based stroke incidence studies published before December 2017. Proportions were pooled by Mantel Haenszel methods, and the pooled percentage of cases with …

Abstract 124: How to Preselect Stroke Patients for Enhanced ECG-Monitoring - Evaluation of Predictors of Paroxysmal Atrial Fibrillation in "Find-AFra…

2019

Background: Detecting concealed paroxysmal atrial fibrillation (pAF) is a major focus of the workup of ischemic-stroke-patients, but requires elaborate ECG-monitoring. We aimed to evaluate pre-specified predictors to determine stroke patients with an increased probability of underlying pAF. We applied cut-off-levels recently suggested by the German Stroke Society 1 . Methods: The Find-AF RANDOMISED -trial (NCT01855035) evaluated 3x10-day Holter-ECG vs. standard-care in 398 patients > 60 years with acute ischemic strokes. The primary endpoint was novel pAF after 6 months. 27 patients in the intervention arm (13.5 %) and 9 patients in the control arm (9.0 %) met the primary endpoint (p=0.…