April 2021 Stroke Highlights

HomeStrokeVol. 52, No. 4April 2021 Stroke Highlights Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree ArticlePDF/EPUBApril Nicole B. SurMD SurNicole Sur https://orcid.org/0000-0002-3541-3599 Search for more papers by this author Originally published22 Mar 2021https://doi.org/10.1161/STROKEAHA.121.034639Stroke. 2021;52:1163is related toComparative Effectiveness and Safety of Non–Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation PatientsSwallowing, Motor, Motor Speech, Language Impairments Following Acute Pediatric Ischemic StrokeComparative Nonvitamin Patients With FibrillationIn meta-analysis Zhu colleagues, the safety efficacy nonvitamin oral antagonists—apixaban, rivaroxaban, dabigatran—were compared primary outcomes stroke systemic embolism major bleeding. Although prior observational studies have made similar comparisons, analysis was unique that only which utilized propensity score matching were included an effort reduce confounding indication thereby closely mimic a randomized trial. A total 17 retrospective cohort studies, used analysis. The majority patient data from United States (65%), with remaining representing European Asian cohorts. When dabigatran, rivaroxaban associated significantly higher rates bleeding, while apixaban lower bleeding no difference terms embolism. Similarly, had In secondary analysis, risk ischemic across 3 anticoagulants; however, increased intracranial gastrointestinal dabigatran. Given lack head-to-head comparisons newer anticoagulants, study may add clarity inform shared decision-making physicians patients atrial fibrillation. See p 1225.Stroke Risk Factor Status Use Prevention Medications Among Hispanic/Latino Adults HCHS/SOL StudyHispanic/Latino individuals high prevalence vascular factors (VRFs) at younger ages. Furthermore, suggest awareness poor control VRFs Hispanic population. multicenter prospective study, Bai colleagues evaluated prevalence, awareness, among Hispanics self-reported history stroke/transient attack (TIA) HCHS (Hispanic Community Health Study)/SOL (Study Latinos). Relative participants without stroke/TIA, those stroke/TIA likely be males household income levels education, longer residence States, VRFs. Not surprisingly, almost all least 1 modifiable VRF, half ≥4 Notably, mostly aware their (with exception low sleep apnea), yet suboptimal use antithrombotics statins. There sex differences observed trends except less dyslipidemia anticoagulants fibrillation females. multivariate older age poorly controlled hypertension diabetes. This confirms Hispanic/Latinos population highlights vulnerable groups—elderly females—that are particularly VRF control. Further research on underlying drivers these highly important designing implementing interventions improving community. 1309.Impact Delirium Its Subtypes OutcomesDelirium is frequently encountered phenomenon after can negative impact outcomes. Silva influence delirium acute stroke, special attention specific motor subtypes (hypoactive, hyperactive, mixed) functional mortality. 227 admitted unit Brazil enrolled monitored twice daily development during admission. poststroke follow-up period 90 days. 31.1% developed hypoactive being most frequent subtype. Compared delirium, 90-day mortality (25.3% versus 3.3%) poorer 30 remained true multivariable adjustment, 3.28-fold worse outcome or death days (P=0.024) subjects delirium. Across subtypes, mixed hyperactive numerically delirium; not significant. small, single-center results highlight strong association stroke. needed confirm larger scale, particular mechanisms contributing potential magnitude outcomes, focus should placed standardizing care paradigms early detection treatment 1322. Previous Back top Next FiguresReferencesRelatedDetailsRelated articlesComparative PatientsWengen Zhu, et al. Stroke. 2021;52:1225-1233Swallowing, StrokeVictoria Sherman, 2021;52:1309-1318 April 2021Vol Issue 4Article InformationMetrics Download: 169 © American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.121.034639PMID: 33750193 publishedMarch 22, PDF download SubjectsRace EthnicityMeta AnalysisSecondary PreventionCerebrovascular Disease/StrokeMortality/Survival