Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"The role of children in promoting stroke literacy across generations: A narrative review of the FAST Heroes initiative","authors":"Emilia Orologa PhDc ,&nbsp;Kalliopi Tsakpounidou PhD ,&nbsp;Maria Baskini PhD ,&nbsp;Myrto Pyrrou MSc ,&nbsp;Jan van der Merwe MSc ,&nbsp;Hariklia Proios PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108404","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108404","url":null,"abstract":"<div><h3>Background &amp; Purpose</h3><div>It has been highlighted that children can serve as effective messengers, helping to raise awareness to their parents, grandparents, and the broader community. Relying on this approach, the FAST Heroes program engages children as central agents of knowledge transfer, aiming to enhance stroke literacy among their families. The purpose of this review is to examine how children acquire stroke-related knowledge and subsequently facilitate its transfer to their families.</div></div><div><h3>Observations</h3><div>Studies have shown that family members whose children have participated in the program were able to identify common stroke symptoms and demonstrate the appropriate course of action in case of a suspected stroke. The FAST Heroes program effectively engaged children by integrating several evidence-based educational principles, such as interactive and multisensory learning. Alongside, the program follows a progressive and structured approach that facilitates knowledge acquisition and long-term retention.</div></div><div><h3>Conclusions</h3><div>FAST Heroes focus on intergenerational learning, creating an effective learning environment that enhances stroke literacy across generations. As the program continues to evolve and expand globally, it offers a sustainable approach to stroke education, demonstrating the lasting impact of well-designed health literacy interventions.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108404"},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714476","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":"Buenos Aires Stroke School: a path to continuous medical education in stroke, empowering and connecting future specialists in vascular neurology across Latin America","authors":"Matías J. Alet ,&nbsp;Raúl C. Rey ,&nbsp;Sebastián F. Ameriso","doi":"10.1016/j.jstrokecerebrovasdis.2025.108405","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108405","url":null,"abstract":"<div><h3>Background</h3><div>The Buenos Aires Stroke School was established in 2019 to address the unmet need for structured, high-quality stroke education in Latin America. Its goal is to provide intensive training in vascular neurology and foster collaboration among early-career professionals across the region.</div></div><div><h3>Approach</h3><div>The program offers a five-day, 50-hour curriculum that includes lectures, clinical case discussions, simulations, and hands-on workshops. Participants are selected based on academic background, motivation, and potential to improve stroke care in their local settings. The course integrates social and cultural activities to strengthen peer and faculty connections.</div></div><div><h3>Outcomes</h3><div>Over five editions, 69 professionals from 11 Latin American countries participated. A follow-up survey was completed by 29 alumni (42% response rate). Among respondents, 62% reported increased use of intravenous thrombolysis, 28% implemented it for the first time, 45% improved existing stroke units, and 17% established new ones. Mechanical thrombectomy was initiated or expanded in 10% of centers. Additionally, 21% of institutions achieved World Stroke Organization (WSO)/Iberoamerican Stroke Organization (IASO) Stroke Center Certification. Educational and outreach activities increased in 72% and 55% of institutions, respectively.</div></div><div><h3>Conclusions</h3><div>The Buenos Aires Stroke School offers an immersive, multidisciplinary, and regionally adapted educational model. By connecting and training early-career professionals, it may help strengthen national and regional stroke networks. While causality cannot be established, the reported outcomes suggest a possible association between participation in the program and subsequent institutional improvements. Continued expansion and structured follow-up efforts are planned to support long-term impact across Latin America.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108405"},"PeriodicalIF":2.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714480","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":"A systematic review and meta-analysis of the late causes of death following successful carotid endarterectomy (CEA)","authors":"Daryll Baker FRCS PhD (Consultant Vascular Surgeon) ,&nbsp;Janice Tsui FRCS MD (Consultant Vascular Surgeon)","doi":"10.1016/j.jstrokecerebrovasdis.2025.108400","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108400","url":null,"abstract":"<div><h3>Introduction</h3><div>Carotid endarterectomy (CEA) reduces the risk of stroke. Knowledge of the eventual causes of death would assist in directing late post-CEA drug management. This review determines the causes of death and assesses whether this has changed over time and is influenced by CEA indications or preoperative coronary artery disease status.</div></div><div><h3>Methods</h3><div>Using PRISMA guidelines, the PROSPERO registered review identified only randomised controlled studies where the cause of late post-CEA death was reported by interrogating the PubMed and Cochrane databases. Titles and abstracts were reviewed, and publication bias was assessed once inappropriate studies had been removed. From the extracted data, a proportional meta-analysis of the non-stroke cardiovascular, stroke and cancer-related deaths was undertaken. A random effect model was used to pool proportions. For each, linear regression analysis determined the effect of changes in the proportion of deaths over time, symptomatic CEA indications, and preoperative coronary artery disease status.</div></div><div><h3>Results</h3><div>From 3838 publications between 1965 and 2025, 27 studies provided information on the late cause of death. 47.1 % (95 % CI 42.2 to 52.0) of deaths were non-stroke cardiovascular-related. This proportion has decreased in more recent publications (<em>r</em> = 0.61, <em>p</em> &lt; 0.001). 6.3 % (95 % CI 4.5 to 8.4) of late deaths were stroke-related, which did not alter over time. 17.5 % (95 % CI 13.7 to 21.7) of late deaths were cancer-related. This proportion has increased with time (<em>r</em> = 0.59 <em>p</em> &lt; 0.001). The indications for CEA or the preoperative coronary artery disease status did not influence the proportion of deaths.</div></div><div><h3>Conclusions</h3><div>Post-CEA, almost half die from cardiovascular causes. A reduction in this proportion may indicate an improvement in treatment. The 6 % post-CEA stroke-related death rate is low compared to the overall proportion of recurrent fatal strokes and may indicate the success of CEA. Further outcome improvements can be achieved by focusing on general cardiovascular treatments rather than stroke-specific ones.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108400"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693103","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":"Intracarotid injection of hyperosmolar mannitol produced a larger infarct than normal saline during the first few hours of distal middle cerebral artery occlusion with a smaller regional plasma volume","authors":"Xia Liu MD ,&nbsp;Harvey R Weiss PhD ,&nbsp;Oak Z Chi MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108403","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108403","url":null,"abstract":"<div><h3>Background</h3><div>Although hyperosmolar mannitol has been used clinically to reduce intracranial pressure, its use in acute ischemic stroke remains controversial. We investigated whether other characteristics of hyperosmolar mannitol such as its effects on cerebral regional plasma volume or blood-brain barrier permeability would affect infarct size when intracranial pressure is zero during the early ischemic stroke.</div></div><div><h3>Methods</h3><div>One hour after a distal middle cerebral artery occlusion with craniotomy which results in essentially zero intracranial pressure, the rats were treated with 25 % mannitol or normal saline via the ipsilateral external carotid artery. Control rats received no treatment. Two hours after middle cerebral artery occlusion, infarct size along with the blood-brain transfer coefficient of ¹⁴C-α-aminoisobutyric acid, and the volume of ³H-dextran distribution were measured to assess blood-brain barrier permeability and plasma volume respectively.</div></div><div><h3>Results</h3><div>At one hour after intracarotid artery injection and two hours after middle cerebral artery occlusion, hyperosmolar mannitol treatment significantly reduced cerebral regional plasma volume in the ischemic cortex (3.0 mL/100 <em>g</em> ± 1.6) compared to normal saline (6.1 mL/100 <em>g</em> ± 1.3, <em>p</em> &lt; 0.0001) or no treatment (4.8 mL/100 <em>g</em> ± 1.2, <em>p</em> &lt; 0.05). Blood-brain barrier permeability was similar regardless of treatments in the ischemic cortex. The percentage of cortical infarcted area relative to total cortical area was significantly higher in the mannitol-treated rats (14.0 % ± 4.5) compared to normal saline treatment (6.6 % ± 1.4, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that when intracranial pressure effect is excluded, hyperosmolar mannitol may exacerbate neuronal damage in the very early stages of acute ischemic stroke, and that cerebral regional plasma volume plays an important role in neuronal survival.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108403"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683963","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":"Comparison of discharge disposition and AHA prehospital stroke compliance among urban, suburban, and rural EMS agencies","authors":"Daria S. Nicke ,&nbsp;Courtney Wham MD ,&nbsp;Ian Espinoza ,&nbsp;Breanna Thrower MS ,&nbsp;Stefan Sillau PhD ,&nbsp;Andra Farcas MD ,&nbsp;Michelle Leppert MD ,&nbsp;Elizabeth Molina Kuna MPH ,&nbsp;Layne Dylla MD, PhD ,&nbsp;the IMPACT Investigators","doi":"10.1016/j.jstrokecerebrovasdis.2025.108402","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108402","url":null,"abstract":"<div><h3>Background</h3><div>Rural community patients with acute stroke fhave worse outcomes compared to those in urban communities. This study determined the associations between agency type (rural, suburban, urban), patient care (compliance with American Heart Association [AHA] guidelines), and patient outcomes (discharge disposition).</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of patients with prehospital impression of suspected stroke and a final diagnosis of an acute stroke or TIA between January 1, 2020 and December 31, 2022. Prehospital agencies were classified by rural-urban commuting area (RUCA) score: urban (RUCA 1), suburban (RUCA 2-3), rural (RUCA 4-10). Descriptive statistics characterized the cohort. Multivariable regression analysis tested the association between agency type and discharge disposition while controlling for age, sex, cardiovascular risk factors, initial NIHSS, in-hospital intervention, and receiving facility type.</div></div><div><h3>Results</h3><div>Urban-, suburban-, and rural-based agencies varied in compliance with the AHA recommendations. Rural agencies had the lowest proportion of encounters with full compliance (2.0 %) compared to suburban (7.0 %) and urban agencies (11.0 %) (<em>p</em> &lt; 0.01). Compared to patients transported by urban agencies, patients transported by suburban agencies had almost twice (1.78 times; 95 % CI, 1.19-2.65) the odds of discharge to hospice or death and 0.56 times (95 % CI, 0.38-0.84) the odds of discharge home after controlling for covariates.</div></div><div><h3>Conclusions</h3><div>Rural EMS agencies had the lowest proportion of full compliance with AHA prehospital stroke guidelines. Acute stroke patients transported by suburban EMS agencies were less likely to be discharged home and more likely to be discharged to death compared to patients transported by urban-based EMS agencies.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108402"},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677202","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":"`Probabilistic ensemble learning for prediction of stroke thrombectomy outcomes from the NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD) Acute Ischemic Stroke Registry","authors":"Chaochao Zhou ,&nbsp;Dayeong An ,&nbsp;Syed Hasib Akhter Faruqui ,&nbsp;Abhinav Patel ,&nbsp;Ramez N. Abdalla ,&nbsp;Ali Shaibani ,&nbsp;Sameer A. Ansari ,&nbsp;Donald R. Cantrell ,&nbsp;NVQI-QOD Registry Investigators","doi":"10.1016/j.jstrokecerebrovasdis.2025.108401","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108401","url":null,"abstract":"<div><h3>Introduction</h3><div>Mechanical Thrombectomy (MT) is the standard of care in the interventional management of Acute Ischemic Stroke (AIS). The NVQI-QOD registry records detailed patient characteristics, pre-operative imaging, procedure metrics, and post-operative outcomes of neurointerventional surgical procedures. Although these data are highly informative, there is substantial uncertainty in all medical interventions, so patient outcomes remain variable after intervention. In this work, we leverage a probabilistic machine learning paradigm to predict MT outcomes in the context of this inherent uncertainty.</div></div><div><h3>Methods</h3><div>Using data from the NVQI-QOD AIS registry, we identified three groups of feature variables: those available prior to MT (Group Preop), post MT (Group Postop), and at discharge (Group DC). Using Probabilistic Neural Networks (PNNs) and XGBoost, we predicted 1) the change in NIH Stroke Scale from presentation to discharge (∆NIHSS), and 2) a binary measure of functional outcome, which was aggregated from the 90-day follow-up Modified Rankin Scale (mRS).</div></div><div><h3>Results</h3><div>Both XGBoost and the PNN are capable of binary probabilistic classification of mRS scores, with accuracies ranging from 0.69 using preoperative feature variables to 0.80 when utilizing input features that are available at the time of discharge. XGBoost and the PNN had similar mean squared error performance for the ∆NIHSS regression task as well, however the PNN can also perform probabilistic regression, predicting distributions of ∆NIHSS with means and standard deviations (SDs). Feature importance analysis showed that predictions of both ∆NIHSS and mRS severity primarily depended upon the presenting NIHSS, Pre mRS, and patient age.</div></div><div><h3>Conclusions</h3><div>The probabilistic machine learning paradigm allows for quantification of predictive uncertainty through outcome probability distributions and may offer clinicians critical insights beyond traditional deterministic methods. With the clinical information available prior to MT, patients with the worst predicted outcomes will have a nearly ∼50% chance of neurological improvement, while those with the <em>best</em> anticipated outcomes have <em>a</em> &gt; 98% probability for improvement, reinforcing both the safety and profound benefits of MT.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108401"},"PeriodicalIF":1.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677201","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":"Association between nutritional status and mortality/neurological outcomes in stroke patients: A systematic review and meta-analysis","authors":"Jihui Hu ,&nbsp;Yang Liu ,&nbsp;Yi Zhang,&nbsp;Meng Zhang,&nbsp;Li Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108398","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108398","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the association between Nutritional Risk Screening 2002 (NRS-2002), Controlling Nutritional Status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), and 3-month mortality and poor neurological outcomes (modified Rankin Scale [mRS] ≥3) in stroke patients.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and other databases up to April 2025 identified 11 observational studies (6 prospective cohorts; <em>n</em> = 7696). Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects models were used to calculate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Heterogeneity, sensitivity, and publication bias were assessed. Meta-regression explored sources of heterogeneity. A gradient boosting classifier and Bayesian MCMC simulations were used for supplementary modeling.</div></div><div><h3>Results</h3><div>NRS-2002 ≥ 3 (OR=3.42, 95 % CI: 2.59–4.51), CONUT ≥5 (OR=3.66, 95 % CI: 2.47–5.43), and GNRI &lt;98 (OR=2.68, 95 % CI: 1.86–3.84) were significantly associated with poor functional outcomes. These indices also predicted higher 3-month mortality: NRS-2002 ≥ 3 (OR=4.13), CONUT ≥5 (OR=3.57), GNRI &lt;98 (OR=2.93). Heterogeneity ranged from moderate to high (I²=42.1–68.9 %). Meta-regression implicated regional and clinical factors as sources of variability. Predictive modeling (AUROC = 0.81) identified GNRI &lt;92, age ≥75, and NIHSS as key mortality predictors, consistent with SHAP and Bayesian analyses.</div></div><div><h3>Conclusion</h3><div>Malnutrition—particularly as defined by NRS-2002 ≥ 3, CONUT ≥5, and GNRI &lt;98—is strongly linked to early mortality and poor recovery after stroke. GNRI showed high predictive value in older patients. Integrating nutritional screening into acute stroke care may enable early, cost-effective interventions to improve outcomes.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108398"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661746","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":"Sleep duration and long-term mortality after stroke: A nationwide analysis","authors":"Sara Hassani MD, MHS, MSCR ,&nbsp;Bruce Ovbiagele MD, MLS, MBA, MAS, MSc, FAHA ,&nbsp;Daniela Markovic MS ,&nbsp;Amytis Towfighi MD, FAHA","doi":"10.1016/j.jstrokecerebrovasdis.2025.108399","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108399","url":null,"abstract":"<div><h3>Background</h3><div>Sleep duration is a key marker of ideal cardiovascular health in the American Heart Association’s new Life’s Essential 8 construct, but studies on outcomes in stroke survivors are scarce. We assessed the association between sleep duration and mortality among self-reported stroke survivors in a nationally representative U.S. sample.</div></div><div><h3>Methods</h3><div>Cross-sectional data (2005–2018) from the National Health and Nutrition Examination Surveys database in patients aged ≥18 (n=42,143) with a self-reported history of stroke (n=1,488) were linked to the 2019 National Death Index to determine the association between nightly sleep duration and mortality. Relationships between sleep duration (short: &lt;7 hrs, normal: 7-8 hrs, long: &gt;8 hrs) and demographic characteristics were assessed. Relationships between sleep duration and mortality (all-cause and cardiovascular causes) were evaluated adjusting for demographic and clinical variables, with multivariable Cox regressions.</div></div><div><h3>Results</h3><div>Among stroke survivors, prevalence of short sleep duration increased with younger age while prevalence of long sleep duration increased with older age (p&lt;0.001). There were no significant sex differences in sleep duration. Long sleep duration was associated with higher all-cause mortality in the unadjusted model (HR 1.82, 1.44-2.31, p&lt;0.0001). After adjustment for co-variates, (HR 1.36, 1.08-1.71, p = 0.01), the association attenuated, but remained significant (HR 1.30, 1.02-1.65, p = 0.03). Sensitivity analysis further verified the reliability of this conclusion. Short sleep duration was not associated with all-cause or cardiovascular mortality after adjusted analyses. There were no significant associations between long sleep duration and cardiovascular mortality.</div></div><div><h3>Conclusion</h3><div>Long sleep duration is independently associated with higher risk, all-cause mortality after stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108399"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633900","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":"Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals","authors":"Miguel A. Vences ,&nbsp;Miguel A. Barboza ,&nbsp;Leonardo Augusto Carbonera ,&nbsp;Virgilio E. Failoc-Rojas ,&nbsp;Julieta Rosales ,&nbsp;Pablo Amaya ,&nbsp;Pablo Lavados","doi":"10.1016/j.jstrokecerebrovasdis.2025.108396","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108396","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals is a multicenter registry from various stroke centers in Latin America, exploring demographic, clinical, imaging, and functional outcomes in acute ischemic stroke (AIS) patients, with the intention of determining case-fatality rates (in-hospital, 30 and 90 days follow up) and analyzing associated risk factors.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from hospitalized AIS patients over 18 years of age, collected from 27 centers in 11 Latin American countries between January 1 and December 31, 2022. The effect size was estimated using the hazard ratio (HR) and 95 % confidence intervals (95 % CI) through Cox regression models to assess the association between time to 30-day fatality event and covariates.</div></div><div><h3>Results</h3><div>A total of 2,997 patients were included. The mean age was 68.7 years and 48.1 % were women. In-hospital case-fatality was 9.42 %, 277 patients (10.2 %) died within 30 days, and 90-day case-fatality was relatively close at 353 patients (13.3 %). Complications were reported in 31.3 % of cases, most frequently infections (18.5 %). Age over 75 years (HRa=2.28), hyperglycemia (HRa=1.28), baseline status (HRa=1.61), stroke severity according to NIHSS &gt;26 (HRa=6.11) and the presence of neurological complications (HRa=3.2) were risk factors for 30-day follow up case-fatality in these patients.</div></div><div><h3>Conclusion</h3><div>AIS patients in Latin America stroke centers had an in-hospital case-fatality of 9.42 % and the 30-day case-fatality was 10.2 %. Older age, hyperglycemia, baseline status, stroke severity and neurological complications were the strongest predictors of early case-fatality. The findings underscore the need to optimize stroke management protocols in the region.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108396"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621720","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":"From brain to heart: Causality and therapeutic potential in atrial fibrillation","authors":"Kaiyuan Li,&nbsp;Zongyi Xia,&nbsp;Chi Zhou,&nbsp;Zhexun Lian","doi":"10.1016/j.jstrokecerebrovasdis.2025.108394","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108394","url":null,"abstract":"<div><h3>Objective</h3><div>To elucidate the causal relationship between resting-state brain function and atrial fibrillation (AF), and to pinpoint potential genetic targets and therapeutic compounds for AF.</div></div><div><h3>Methods</h3><div>Employing GTEx V8 eQTL and deCODE Genetics pQTL datasets, key genes associated with AF were identified through Mendelian Randomization (MR) and Summary-based Mendelian Randomization (SMR) analyses. Colocalization analysis was subsequently conducted to confirm the shared genetic loci influencing both brain function and AF. In addition, transcriptome differential expression and pathway enrichment analysis were undertaken to delineate the potential molecular mechanism. Drug screening and molecular docking are employed to evaluate the therapeutic efficacy of the candidate compounds.</div></div><div><h3>Results</h3><div>MR Analysis revealed a significant causal relationship between resting-state brain functions of the default mode network (DMN) and central executive network (CEN) and AF. SMR and co-localization analyses identify the WIPF1 gene as a key genetic locus shared with brain function and AF. Candidate compounds C₁₂H₁₂N₄S, C₁₆H₁₅N₅O₂ and C₁₆H₁₃NO₆ showed anti-inflammatory and antibacterial properties, and exhibited good binding affinity in molecular docking, supporting their potential as therapeutic agents.</div></div><div><h3>Conclusions</h3><div>This study reveals a novel genetic association between resting-state brain function and AF and identifies WIPF1 as a potential therapeutic target, offering fresh insights into the study of brain-heart interaction and targeted treatment strategies for AF.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 9","pages":"Article 108394"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605742","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}