August 2021 Stroke Highlights

HomeStrokeVol. 52, No. 8August 2021 Stroke Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree BriefPDF/EPUBAugust Nicole B. SurMD SurNicole Sur https://orcid.org/0000-0002-3541-3599 Search for more papers by this author Originally published26 Jul 2021https://doi.org/10.1161/STROKEAHA.121.036397Stroke. 2021;52:2483is related toAccess Mechanical Thrombectomy Ischemic in the United StatesTranexamic Acid Prevention of Hematoma Expansion Intracerebral Hemorrhage Patients With or Without Spot SignDeintensification No Statin Treatment Is Associated Higher Mortality Transient AttackTranexamic SignPrior trials hemostatic agents patients with intracerebral hemorrhage have not been associated improved functional outcomes. In prespecified subgroup analysis TICH-2 trial (Tranexamic Hyperacute Haemorrhage), investigators hypothesized that and spot sign, who are at high risk hematoma expansion, may benefit from tranexamic acid relative without sign. A total 245 were included study similar baseline characteristics original cohort, except time onset administration drug was shorter those underwent computed tomography angiography contrast-enhanced tomography. Overall, there no difference progression between group placebo group. Similarly, adverse events outcomes 90 days 2 groups. The were, therefore, unable demonstrate presence a sign impacted response versus hemorrhage. These results, however, limited setting small, underpowered sample size. Similar prior which agent delayed, delays administering after identifying (median 76 minutes) overall results extent expansion could prevented. Further research is needed assess whether very early would be beneficial preventing improving See p 2629.Deintensification AttackThe statins secondary stroke prevention atherosclerotic disease has well established. observational study, identified effect various statin treatment patterns on mortality transient ischemic attack using pharmacy data across Veterans Health Administration hospitals States. cohort 9380 (predominantly white males), 51% hospital admission, 34% discharged attack. Deintensification therapy discharge occurred 14% 21% had admission discharge. Compared goal discharge, deintensification 1.6 greater odds 30-day (95% CI, 1.06–2.41) 1.26 1-year 1.02–1.57). 2-fold increased 1.42–2.82) 1.6-fold higher 1.30–1.93). Interestingly, less chronic comorbidities severe stroke, yet remain multivariable adjustment. This only confirms but also raises awareness underutilization real-world potentially devastating patient 2521.Access StatesAlthough endovascular (EVT) become standard care large vessel occlusion timely access comprehensive center can provide EVT post-EVT vary geographically. used all-payer claims database characterize 11 states States, characterizing centers as thrombectomy hub if they perform EVT, gateway transferred hub, gap neither performed nor EVT. initially treated hubs comprised 48.7% 4.8% thrombectomy. Those presenting gateways significantly likely undergo compared hubs. Furthermore, 16% gap, where transfer an facility offered. Not surprisingly, living rural locations urban areas. Even locations, roughly one-third population did speedy hub. <50% acute presented 2016 2018. highlights geographic disparities exist obviating need optimizing systems US equal regardless region. 2554. Previous Back top Next FiguresReferencesRelatedDetailsRelated articlesAccess StatesHooman Kamel, et al. Stroke. 2021;52:2554-2561Tranexamic SignChristian Ovesen, 2021;52:2629-2636Deintensification AttackJennifer L. Dearborn-Tomazos, 2021;52:2521-2529 August 2021Vol Issue 8Article InformationMetrics Download: 1,331 © American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.121.036397 publishedJuly 26, PDF download SubjectsCerebrovascular ProceduresIntracranial HemorrhageIschemic StrokeCerebrovascular Disease/Stroke