Vascular Risk Factors and High-Sensitivity Troponin Elevation Predict Left Ventricular Dysfunction Following Acute Ischaemic Stroke

2018 ◽  
Vol 27 ◽  
pp. S358
Author(s):  
J. Sajeev ◽  
H. Dewey ◽  
A. Koshy ◽  
K. Rajakariar ◽  
L. Roberts ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Left Ventricular Dysfunction ◽  
Acute Ischaemic Stroke ◽  
Ventricular Dysfunction ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Troponin Elevation

scholarly journals A large number of cerebral microbleeds in CADASIL patients presenting with recurrent seizures: A case report

2019 ◽  
Author(s):  
Chumpol Anamnart ◽  
Dittapong Songsaeng ◽  
Sirisak Chanprasert
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Vascular Risk Factors ◽  
Cerebral Microbleeds ◽  
Diagnostic Study ◽  
Vascular Risk ◽  
Notch3 Gene ◽  
Study Results ◽  
The Brain

Abstract Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy associated with the NOTCH3 gene. Clinical manifestations include strokes, transient ischaemic events, psychiatric disturbances, dementia, and migraines. We report a case of a Thai man with a severe CADASIL phenotype who presented with recurrent seizures and acute ischaemic stroke and classic vascular risk factors. Case presentation: A 50-year-old man with a history of mood disorder and progressive cognitive decline for 20 years as well as well-controlled diabetes mellitus and hypertension presented with recurrent generalized seizures and acute right-sided weakness. An MRI of the brain showed acute infarction of the left pons, a large number of cerebral microbleeds throughout the brain and white matter abnormalities without classic anterior temporal lobe lesions. Molecular genetic testing identified a homozygous pathologic variant, c.1672C>T (p. Arg558Cys), in the NOTCH3 gene. The diagnosis of CADASIL was confirmed. His clinical symptoms deteriorated, and he died of tracheobronchitis with secretion obstruction. Conclusion: This case raises awareness of an uncommon cause of acute ischaemic stroke in patients with classic vascular risk factors and emphasizes the need for a complete evaluation in cases with unexpected clinical presentation or unexpected diagnostic study results.

Left ventricular dysfunction in acute ischaemic stroke

2008 ◽  
Vol 17 ◽  
pp. S8
Author(s):  
Martin Brown ◽  
Maged William ◽  
William O’Brien ◽  
Jonathan Sturm ◽  
Scott Whyte ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Left Ventricular Dysfunction ◽  
Acute Ischaemic Stroke ◽  
Ventricular Dysfunction ◽  
Left Ventricular

Abstract P676: Rates of Preventable Thrombectomy in Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Rakhee Lalla ◽  
Ryan Dunlow ◽  
Karen L Yarbrough ◽  
Prachi Mehndiratta ◽  
Michael S Phipps ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Vascular Disease ◽  
Antiplatelet Agent ◽  
Left Ventricular ◽  
Vascular Risk Factors ◽  
Large Vessel ◽  
Favorable Outcome ◽  
Vascular Risk ◽  
History Of

Introduction: The AHA notes that more than 76% of strokes are the first occurrence. There are class 1 recommendations for the management of common risk factors such as atrial fibrillation (AF), hyperlipidemia (HLD), hypertension (HTN), diabetes (DM), and vascular disease. The purpose of this study is to investigate the percentage of large vessel strokes that are potentially preventable with adequate management of vascular risk factors. Methods: A retrospective chart review was conducted on all patients undergoing endovascular therapy (EVT) from 2012-2019. Data was collected on vascular risk factors present prior to admission including HTN, DM, HLD, AF, and smoking. Preventable stroke was defined as having at least one of the following: untreated AF, untreated HLD, poorly controlled HTN (presence of left ventricular hypertrophy on transthoracic echo), history of vascular disease not on an antiplatelet agent, poorly controlled DM (A1c>10), current smoking. Groups were compared based on age, sex and 90 day functional outcomes, with favorable outcome defined as mRS ≤ 2. Results: Our sample included 396 patients who underwent EVT (mean age 65, 50% female). 42% of patients with Afib were not on anticoagulation, 31% of patients with HLD were untreated, 39% of patients with HTN were poorly controlled, 27% of patients with a history of vascular disease were not on an antiplatelet, 14% of patients with DM were poorly controlled, and 46% of all patients were smokers. In total, 78% of patients had at least 1 poorly controlled risk factor and 37% had at least 2. There was no difference in rates of preventable stroke between males and females (48% vs 52%, p=0.30) and between age groups above and below 70 (40% vs 60%, p=0.68). 64% of patients with well controlled risk factors had a favorable outcome compared to 51% with at least one poorly controlled risk factor (p=0.03). Conclusions: Our data suggests that despite guidelines on management of vascular risk factors, a large number of these are poorly controlled prior to admission for large vessel stroke, leading to a potentially preventable procedure. Not only could improved primary prevention save the wide array of resources utilized in EVT, but it could also influence long term outcomes in this cohort of patients.

scholarly journals Prevalence of the Frank’s sign by aetiopathogenic stroke subtype: A prospective analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261080
Author(s):  
Laura Sánchez-Cirera ◽  
Saima Bashir ◽  
Adina Ciscar ◽  
Carla Marco ◽  
Verónica Cruz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Haemorrhagic Stroke ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Cross Sectional ◽  
Stroke Subtypes ◽  
Artery Disease

Background and purpose The Frank’s sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank’s sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Methods Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank’s sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. Results The Frank’s sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank’s sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank’s sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank’s sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. Conclusion The Frank’s sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank’s sign.

scholarly journals Association between excessive premature atrial complexes and cryptogenic stroke: results of a case–control study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029164 ◽  
Author(s):  
Jithin K Sajeev ◽  
Anoop N Koshy ◽  
Helen Dewey ◽  
Jonathan M Kalman ◽  
Kevin Rajakariar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Case Control Study ◽  
Cryptogenic Stroke ◽  
Case Control ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Prior History ◽  
Vascular Risk ◽  
Control Study

ObjectiveRecent anticoagulation trials in all-comer cryptogenic stroke patients have yielded equivocal results, reinvigorating the focus on identifying reproducible markers of an atrial myopathy. We investigated the role of excessive premature atrial complexes (PACs) in ischaemic stroke, including cryptogenic stroke and its association with vascular risk factors.Methods and resultsA case–control study was conducted utilising a multicentre institutional stroke database to compare 461 patients with an ischaemic stroke or transient ischaemic attack (TIA) with a control group consisting of age matched patients without prior history of ischaemic stroke/TIA. All patients underwent 24-hour Holter monitoring during the study period and atrial fibrillation was excluded. An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively. On multivariate regression, excessive PACs (OR 1.97; 95% CI 1.29 to 3.02; p<0.01), smoking (OR 1.58; 95% CI 1.06 to 2.36; p<0.05) and hypertension (OR 1.53; 95% CI 1.07 to 2.17; p<0.05) were independently associated with ischaemic stroke/TIA. Excessive PACs remained the strongest independent risk factor for the cryptogenic stroke subtype (OR 1.95; 95% CI 1.16 to 3.28; p<0.05). Vascular risk factors that promote atrial remodelling, increasing age (≥75 years, OR 3.64; 95% CI 2.08 to 6.36; p<0.01) and hypertension (OR 1.54; 95% CI 1.01 to 2.34; p<0.05) were independently associated with excessive PACs.ConclusionsExcessive PACs are independently associated with cryptogenic stroke and may be a reproducible marker of atrial myopathy. Prospective studies assessing their utility in guiding stroke prevention strategies may be warranted.

scholarly journals Contrast Medium Induced Nephropathy after Endovascular Stent Graft Placement: An Examination of Its Prevalence and Risk Factors

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Yohei Kawatani ◽  
Yoshitsugu Nakamura ◽  
Yoshihiko Mochida ◽  
Naoya Yamauchi ◽  
Yujiro Hayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Contrast Medium ◽  
Stent Graft ◽  
Left Ventricular Dysfunction ◽  
Ventricular Dysfunction ◽  
Renal Perfusion ◽  
Left Ventricular ◽  
Endovascular Stent ◽  
Endovascular Stent Graft ◽  
Graft Placement

Endovascular stent graft placement has become a major treatment for thoracic and abdominal aneurysms. While endovascular therapy is less invasive than open surgery, it involves the use of a contrast medium. Contrast media can cause renal impairment, a condition termed as contrast-induced nephropathy (CIN). This study sought to evaluate the incidence and risk factors of CIN following endovascular stent graft placement for aortic aneurysm repair. The study included 167 consecutive patients who underwent endovascular stent graft placement in our hospital from October 2013 to June 2014. CIN was diagnosed using the European Society of Urogenital Radiology criteria. Patients with and without CIN were compared. Chi-squared tests,t-tests, and multivariate logistic regression analyses were performed. Thirteen patients (7.8%) developed CIN. Left ventricular dysfunction and intraoperative blood transfusion were significantly more frequent in the CIN group (P=0.017andP=0.032, resp.). Multivariate analysis showed that left ventricular dysfunction had the strongest influence on CIN development (odds ratio 9.34,P=0.018, and 95% CI = 1.46–59.7). Patients with CIN also experienced longer ICU and hospital stays. Measures to improve renal perfusion flow should be considered for patients with left ventricular dysfunction who are undergoing endovascular stent graft placement.

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