Stroke

Articles

• Investigators Identify Connection Between Vascular Malformation, Gut Bacteria Profile

  The presence of gram-negative bacteria was linked to an abundance of abnormalities known to cause strokes, seizures, and headaches.

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• Cannabis Use and Stroke Risk: The Debate Continues

  A recently published paper suggests there may be no connection, but the conversation on this topic, as well as the general efficacy of medical marijuana, goes on.

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• Investigators Uncover More Troubling Data About the Adverse Health Effects of Sugar-Sweetened Beverages

  Recent study revealed women who consume just one such beverage per day were at a much higher risk for stroke and cardiovascular disease.

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• Dual Antiplatelet Therapy Results in Increase in Serious Hemorrhages Following TIA or Minor Stroke

  The POINT trial showed a 25% reduction in the composite outcome of ischemic stroke, myocardial infarction, or ischemic vascular death in patients treated with clopidogrel plus aspirin for 90 days, immediately following a transient ischemic attack (TIA) or minor acute ischemic stroke. The investigators performed a secondary analysis and found the risk of major hemorrhages was low in both groups, although treatment with clopidogrel and aspirin together increased the risk of major hemorrhages over aspirin alone. Caution should be taken and very close observation of patients maintained when treating with dual antiplatelet therapies.

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• Smartwatches for the Diagnosis of Atrial Fibrillation

  The Apple Heart Study participants were people without atrial fibrillation who purchased a smart phone app and consented to monitoring using a smartwatch-based irregular pulse notification algorithm, which identified possible atrial fibrillation. If notification occurred, the person was mailed an electrocardiography (ECG) patch to be worn for seven days to confirm the findings first identified by the smartwatch. The age distribution of this group is different than the usual cohort at risk for atrial fibrillation: 52% were between the ages of 22 and 39 years of age, and only 5.9% were 65 years or older. A much more useful study would have included an older cohort that carries a higher risk of atrial fibrillation.

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• What Is the Optimal Blood Pressure for Secondary Prevention of Stroke?

  High blood pressure is the most prevalent and important risk factor for stroke, and great efforts have been made to reduce blood pressure for both primary and secondary stroke prevention. However, at this time, we do not have evidence to support a firm recommendation for optimal blood pressure management for secondary stroke prevention.

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• Patients With Stable Coronary Disease and Atrial Fibrillation Are Best Treated With Rivaroxaban, Alone

  Optimal antithrombotic therapy for stroke prevention in patients with atrial fibrillation continues to evolve.Monotherapy with rivaroxiban was noninferior to combination therapy for the primary efficacy endpoint.

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• Intravenous Thrombolysis Prior to Mechanical Thrombectomy Improves Outcome

  Bridging therapy with intravenous thrombolysis appears to be associated with improved functional outcome without any additional complications compared to direct mechanical thrombectomy for patients with acute ischemic stroke who have LVOs.

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• After Ischemic Stroke Related to Atrial Fibrillation, Direct Oral Anticoagulants Are Superior to Vitamin K Antagonists

  The authors of this trial investigated the benefits and risks of early anticoagulation following acute ischemic stroke, and compared the effects of direct oral anticoagulants vs. vitamin K antagonists. Overall, treatment with direct oral anticoagulants resulted in a reduced risk of poor clinical outcomes, primarily due to reduced risk of intracerebral hemorrhage.

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• Faster Time to Endovascular Reperfusion Therapy Results in Better Outcomes

  Endovascular reperfusion therapy has been demonstrated to be of benefit for the treatment of large vessel occlusion in patients with acute ischemic stroke.

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