Stroke最新文献

{"title":"Language and Attention Networks Have Distinct Roles in Language Improvement Following an Intensive Comprehensive Aphasia Program.","authors":"Evan Houldin, Edna M Babbitt, Rosalind Hurwitz, Marwan N Baliki, Leora R Cherney","doi":"10.1161/STROKEAHA.124.047683","DOIUrl":"10.1161/STROKEAHA.124.047683","url":null,"abstract":"<p><strong>Background: </strong>Attention is known to play an important role in language, and attentional deficits have been associated with language impairments in people with aphasia (PWA). A prior study by our laboratory indicated that behavioral measures for PWA participating in an intensive comprehensive aphasia program (ICAP) clustered into 1 language and 1 attention-related factor, with each factor correlated with independent resting state functional connectivity (rsFC) networks. The present study includes additional attention measures and participants to better assess the relationship between attention, language, and rsFC.</p><p><strong>Methods: </strong>PWA participated in 120 hours of ICAP therapy over 4 weeks, between April 2018 and August 2022. Participants were evaluated with the Western Aphasia Battery and Conners' Continuous Performance Test, pre- and post-ICAP. rsFC data were collected during functional magnetic resonance imaging scans pre- and post-ICAP. Principal component analysis identified behavioral score associations pre- and post-ICAP. FC matrices and graph measures were evaluated for both PWA and healthy controls.</p><p><strong>Results: </strong>Twenty-three PWA participated (19 included in the final analysis). Data for 179 age and sex-matched healthy controls were taken from a public data set. The principal component analysis indicated 1 language and 2 attention-related principal components (PCs). The attention PCs were labeled Attention Accuracy and Attention Rate, in accordance with their best-associated behavioral measures. Importantly, each PC was associated with distinct networks, including higher-order networks, so-called because of their involvement in higher-order cognition. Notably, the language PC was significantly correlated with the ventral attention-memory-retrieval network rsFC (<i>r</i>=0.67, <i>P</i>=0.003) and the default mode-frontoparietal network rsFC (<i>r</i>=-0.56, <i>P</i>=0.019). Attention Accuracy was significantly correlated with cingulo-opercular-subcortical network rsFC (<i>r</i>=0.60, <i>P</i>=0.011). Attention Rate was significantly negatively correlated with visual-somatomotor network rsFC (<i>r</i>=-0.74, <i>P</i>=0.0007).</p><p><strong>Conclusions: </strong>This study supports the notion that language improvements for PWAs participating in an ICAP are associated with distinct network changes. Importantly, these networks are not restricted to language networks but also include attention, and task-control networks.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"705-715"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Early Stroke Care Through Mobile Stroke Treatment Unit Rendezvous With Rural Emergency Medical Services.","authors":"Nicolle W Davis, Mahmoud Fayed, Evan Hardee, David Lykens, Jeannette M Hester, Ashley E Magnuson, Amita Singh, Teng J Peng, Anna Khanna","doi":"10.1161/STROKEAHA.124.048633","DOIUrl":"10.1161/STROKEAHA.124.048633","url":null,"abstract":"<p><strong>Background: </strong>Mobile stroke units, also sometimes called Mobile Stroke Treatment Units (MSTUs) are changing the paradigm of acute stroke care and are considered to be an extension of the time is brain concept. Of the <20 active Mobile Stroke Programs in the United States, most are rooted in urban settings. In July 2023, the first MSTU in Florida was launched in Alachua County, implementing a unique and innovative rendezvous process with rural emergency medical services (EMS). We compared stroke outcome metrics between the MSTU, including rendezvous patients, and the standard process of EMS to the emergency department (ED).</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with acute stroke evaluated in the MSTU and those transported to the ED by the standard EMS stroke alert process at an academic Comprehensive Stroke Center between July 25, 2023 and May 31, 2024. Patient demographic and acute stroke metrics were extracted to complete univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>Across all 3 groups, both MSTU patients with (n=76) and without (n=291) rendezvous compared with EMS-to-ED patients (n=807), had significantly shorter mean dispatch-to-door times (29.4 versus 28.5 versus 73.2 minutes, respectively; <i>P</i><0.01), dispatch-to-needle times (41.3 versus 44.6 versus 104.1 minutes, respectively; <i>P</i><0.01), and dispatch-to-puncture (92.7 versus 81.9 versus 138.0 minutes, respectively; <i>P</i><0.01). In rural counties, MSTU rendezvous patients (n=76) compared with EMS-to-ED patients (n=206), had shorter mean dispatch-to-door and dispatch-to-needle times (41.3 versus 97.8 minutes, respectively; <i>P</i><0.001). After adjusting for age and sex, these differences remained significant (odds ratio, 1.21 [95% CI, 1.07-1.37]; <i>P</i><0.01 and odds ratio, 1.80 [95% CI, 1.07-3.04]; <i>P</i>=0.03, respectively).</p><p><strong>Conclusions: </strong>Our study demonstrates the effectiveness of MSTUs in Florida and establishes that the MSTU rendezvous process significantly improves timely stroke care in underserved rural counties.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"741-744"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Status and Stroke: A Review of the Latest Evidence on Inequalities and Their Drivers.","authors":"Camila Pantoja-Ruiz, Rufus Akinyemi, Diego I Lucumi-Cuesta, Daniel Youkee, Eva Emmett, Marina Soley-Bori, Wasana Kalansooriya, Charles Wolfe, Iain J Marshall","doi":"10.1161/STROKEAHA.124.049474","DOIUrl":"10.1161/STROKEAHA.124.049474","url":null,"abstract":"<p><p>The latest research on socioeconomic status (SES) and stroke continues to demonstrate that individuals with low SES are at a higher risk of stroke, receive lower-quality care, and experience poorer outcomes. Despite growing evidence on the impact of SES on stroke, gaps remain in understanding the underlying mechanisms and the influence of SES in different contexts, particularly in low- and middle-income countries. This narrative review builds upon our previous reviews from 2006 to 2015, focusing on studies published since 2015 to update on the influence of SES on stroke. Reports from nationwide or population-based observational studies in the past decade have confirmed that these inequalities persist globally and have provided new evidence on their mechanisms. In high-income countries, inadequate control of cardiovascular risk factors (hypertension, diabetes, obesity, and dyslipidemia) among lower socioeconomic groups has been found to explain much of the inequality in stroke risk. Exposure to particulate air pollution (both environmental and indoor from solid fuel cooking) synergizes with cardiovascular risk factors, especially hypertension, as major causes in low- and middle-income countries. Lower SES is persistently associated with disparities in care and increased poststroke disability and mortality. Lower SES also exacerbates other causes of health inequality among women, ethnic minorities, and migrants. Addressing stroke inequalities requires an interdisciplinary approach. Targeting cardiovascular risk factors, providing equitable quality of acute and rehabilitative stroke care, enacting legislative measures, and implementing societal changes remain leading global priorities.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"794-805"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Myelin Quantification Using Synthetic Magnetic Resonance Imaging for Predicting Outcomes in Patients With Acute Ischemic Stroke.","authors":"Megumi Toko, Tomohisa Nezu, Futoshi Eto, Shiro Aoki, Tomohiko Ohshita, Hiroki Ueno, Yuji Akiyama, Hirofumi Maruyama","doi":"10.1161/STROKEAHA.124.049851","DOIUrl":"10.1161/STROKEAHA.124.049851","url":null,"abstract":"<p><strong>Background: </strong>Synthetic magnetic resonance imaging (MRI) is an innovative MRI technology that enables the acquisition of multiple quantitative values, including T1 and T2 values, proton density, and myelin volume, in a single scan. Although the usefulness of myelin measurement with synthetic MRI has been reported for assessing several diseases, investigations in patients with stroke have not been reported. We aimed to explore the utility of myelin quantification using synthetic MRI in predicting outcomes in patients with acute ischemic stroke.</p><p><strong>Methods: </strong>Patients with acute ischemic stroke (n=101) with a premorbid modified Rankin Scale score ≤2 were enrolled. We performed MRI with a 3 T scanner, acquiring synthetic MRI data in addition to data acquired using the routine protocol; we measured total myelin volume (TMV) using synthetic MRI software. After hospitalization, a synthetic MRI was performed when the patient's condition was stable, with a median of 7 days from onset to MRI. We examined the factors related to good stroke outcomes (defined by a modified Rankin Scale score of ≤2 at 3 months).</p><p><strong>Results: </strong>Patients with larger TMV were younger, were more frequently male, and had higher body mass index. In addition, TMV was associated with the severity of white matter hyperintensities and total small vessel burden scores. The patients with good outcomes (n=66) had larger TMVs than those without (144.85±22.19 versus 126.62±21.81 mL, <i>P</i><0.001). Multivariable analysis revealed that the TMV quartiles were independently associated with good functional outcomes (odds ratio, 2.54 [95% CI, 1.12-6.70]; <i>P</i>=0.025) after adjusting for baseline clinical characteristics including initial stroke severity, acute brain infarct volume, and brain parenchymal volume.</p><p><strong>Conclusions: </strong>A large TMV quantified using synthetic MRI was independently associated with good functional outcomes after adjusting for several confounding factors. TMV, which suggests the validity of myelin quantification, might be a useful indicator for predicting stroke outcomes.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"649-656"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WMH Contributions to Cognitive Impairment: Rationale and Design of the Diverse VCID Study.","authors":"Charles DeCarli, Kumar B Rajan, Lee-Way Jin, Jason Hinman, David K Johnson, Danielle Harvey, Myriam Fornage","doi":"10.1161/STROKEAHA.124.045903","DOIUrl":"10.1161/STROKEAHA.124.045903","url":null,"abstract":"<p><p>As awareness of dementia increases, more individuals with minor cognitive complaints are requesting clinical assessment. Neuroimaging studies frequently identify incidental white matter hyperintensities, raising patient concerns about their brain health and future risk for dementia. Moreover, current US demographics indicate that ≈50% of these individuals will be from diverse backgrounds by 2060. Racial and ethnic minority populations bear a disproportionate burden of vascular risk factors magnifying dementia risk. Despite established associations between white matter hyperintensities and cognitive impairment, including dementia, no study has comprehensively and prospectively examined the impact of individual and combined magnetic resonance imaging measures of white matter injury, their risk factors, and comorbidities on cognitive performance among a diverse, nondemented, stroke-free population with cognitive complaints over an extended period of observation. The Diverse VCID (Diverse Vascular Cognitive Impairment and Dementia) study is designed to fill this knowledge gap through 3 assessments of clinical, behavioral, and risk factors; neurocognitive and magnetic resonance imaging measures; fluid biomarkers of Alzheimer disease, vascular inflammation, angiogenesis, and endothelial dysfunction; and measures of genetic risk collected prospectively over a minimum of 3 years in a cohort of 2250 individuals evenly distributed among Americans of Black/African, Latino/Hispanic, and non-Hispanic White backgrounds. The goal of this study is to investigate the basic mechanisms of small vessel cerebrovascular injury, emphasizing clinically relevant assessment tools and developing a risk score that will accurately identify at-risk individuals for possible treatment or clinical therapeutic trials, particularly individuals of diverse backgrounds where vascular risk factors and disease are more prevalent.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"758-776"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence.","authors":"Scott E Kasner, Philip M Bath, Michael D Hill, John J Volpi, Michael Giuffre, Lorianne Masuoka, David Wambeke, Paolo R Madeddu","doi":"10.1161/STROKEAHA.124.048858","DOIUrl":"10.1161/STROKEAHA.124.048858","url":null,"abstract":"<p><p>Novel strategies are needed for the treatment of acute ischemic stroke when revascularization therapies are not clinically appropriate or are unsuccessful. rKLK1 (recombinant human tissue kallikrein-1), a bradykinin-producing enzyme, offers a promising potential solution. In animal studies of acute stroke, there is a marked 36-fold increase in bradykinin B2 receptor on brain endothelial cells of the ischemic region. Due to this environment, rKLK1-generated bradykinin will exert a potent local vasodilation and increase brain perfusion via 3 synergistic signaling pathways downstream to the B2 receptor. Because of its preferential effect on ischemic tissue, systemic adverse effects such as hypotension are avoided with proper dosing. In addition, with initial vasodilation through recruitment of preexisting collaterals, rKLK1 promotes long-term benefit of brain perfusion by promoting new collateral formation. With an extended course of therapy for weeks after acute ischemic stroke, these multifaceted effects may also reduce the risk of stroke recurrence. A prior phase II trial demonstrated a favorable impact on clinical outcomes and recurrent strokes, particularly among patients who were not eligible for mechanical thrombectomy. A phase II/III trial has launched in this population, though opportunities for combination revascularization therapies deserve further investigation.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"745-753"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case for Establishing a National Stroke Activation Fee in the United States: Learning From Trauma Centers.","authors":"Paul D Johnson, Jennifer J Majersik","doi":"10.1161/STROKEAHA.124.049151","DOIUrl":"10.1161/STROKEAHA.124.049151","url":null,"abstract":"<p><p>There is a large burden of stroke in the United States, and extensive systems of care have been established to address it. The resources devoted to stroke centers are analogous to those of trauma centers, both sharing many strict requirements for certification, clinical preparedness, quality improvement, data management, and reporting. However, trauma programs partly defray these costs through a trauma activation billing code, a billable fee that is charged for activation of the trauma team under strict criteria. There are potential benefits to establishing an analogous national stroke code activation fee. Although a billable stroke code activation fee may increase financial burden on patients, this may be counterbalanced by the significant potential for individual and societal benefits. Providing additional financial support for stroke systems of care may improve acute stroke treatment, reduce stroke burden and poststroke disability, and reduce inequality by broadening the reach of stroke systems of care to disadvantaged communities. Further evaluation of the costs and benefits of implementing a stroke code activation fee based on that currently used by trauma centers is needed.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"754-757"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Requiring an Interpreter Influences Stroke Care and Outcomes for People With Aphasia During Inpatient Rehabilitation.","authors":"Kathleen Mellahn, Monique F Kilkenny, Samantha Siyambalapitiya, Ali Lakhani, Catherine Burns, Tara Purvis, Dominique A Cadilhac, Miranda L Rose","doi":"10.1161/STROKEAHA.124.047893","DOIUrl":"10.1161/STROKEAHA.124.047893","url":null,"abstract":"<p><strong>Background: </strong>Communicative ability after stroke influences patient outcomes. Limited research has explored the impact of aphasia when it intersects with cultural or linguistic differences on receiving stroke care and patient outcomes. We investigated associations between requiring an interpreter and the provision of evidence-based stroke care and outcomes for people with aphasia in the inpatient rehabilitation setting.</p><p><strong>Methods: </strong>Retrospective patient-level data from people with aphasia were aggregated from the Australian Stroke Foundation National Stroke Audit-Rehabilitation Services (2016-2020). Multivariable regression models compared adherence to processes of care (eg, home assessment complete, type of aphasia management) and in-hospital outcomes (eg, length of stay, discharge destination) by the requirement of an interpreter. Outcome models were adjusted for sex, stroke type, hospital size, year, and stroke severity factors.</p><p><strong>Results: </strong>Among 3160 people with aphasia (median age, 76 years; 56% male), 208 (7%) required an interpreter (median age, 77 years; 52% male). The interpreter group had a more severe disability on admission, reflected by reduced cognitive (6% versus 12%, <i>P</i>=0.009) and motor Functional Independence Measure scores (6% versus 12%, <i>P</i>=0.010). The interpreter group were less likely to have phonological and semantic interventions for their aphasia (odds ratio, 0.57 [95% CI, 0.40-0.80]) compared with people not requiring an interpreter. They more often had a carer (68% versus 48%, <i>P</i><0.001) and were more likely to be discharged home with supports (odds ratio, 1.48 [95% CI, 1.08-2.04]). The interpreter group had longer lengths of stay (median 31 versus 26 days, <i>P</i>=0.005).</p><p><strong>Conclusions: </strong>Some processes of care and outcomes differed in inpatient rehabilitation for people with poststroke aphasia who required an interpreter compared with those who did not. Equitable access to therapy is imperative and greater support for cultural/linguistic minorities during rehabilitation is indicated.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"716-724"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"March 2025 <i>Stroke</i> Highlights.","authors":"José Rafael Romero","doi":"10.1161/STROKEAHA.125.050778","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.050778","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":"56 3","pages":"579"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Remote Ischemic Conditioning on the Form and Function of Red Blood Cells in Patients With Acute Ischemic Stroke.","authors":"Rolf Ankerlund Blauenfeldt, Jennifer Waller, Kim Ryun Drasbek, Jesper Nørgaard Bech, Anne-Mette Hvas, Julie Brogaard Larsen, Morten Nørgaard Andersen, Marlene Christina Nielsen, Maria Kjølhede, Mathilde Kjeldsen, Martin Faurholdt Gude, Mohammad Badruzzaman Khan, Babak Baban, Grethe Andersen, David Charles Hess","doi":"10.1161/STROKEAHA.124.048976","DOIUrl":"10.1161/STROKEAHA.124.048976","url":null,"abstract":"<p><strong>Background: </strong>Remote ischemic conditioning (RIC) is a simple and low-cost intervention that is thought to increase collateral blood flow through the vasodilatory effects of nitric oxide (NO) produced by the endothelium and red blood cells (RBCs). This study aims to investigate whether RIC affects RBC deformability and levels of NO and nitrite in patients with ischemic stroke.</p><p><strong>Methods: </strong>This is a predefined substudy to the RESIST (Remote Ischemic Conditioning in Patients With Acute Stroke Trial) randomized clinical trial conducted in Denmark. RIC was started in the ambulance and continued at the hospital for seven days. Blood samples were collected at different time points: prehospital in the ambulance, in-hospital upon arrival, 2 hours postadmission, and 24 hours postadmission. RBC deformability and erythrocyte aggregation rate were assessed using ektacytometry, NO using flowcytometry, and nitrite content using ozone chemiluminescence.</p><p><strong>Results: </strong>Of 1500 prehospital randomized patients, 486 patients were included in this study between July 28, 2020, and November 11, 2023, and had blood samples taken. Of these, 249 (51%) had AIS, and here RIC treatment was not associated with increased RBC maximal deformability (RIC, 0.549; sham, 0.548; <i>P</i>=0.31), RBC NO (RIC, 35 301 median fluorescence intensity; sham, 34979 median fluorescence intensity; <i>P</i>=0.89), or nitrite (RIC, 0.036 µmol/L; sham, 0.034 µmol/L; <i>P</i>=0.38), but RIC treatment was associated with a significantly reduced aggregation pressure and a slower erythrocyte aggregation rate (RIC, 323.76 millipascal; sham, 352.74 millipascal; <i>P</i>=0.0113).</p><p><strong>Conclusions: </strong>Prehospital and in-hospital RIC significantly reduced erythrocyte aggregation rate in patients with acute ischemic stroke, while there was no change in RBC deformability, NO content, or whole blood nitrite levels.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03481777.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"603-612"},"PeriodicalIF":7.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}