Hemorrhagic Stroke in an Atorvastatin Stroke-Prevention Trial
Neurology Summary and Comment
Analysis of the hemorrhagic-stroke events in the SPARCL study demonstrates higher risk in certain subgroups, independent of the statin.
By Michael A. Kelly, MD
October 21, 2008
Covering:
Goldstein LB et al., Neurology 2008 Jun 10; 70:2364
Jacobs BS and Greenberg SM., Neurology 2008 Jun 10; 70:2355
Antiplatelet Agents to Prevent Recurrent Stroke
Aspirin plus dipyridamole showed similar efficacy compared with clopidogrel.
By David Green, MD, PhD
October 14, 2008
Covering:
for the PRoFESS Study Group., N Engl J Med 2008 Sep 18; 359:1238
Kent DM and Thaler DE., N Engl J Med 2008 Sep 18; 359:1287
Carotid Stenting vs. Endarterectomy: Longer-Term Outcomes
General Medicine Summary and Comment
Free
Among patients without periprocedural complications, adverse outcomes at
By Allan S. Brett, MD
October 9, 2008
Covering:
Eckstein H-H et al., Lancet Neurol 2008 Oct; 7:893
Mas J-L et al., Lancet Neurol 2008 Oct; 7:885
Cigarette Smoking and Stroke Risk in Young Women
Women's Health Summary and Comment
Stroke risk was substantially higher in current smokers than in never smokers or former smokers and increased sharply with number of cigarettes smoked daily.
Antipsychotics Increase Risk for Stroke in Elders
Psychiatry Summary and Comment
The presence of dementia worsens the risk.
By Peter Roy-Byrne, MD
September 29, 2008
Covering:
Douglas IJ and Smeeth L., BMJ 2008 Aug 28; 337:a1227
Extending the Time Frame for Alteplase: The ECASS III Trial
Cardiology Summary and Comment
In patients with acute ischemic stroke, alteplase may be effective up to 4.5 hours after symptom onset.
By Harlan M. Krumholz, MD, SM
September 24, 2008
Covering:
Hacke W et al. for the ECASS Investigators., N Engl J Med 2008 Sep 25; 359:1317
Thrombolysis for Stroke Within 4.5 Hours Is Safe and Effective
Emergency Medicine Summary and Comment
Free
But still, the sooner treatment is administered, the better!
By J. Stephen Bohan, MD, MS, FACP, FACEP
September 24, 2008
Covering:
Hacke W et al. for the ECASS Investigators., N Engl J Med 2008 Sep 25; 359:1317
Lyden P., N Engl J Med 2008 Sep 25; 359:1393
Transcranial Color Doppler and Outcome Prediction in Reversible Cerebral Vasoconstriction Syndrome
Neurology Summary and Comment
A first look at what transcranial color Doppler can tell us about risk for poor outcomes in this group of disorders
By Farzaneh A. Sorond, MD, PhD
September 23, 2008
Covering:
Chen S-P et al., Ann Neurol 2008 Jun; 63:751
TPA Treatment for Acute Stroke: Legally Risky?
Emergency Medicine Summary and Comment
Not treating seems to be riskiest.
Aspirin Does Not Affect Cognitive Function in People at Moderate CV Risk
General Medicine Summary and Comment
Results of a double-blind randomized trial in middle-aged and older patients indicate no effect of long-term low-dose aspirin use on cognitive function.
Telmisartan in ACE-Inhibitor–Intolerant Patients: A Disappointment
Cardiology Summary and Comment
In a placebo-controlled trial, researchers found an unexpectedly low, statistically nonsignificant reduction in clinical outcomes.
By Beat J. Meyer, MD
September 17, 2008
Covering:
The TRANSCEND Investigators., Lancet 2008 August 31
Good Outcomes for Thrombolysis at 3.0 to 4.5 Hours After Stroke
Emergency Medicine Summary and Comment
Free
In a large registry study, rates of mortality, symptomatic intracerebral hemorrhage, and independence at 3 months were similar between patients treated with alteplase within 3.0 hours and patients treated at 3.0 to 4.5 hours after ischemic stroke onset.
By Daniel J. Pallin, MD, MPH
September 15, 2008
Covering:
Wahlgren N et al., Lancet 2008 Sep 15
Antipsychotic Medication Increases Stroke Risk
Emergency Medicine Summary and Comment
The effects were more pronounced in patients who took atypical antipsychotics and in patients with dementia.
Exposure to Antipsychotics and Risk for Stroke
General Medicine Summary and Comment
Free
Use of antipsychotics, especially atypical drugs, raises risk for stroke, and this risk is higher in patients with dementia than in those without.
Clinical Implications of Intraventricular Hemorrhage
Neurology Summary and Comment
Free
Intracerebral hemorrhage volume was linked to presence of intraventricular hemorrhage in this retrospective study.
By Kevin Sheth, MD
September 9, 2008
Covering:
Hallevi H et al., Neurology 2008 Mar 11; 70:848
Aspirin/Dipyridamole vs. Clopidogrel to Prevent Recurrent Stroke: A Toss-Up?
General Medicine Summary and Comment
Aspirin/dipyridamole and clopidogrel were similarly effective.
By Allan S. Brett, MD
September 4, 2008
Covering:
Sacco RL et al., N Engl J Med 2008 Aug 27
Kent DM and Thaler DE., N Engl J Med 2008 Aug 27
Telmisartan to Prevent Recurrent Stroke — No Benefit
General Medicine Summary and Comment
The rate of recurrent stroke was not significantly different in the telmisartan and placebo groups.
By Allan S. Brett, MD
September 4, 2008
Covering:
Yusuf S et al., N Engl J Med 2008 Aug 27
Preventing Stroke Recurrence: How Best to Control Hypertension?
Cardiology Summary and Comment
Free
In a randomized trial, use of an ARB to lower blood pressure in patients with recent stroke did not improve outcomes.
Preventing Stroke Recurrence: Which Antiplatelet Strategy Is Best?
Cardiology Summary and Comment
Free
In a randomized trial, aspirin plus extended-release dipyridamole showed similar efficacy compared with clopidogrel, although clopidogrel showed a very slight safety advantage.
No Role for Folic Acid or B Vitamins in Lowering Cardiovascular Risk
Cardiology Summary and Comment
Another randomized trial fails to show a positive effect of folic acid or B-vitamin supplementation on secondary prevention of CVD events.
Telemedicine for Stroke Patients
Emergency Medicine Summary and Comment
Free
Telemedicine consultation with a stroke-certified neurologist might increase appropriate use of thrombolytic agents in stroke patients.
Homocysteine-Lowering Therapy: Another Negative Study
General Medicine Summary and Comment
Free
No benefits were found with folic acid, vitamin B12 , or vitamin B6 supplementation.
By Allan S. Brett, MD
August 19, 2008
Covering:
Ebbing M et al., JAMA 2008 Aug 20; 300:795
Anterior Cerebral Artery Territory Infarction
Neurology Summary and Comment
A description of findings in a Korean cohort
By Louis R. Caplan, MD
August 19, 2008
Covering:
Kang SY and Kim JS., Neurology 2008 Jun 10; 70:2386
Generalist vs. Neurologist Care in Acute Ischemic Stroke: Does It Matter?
Hospital Medicine Summary and Comment
According to a recent study — no
Gastrointestinal Bleeding Is Associated with Poor Outcomes in Ischemic Stroke Patients
Gastroenterology Summary and Comment
Ischemic stroke patients who have GIB have a higher short-term mortality rate and poorer prognosis than those who do not bleed.
