Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Trends in stroke mortality in Latin America and the Caribbean from 1997 to 2020 and predictions to 2035: An analysis of gender, and geographical disparities","authors":"J. Smith Torres-Roman MD,MSc ,&nbsp;Carlos Quispe-Vicuña MD ,&nbsp;Alexandra Benavente-Casas MD ,&nbsp;Dante Julca-Marin MS ,&nbsp;Wagner Rios-Garcia MS ,&nbsp;Mabel R. Challapa-Mamani MS ,&nbsp;Lita del Rio-Muñiz MD ,&nbsp;Jorge Ybaseta-Medina MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108286","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108286","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a leading cause of death and disability globally, with significant public health implications. In Latin America, while mortality rates have declined, the number of stroke cases has increased due to prevalent risk factors like high blood pressure and obesity. Unlike Europe, recent trends in stroke mortality in this region remain underreported.</div></div><div><h3>Objective</h3><div>This study evaluates stroke mortality rates in Latin America Latin American and Caribbean (LAC) countries from 1997 to 2020 and predictions to 2035.</div></div><div><h3>Methods</h3><div>This ecological observational study utilized mortality data from the World Health Organization database. Trends were analyzed using Joinpoint regression to evaluate the annual percent change (APC) by sex and country. Predicted mortality rates through 2035 were calculated using the Nordpred package in R. Changes in stroke mortality were assessed by disentangling the effects of population growth, aging, and risk factor modifications, based on age-specific rates and projections. Results were presented as absolute case numbers and relative percentages.</div></div><div><h3>Results</h3><div>From 1997 to 2020, twelve countries presented significant reductions in stroke mortality rates for men in LAC, the main ones being Chile (−4.2 %), El Salvador (−4.2 %), and Puerto Rico (−4.0 %). Thirteen countries reported a reduction in their mortality for women, mainly in Puerto Rico (−4.3 %), Chile (−3.7 %), Argentina, El Salvador, and Uruguay (−3.5 %). By 2035, an increase in deaths among men and women is expected, mainly due to the increase in population structure and size. However, a decrease in the mortality rate will be reported, mainly due to the reduction of risk factors.</div></div><div><h3>Conclusion</h3><div>Our final findings show a reduction in stroke mortality trends in LAC countries between 1997 and 2020, due to creating public awareness about vascular risk factors by authorities and the implementation of effective health policies. By 2035, an overall increase in mortality is expected, mainly due to population change in each country.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108286"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in door-to-device times in a retrospective cohort of patients with ischemic stroke who received CTA only or CTA and CTP imaging","authors":"Jason W. Tarpley MD, PhD ,&nbsp;Horia Marginean MD, MS ,&nbsp;Weston Anderson BA ,&nbsp;Kamila Szweda ,&nbsp;Reza Bavarsad Shahripour ,&nbsp;Tamela Stuchiner MA","doi":"10.1016/j.jstrokecerebrovasdis.2025.108272","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108272","url":null,"abstract":"<div><div>Background: In the treatment of acute ischemic stroke, there are differing views about the utility of computerized tomography perfusion (CTP). Two approaches are employed depending on hospital preference. The first approach is to perform non-contrast computed tomography (CT) scans followed by vascular imaging with computed tomography angiography (CTA) for patients arriving within 6 h of last known well. In the first approach, CTP is reserved for patients who arrive 6-24 h after last known well. The second approach is to utilize both CTA and CTP regardless of the time window in which the patient presents. In this study, we sought to answer whether patients triaged with CTP and CTA had increased door-to-device times compared to those only triaged with CTA.</div><div>Methods: We investigated a retrospective cohort of 1,357 patients with ischemic stroke who received endovascular therapy (EVT) and were triaged with CTA only or CTA and CTP. Patients were stratified by when they arrived at the hospital (&lt;6 h and 6-24 h from last known well). Linear mixed-effects models (LMM) were used to investigate the association between door-to-device times and CTA/CTP usage.</div><div>Results: Our results showed that using CTP and CTA was not associated with increased time to treat compared to CTA alone. There was no increase in time from door to device in patients presenting within 6 h. Furthermore, for patients who arrived 6-24 h of last known well, the use of CTP and CTA was associated with an accelerated time to treatment with EVT.</div><div>Conclusions: CTA and CTP usage was not associated with added time costs with respect to door-to-device in this patient cohort. Our results are consistent with other data showing that radiologists have faster read times when given both CTP and CTA. It is noteworthy that the majority of EVT patients in our dataset (70.6 %) presented in the &lt;6-hour time window.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108272"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"ROTEM and von Willebrand Factor in COVID patients presenting with acute ischemic stroke: A case series: ROTEM and von Willebrand Factor in COVID-19 Related Stroke\" [Journal of Stroke and Cerebrovascular Diseases, Volume 33 (11), 2024 Nov 1, p.107894].","authors":"Tamara Strohm","doi":"10.1016/j.jstrokecerebrovasdis.2025.108275","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108275","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108275"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between fibrous cap status or plaque surface morphology and intraplaque hemorrhage volume over time: The PARISK Study","authors":"Mohamed Kassem ,&nbsp;Tahnee Gorissen ,&nbsp;Mohammad Albenwan ,&nbsp;Juul Bierens ,&nbsp;Dianne H.K. van Dam-Nolen ,&nbsp;Madieke I. Liem ,&nbsp;Paul A.M. Hofman ,&nbsp;Joachim E Wildberger ,&nbsp;Jeroen Hendrikse ,&nbsp;Werner Mess ,&nbsp;Paul J. Nederkoorn ,&nbsp;Daniel Bos ,&nbsp;Patty Nelemans ,&nbsp;Robert J. van Oostenbrugge ,&nbsp;M. Eline Kooi","doi":"10.1016/j.jstrokecerebrovasdis.2025.108283","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108283","url":null,"abstract":"<div><h3>Background</h3><div>Carotid intraplaque hemorrhage (IPH) is a strong predictor of stroke, but factors contributing to IPH development are incompletely understood. Therefore, we investigate the longitudinal relationship between a thin/ruptured fibrous cap (TRFC)/disrupted plaque surface and IPH volume.</div></div><div><h3>Methods</h3><div>116 ischemic TIA/stroke patients with ipsilateral carotid plaques underwent baseline and two-year follow-up MRI. IPH and fibrous cap status (thick versus TRFC) on MRI and disruption of the plaque surface (smooth versus fissure/ulceration) on CTA were assessed.</div></div><div><h3>Results</h3><div>In the TRFC and disrupted plaque surface groups, the median IPH volume (tended) to decrease during follow-up (baseline: 97.3 IQR: [3.2-193.3] mm³ versus follow-up: 29.7 [0.0-115.1] mm³, <em>p</em> = 0.09, and baseline: 25.1 [0.0-166.2] mm³ versus follow-up: 11.2 [0.0-68.3] mm³, <em>p</em> = 0.04, respectively). In the group with a thick fibrous cap/smooth plaque surface, the median IPH volumes were zero at baseline and follow-up. The risk of IPH progression was higher in the TRFC/disrupted plaque groups (risk ratio (RR): 2.9 and 2.0, respectively) than in patients with a thick fibrous cap/smooth plaque surface.</div></div><div><h3>Conclusion</h3><div>TIA/stroke patients with a TRFC/disrupted plaque showed a net decrease in IPH volume over time, indicating plaque healing in some patients, but patients with a TRFC/disrupted plaque are still at increased risk for IPH progression.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov NCT01208025.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108283"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiomics analysis demonstrated a strong correlation between lipid-mediated chronic kidney disease and stroke: Potential benefits of affected patient cohorts","authors":"Yan-song Liu ,&nbsp;Jian-hang Zhang ,&nbsp;Jia-yue Han ,&nbsp;Yu-yan Long ,&nbsp;Yu-chen Liu ,&nbsp;Kai-ni Mao ,&nbsp;Yu-jing Feng ,&nbsp;Zhi-guang Song ,&nbsp;Si-min Peng ,&nbsp;Shi-min Tan ,&nbsp;Si-le Cai ,&nbsp;Jing-yi Yang ,&nbsp;Li-hua Lin ,&nbsp;Wan-ying Song ,&nbsp;Hua Li ,&nbsp;Wang-hua Liu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108285","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108285","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with chronic kidney disease (CKD) exhibit a disproportionately elevated risk of stroke, frequently compounded by renal impairment. Therapeutic strategies for stroke based on Traditional Chinese Medicine's 'kidney–brain axis' theory demonstrate clinical efficacy, indicating that there may be a potential association between chronic kidney disease and stroke, which needs further exploration and verification.</div></div><div><h3>Methods</h3><div>In this study, databases such as GEO, NHANES, and GWAS were used to collect data related to CKD and stroke. GEO gene data enrichment analysis was used to explore possible mediating factors between CKD and stroke. NHANES clinical data were used to verify the GEO data analysis results. Mendelian randomization was used to confirm the causal relationship between CKD and stroke and verify the association effect of mediating factors in these two diseases.</div></div><div><h3>Results</h3><div>Cross-gene analysis and transcription factor analysis of GEO data revealed that lipid-related pathways may have a mediating effect on the relationship between CKD and stroke. Logistic regression analysis based on NHANES data revealed that changes in LDL-C, HDL-C, TC, and TG can affect the occurrence of stroke. Mendelian randomization analysis was used to determine the causal relationship between CKD and stroke and verified the mediating effects of lipid factors, such as LDL-C, HDL-C, TC, and TG, indicating that LDL-C, HDL-C, TC, and TG may be potential mediating factors for these two diseases. Our findings highlight the clinical relevance of lipid pathways in bridging CKD and stroke. By integrating predictive biomarkers and multi-level diagnostics, this study paves the way for AI-driven precision medicine in stroke prevention. Specifically, machine learning approaches could enhance risk stratification of high-risk CKD cohorts, enabling tailored interventions such as lipid-lowering therapies and personalized monitoring protocols. These strategies align with emerging paradigms in healthcare benefits and population-specific management.</div></div><div><h3>Conclusion</h3><div>This study provides new insights into the interactive relationship between CKD and stroke and provides a scientific basis for the process of syndrome differentiation and the treatment of stroke under the guidance of the \"kidney–brain correlation\". Moreover, the influence of mediating factors related to lipid metabolism on the occurrence of these two diseases was investigated, which deepened researchers' understanding of the potential association mechanism between the two diseases.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108285"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure misclassification among stroke survivors followed in a comprehensive stroke prevention clinic","authors":"M. Carter Denny MD, MPH ,&nbsp;Maha Almohamad PhD, MS ,&nbsp;Emmanuel Ebirim MD ,&nbsp;Adriana Morell MD ,&nbsp;Munachi Okpala DNP, MBA, MSN, APRN ,&nbsp;Kevin O. Hwang MD, MPH ,&nbsp;Sean Savitz MD ,&nbsp;Anjail Sharrief MD, MPH","doi":"10.1016/j.jstrokecerebrovasdis.2025.108282","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108282","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is the most important modifiable risk factor for secondary stroke prevention; however, blood pressure (BP) remains uncontrolled for at least 50 % of stroke survivors following an incident stroke. Accurate in-clinic assessment of BP is important for appropriate medication titration. We evaluated misclassification of clinic BP control in a racially diverse stroke clinic population using two BP measurement methods.</div></div><div><h3>Observations</h3><div>We followed ischemic stroke, intracerebral hemorrhage, and transient ischemic attack patients after hospital discharge in a comprehensive stroke clinic. Casual BP was obtained using a standard office automated machine, attended by a medical assistant. BP was also measured with an unattended automated office BP (AOBP) machine and was categorized as concordant control, concordant uncontrolled, pseudoresistant hypertension, and masked uncontrolled. Multinomial logistic regression was used to assess relationships between demographic/clinical variables and misclassification categories, controlling for confounders. Among 216 patients, mean age was 59.5 (SD 12.9); 57 % were male, and by race, 50.5 % were non-Hispanic Black/ African American, 21.3 % Hispanic, and 25.5 % non-Hispanic White. BP control was misclassified by casual office BP for 27.3 % of patients. Race was significantly associated with misclassification in regression analysis. The odds ratio for masked uncontrolled compared to concordant controlled BP was 12.2 (95 % CI 1.5, 99.2) for non-Hispanic Black/ African American and 9.9 (95 % CI 1.1, 87.4) for Hispanic compared to non-Hispanic White patients.</div></div><div><h3>Conclusions</h3><div>These findings highlight barriers to assessment of BP control using standard office measurements among stroke survivors. Accurate BP measurement tools, including AOBP, home BP, and ambulatory BP monitoring, should be utilized to optimize BP treatment after stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108282"},"PeriodicalIF":2.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of ischemic stroke in korean patients with Cancer: Insights from national health insurance data","authors":"Juwang Moon ,&nbsp;Ji Min Ryu MD ,&nbsp;Choyun Jeong ,&nbsp;Seung Jae Lee PhD ,&nbsp;Jong Seung Kim MD, PhD ,&nbsp;Hyun Goo Kang MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108281","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108281","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare the cumulative incidence of ischemic stroke between patients with and without cancer, estimate the hazard ratio of stroke in patients with cancer compared to those without cancer, and compare our results with those of other nationwide studies.</div></div><div><h3>Materials and Methods</h3><div>We recruited 91,424 patients diagnosed with cancer from the Korean National Health Insurance Service database between 2011 and 2015 and enrolled 182,848 controls. These participants were followed up for 5 years. We estimated the hazard ratios for ischemic stroke occurrence in the patient groups for all cancer types and nine specific cancer types during follow-up at 6 months and 1, 3, and 5 years.</div></div><div><h3>Results</h3><div>For all cancer types, except colorectal, gallbladder, bile duct, and head and neck cancers, the slope of the cumulative increase in ischemic stroke in the early period was higher than that in longer follow-up durations. Ischemic stroke risk was elevated after the 6-month follow-up in patients with cancer compared to patients without cancer (95% confidence interval [CI]: 1.56–1.94). Over 3–5 years, Ischemic stroke risk increased in patients with lung (CI: 1.56–2.04), pancreatic (CI: 1.33–1.95), and liver cancers (CI: 1.07–1.39), compared to cancer-free individuals, whereas no significant increase was observed in patients with thyroid (CI: 0.79–1.13), stomach (CI: 0.92–1.17), colorectal (CI: 0.69–1.48), gallbladder (CI: 0.91–9.89), bile duct (CI: 0.39–3.50), and head and neck (CI: 0.26–74.30) cancers.</div></div><div><h3>Conclusion</h3><div>Our findings regarding stomach, colorectal, and liver cancers differ from the results of Western studies. Conducting a nationwide study within each country, rather than applying findings from other countries, is preferable for predicting and preventing ischemic stroke development in patients with cancer when using insurance-based data.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108281"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of electrical stimulation in the treatment on patients with foot drop after stroke: a systematic review and network meta-analysis","authors":"Wang He MD ,&nbsp;Li Yaning MD ,&nbsp;Yu Shaohong DD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108279","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108279","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the efficacy of electrical stimulation (ES) in the treatment of patients with foot drop (FD) after stroke, and to compare the efficacy of different types of ES.</div></div><div><h3>Data sources</h3><div>We searched 5 English database (PubMed, Web of Science, Embase, Cochrane Library and Scopus) and 4 Chinese databases (China National Knowledge Infrastructure (CNKI), SinoMed (CBM), VIP and Wanfang Data) from inception to June, 2024.</div></div><div><h3>Data synthesis</h3><div>Traditional meta-analysis and network meta-analysis were performed using RevMan5.4 software and Stata 14.0 software respectively. A total of 37 RCTs were included, involving 2309 patients. The results of the traditional meta-analysis showed that compared with CRT, ES combined with CRT was effective in improving the range of motion (ROM) of ankle dorsiflexion in patients with FD after stroke and significantly improved the fugl-meyer assessment of lower extremity (FMA-LE) scores. For patients with FD with different disease duration, the subgroup analysis results showed that the ES improved the ROM of ankle dorsiflexion of patients in recovery phases (1-6 months) better than those in the acute phases (≤ 1 month) and sequelae phases (≥ 6 months), but the overall results of the three groups were not significantly different. The ES improved the lower limb motor function of patients in the recovery phases better than those in the acute phases, and the efficacy was not significant in patients in the sequelae phases (P &gt; 0.05). The results of network meta-analysis showed that the best probability of improving the dorsiflexion angle of the ankle was electroacupuncture (EA) &gt; transcranial direct current stimulation (tDCS) &gt; transcutaneous electrical nerve stimulation (TENS) &gt; functional electrical stimulation (FES) &gt; neuromuscular electrical stimulation (NMES) &gt; electromyographic biofeedback therapy (EMGBFT) &gt; conventional rehabilitation therapy (CRT); the best probability of improving the dorsiflexion angle of the ankle was EA &gt; EMGBFT &gt; tDCS &gt; FES &gt; TENS &gt; NMES &gt; CRT.</div></div><div><h3>Conclusions</h3><div>The current evidence showed that the ES combined with CRT can effectively improve the ROM of ankle dorsiflexion and lower limb motor function in patients with FD after stroke, especially the patients in recovery phases. Among the different types of ES, EA had the best effect than other types of ES.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108279"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of perioperative stroke in patients with Ischemic-type moyamoya disease treated with surgical revascularization: A retrospective multicenter study","authors":"Basel Musmar MD ,&nbsp;Joanna M. Roy MD ,&nbsp;Hammam Abdalrazeq MD ,&nbsp;Elias Atallah MD ,&nbsp;Kareem El Naamani MD ,&nbsp;Ching-Jen Chen MD ,&nbsp;Roland Jabre MD ,&nbsp;Hassan Saad MD ,&nbsp;Jonathan A. Grossberg MD ,&nbsp;Adam A. Dmytriw MD, MPH, MSc ,&nbsp;Aman B. Patel MD ,&nbsp;Mirhojjat Khorasanizadeh MD ,&nbsp;Christopher S Ogilvy MD ,&nbsp;Ajith J. Thomas MD ,&nbsp;Andre Monteiro MD ,&nbsp;Adnan Siddiqui MD ,&nbsp;Gustavo M. Cortez MD ,&nbsp;Ricardo A. Hanel MD,PhD ,&nbsp;Guilherme Porto MD ,&nbsp;Alejandro M. Spiotta MD ,&nbsp;Pascal Jabbour MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108277","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108277","url":null,"abstract":"<div><h3>Introduction</h3><div>Moyamoya disease (MMD) is a chronic cerebrovascular disorder characterized by progressive stenosis or occlusion of the internal carotid arteries and the development of collateral moyamoya vessels. Surgical revascularization is commonly used to prevent future ischemic events in ischemic-type MMD, but there remains a high rate of stroke perioperatively. This study aims to analyze the predictive factors for perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization using a large multicenter database.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study included patients with ischemic-type MMD who underwent surgical revascularization across 13 academic institutions in North America. Data were collected and analyzed on a per-hemisphere basis, covering patient demographics, disease characteristics, procedural details, and outcomes. Statistical analyses were performed using Stata (V.17.0), comparing baseline characteristics, and using univariable and multivariable logistic regression to identify predictors of perioperative stroke.</div></div><div><h3>Results</h3><div>A total of 301 patients with ischemic-type MMD underwent surgical revascularization, with 34 patients (11.3 %) experiencing perioperative stroke. Patients who experienced perioperative stroke had a mean age of 43.6 years (SD 14.0) compared to 40.0 years (SD 13.9) in those without perioperative stroke (<em>P</em> = 0.16). Hypertension was significantly more prevalent in the perioperative stroke group (73.5 % vs. 47.9 %, <em>P</em> = 0.005). Current smoking was also more common in the perioperative stroke group (55.8 % vs. 38.2 %, <em>P</em> = 0.04). Multivariate logistic regression identified hypertension (OR 2.32, 95 % CI 1.01 to 5.37, <em>P</em> = 0.04) and current smoking (OR 2.28, 95 % CI 1.04 to 4.97, <em>P</em> = 0.03) as significant independent predictors of perioperative stroke.</div></div><div><h3>Conclusion</h3><div>Hypertension and smoking were significant predictors of perioperative stroke in patients with ischemic-type MMD undergoing surgical revascularization. These findings emphasize the importance of managing risk factors in ischemic-type MMD. Further prospective studies are needed to validate these findings.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108277"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HBCOC attenuates cerebral ischemia-reperfusion injury in mice by inhibiting the inflammatory response and autophagy via TREM-1/ERK/NF-κB","authors":"Rongyuan Li ,&nbsp;Qin Li ,&nbsp;Congmin Yang ,&nbsp;Hanlin Liu ,&nbsp;Yijun Xiao ,&nbsp;Pengyu Yang ,&nbsp;Gu Gong ,&nbsp;Wei Wu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108280","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108280","url":null,"abstract":"<div><h3>Objective</h3><div>Hemoglobin-based carbon monoxide carrier (HBCOC) can dissociate carbon monoxide and ameliorate organ damage by inhibiting inflammation and oxidative stress. In this study, we evaluated its effect on cerebral ischemia-reperfusion injury in mice and explored its potential mechanism.</div></div><div><h3>Methods</h3><div>A middle cerebral artery occlusion/reperfusion (MCAO/R) mouse model was established using the wire embolization method, and HBCOC or equivalent normal saline was administered via the tail vein during reperfusion. HE staining and TEM were used to observe the injury in the tissue. The levels of IL-1β, IL-6, TNF-α were detected by ELISA and RT-qPCR, meantime, western blotting were used to detect expressions of TREM-1, ERK, NF-κB,LC3 and P62.</div></div><div><h3>Results</h3><div>We found that the HBCOC treatment alleviated nerve injury and reduced the cerebral infarction area caused by ischemia-reperfusion, simultaneously lowered the expression of IL-1β, IL-6, and TNF-α in plasma and brain tissues. HBCOC suppressed the levels of LC3II, lysosomes, and autophagy in the brain, suggesting potent inhibition of autophagy. Mechanistic analysis indicated that the expression of TREM-1/ERK/NF-κB pathway-related proteins and mRNA was higher in the saline group than that in the HBCOC group. HBCOC combined with the targeting TREM-1 receptor inhibitors LP17 inhibited the expression of the TREM-1 protein, further reducing the release of inflammatory factors and autophagy, restoring nerve function and infarct area after reperfusion, and exerting an overall protective effect against cerebral reperfusion injury. In summary, our results indicated that HBCOC alleviated cerebral ischemia-reperfusion injury in mice and inhibited inflammation and autophagy via TREM-1.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108280"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}