January 2021 Stroke Highlights

HomeStrokeVol. 52, No. 1January 2021 Stroke Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree BriefPDF/EPUBJanuary José Rafael Romero, MD RomeroJosé Romero Search for more papers by this author Originally published28 Dec 2020https://doi.org/10.1161/STROKEAHA.120.033572Stroke. 2021;52:4is related toInfluence of the COVID-19 Pandemic on Treatment Times Acute Ischemic StrokeVessel Wall Magnetic Resonance Imaging Biomarkers Symptomatic Intracranial AtherosclerosisSmall Vessel Disease and Risk During Anticoagulation Atrial Fibrillation After Cerebral IschemiaSmall IschemiaPatients with atrial fibrillation may have competing mechanisms stroke recurrence. Du et al studied role cerebral small vessel disease (CSVD) risk recurrent in patients despite treatment oral anticoagulation. They included 1419 from CROMIS-2 (Clinical Relevance Microbleeds Study)—a multicenter prospective inception cohort study anticoagulated after ischemic or transient attack (2011–2015). Recurrent was classified using TOAST (Trial ORG 10172 Treatment) classification. CSVD measures were assessed brain magnetic resonance imaging, including microbleeds, enlarged perivascular spaces, white matter hyperintensities, lacunar stroke. Over a median follow-up 2.3 years, 53 had strokes. The presence any measure associated higher recurrence, an absolute rate increase 1.22 per 100 patient-years (95% CI, 1.01–1.40). In analysis adjusted CHA2DS2VASc score, 1.9× during 1.01–3.53), increasing as total score increased (hazard ratio point increase, 1.33 [95% 1.04–1.07]). sensitivity analysis, remained adjustment time therapeutic range (for treated vitamin K antagonist anticoagulant), carotid stenosis, statin, hypertension. This underscores importance considering coexistent mechanism accounting recurrence adequate anticoagulant therapy fibrillation. See p 91.The Influence Stroke: SVIN Multicenter CollaborationIn study, Siegler evaluated effect coronavirus 2019 (COVID-19) delays acute pandemic. authors data 14 comprehensive centers that 47% all cases United States September 2020. compared treatments across 2 periods: pre–COVID-19 (March 1, 2019, July 31, 2019) 2020, 2020). Among 2955 included, those admitted period younger vascular comorbidities severity. multivariable relevant confounders, odds door-to-needle ≤60 minutes intravenous thrombolysis lower (OR, 0.55 0.35–0.85]). delay due longer periods between imaging alteplase bolus (median, 29 versus 22 minutes; P=0.02) coincided months when diagnoses peaked. No significant observed who underwent thrombectomy occlusion internal carotid, middle M1 segment, basilar arteries. view expected additional peaks pandemic possible future pandemics, calls attention assess potential barriers solutions timely administration under circumstances. 40.Vessel MR Atherosclerosis: Meta-AnalysisIntracranial atherosclerotic has high limited options. Song use intracranial wall characterize plaques be surrogate end points clinical trials. conducted meta-analysis based 21 studies (n=1542 1750 segments) random-effects models association characteristics event. Plaque plaque enhancement, positive remodeling, T1 hyperintensity, surface irregularity. subacute events (stroke attack), examined differences design, technique, subject inclusion criteria. Most cross-sectional artery alone combination other main findings strong associations above symptomatic status plaques. Subgroup event limited. supports However, further are needed validate its marker 193. Previous Back top Next FiguresReferencesRelatedDetailsRelated articlesInfluence StrokeJames E. Siegler, al. Stroke. 2021;52:40-47Vessel AtherosclerosisJae W. Song, 2021;52:193-202Small IschemiaHouwei Du, 2021;52:91-99 January 2021Vol Issue 1Article InformationMetrics © 2020 American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.120.033572 publishedDecember 28, PDF download Advertisement SubjectsCerebrovascular Disease/StrokeIschemic StrokeMagnetic (MRI)Quality Outcomes