Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Smartphone pupillometry with machine learning differentiates ischemic from hemorrhagic stroke: A pilot study.","authors":"Anthony J Maxin, Bernice G Gulek, Do H Lim, Samuel Kim, Rami Shaibani, Graham M Winston, Lynn B McGrath, Alex Mariakakis, Isaac J Abecassis, Michael R Levitt","doi":"10.1016/j.jstrokecerebrovasdis.2024.108198","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108198","url":null,"abstract":"<p><strong>Objectives: </strong>Similarities between acute ischemic and hemorrhagic stroke make diagnosis and triage challenging. We studied a smartphone-based quantitative pupillometer for differentiation of acute ischemic and hemorrhagic stroke.</p><p><strong>Materials and methods: </strong>Stroke patients were recruited prior to surgical or interventional treatment. Smartphone pupillometry was used to quantify components of the pupillary light reflex (PLR). A synthetic minority oversampling technique (SMOTE) was applied to correct sample size imbalance. Four binary classification model types were trained using all possible combinations of the PLR components with 10-fold cross validation stratified by cohort. Models were evaluated for accuracy, sensitivity, specificity, area under the curve (AUC), and F1 score. The three best-performing models were selected based on AUC. Shapley additive explanation plots were produced to explain PLR parameter impacts on model predictions.</p><p><strong>Results: </strong>Eleven subjects with intraparenchymal hemorrhage and 22 subjects with acute ischemic stroke were enrolled. One way ANOVA demonstrated significant differences between healthy control data, AIS, and IPH in five out of seven PLR parameters. After SMOTE, each class had n=22 PLR recordings for model training. The best-performing model was random forest using a combination of latency, mean and maximum constriction velocity, and mean dilation velocity to discriminate between stroke types with 91.5% (95% confidence interval: 84.1-98.9) accuracy, 90% (82.9-97.1) sensitivity, 93.3% (83-100) specificity, 0.917 (0.847-0.987) AUC, and 90.7% (84.1-97.3) F1 score.</p><p><strong>Conclusions: </strong>Smartphone-based quantitative pupillometry could be useful in differentiating between acute ischemic and hemorrhagic stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108198"},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824746","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":"Tetramethylpyrazine attenuates cerebral ischemia-reperfusion injury by inhibiting ferroptosis via the AMPK / Nrf2 pathways.","authors":"Ke-Xin Zhong, Qi Zeng, Hao Tang, Biao Tang, Hao Wang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108196","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108196","url":null,"abstract":"<p><strong>Objectives: </strong>Ferroptosis is involved in the development and exacerbation of cerebral ischemia-reperfusion injury (CIRI), and its inhibition can alleviate CIRI. Tetramethylpyrazine (TMP) is used for the treatment of ischemic stroke. However, the mechanism by which TMP regulates ferroptosis in CIRI is yet to be explored. This study demonstrated the effects of TMP on ferroptosis and CIRI, including the roles of the adenosine 5'-monophosphate-activated protein kinase (AMPK)/nuclear factor erythroid-2-related factor 2 (Nrf2) signaling pathway.</p><p><strong>Materials and methods: </strong>A Sprague-Dawley rat middle cerebral artery occlusion/reperfusion (MCAO/R) model was generated. The extent of neuronal injury was measured using 2,3,5-triphenyl tetrazolium chloride staining and Garcia neurological scoring and behavior was evaluated using open-field tests. Ferroptosis-related indexes were examined and ferroptosis-related proteins were detected using western blotting. The binding modes of TMP and AMPK were evaluated using molecular docking and molecular dynamics simulations.</p><p><strong>Results: </strong>MCAO/R rats showed a reduced cerebral infarct area and improved neurological function after TMP intervention. TMP reduced levels of Fe²⁺, 4-hydroxynonenal, malonaldehyde, and acyl-coenzyme synthetase long-chain family member 4 and increased levels of glutathione and glutathione peroxidase 4. Increased AMPK phosphorylation and Nrf2 expression were also detected. TMP bound tightly to the AMPKα subunit in silico, and the LEU157, VAL41, LEU33, VAL107, and TYR106 residues were important for binding.</p><p><strong>Conclusions: </strong>Our results indicate that TMP can alleviate CIRI by inhibiting ferroptosis via the activation of the AMPK/Nrf2 pathway, providing a theoretical basis for the clinical use of TMP in treating CIRI.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108196"},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824702","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":"Conicity index and sex differences in relation to carotid plaque instability in Chinese community residents: Conicity index and carotid plaque.","authors":"Bi Deng, Zeyu Liu, Qin Huang, Xianjing Feng, Di Liao, Fang Yu, Jie Feng, Qing Huang, Yunhai Liu, Jian Xia","doi":"10.1016/j.jstrokecerebrovasdis.2024.108193","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108193","url":null,"abstract":"<p><strong>Objectives: </strong>The conicity index (CI), an anthropometric parameter of visceral obesity, has exhibited a strong correlation with the incidence of atherosclerosis and cardiovascular events. This study aimed to explore the relationship between CI and carotid plaque instability, as well as the potential differences between sexes in this context.</p><p><strong>Methods: </strong>Our cross-sectional study included a total of 44,248 participants from the China Stroke High-risk Population Screening and Intervention Program (CSHPSIP), all of whom underwent carotid ultrasound for the evaluation of carotid plaque. Multivariate logistics regression analysis and restricted cubic spline (RCS) curves were employed to examine the association between CI and the prevalence of carotid plaques and unstable plaques. A subgroup analysis was conducted to account for potential confounding variables.</p><p><strong>Results: </strong>Patients belonging to the higher CI quartiles had a greater prevalence of carotid plaque and unstable carotid plaque. After adjusting for confounding factors, each standard deviation (SD) increase in CI was associated with an odds ratio (OR) of 1.06 (95% confidence interval: 1.03-1.08) for carotid plaque and 1.03 (95% confidence interval: 1.00-1.05) for unstable carotid plaque. The RCS analysis revealed an escalating trend in the prevalence of unstable carotid plaque with increasing CI values. However, this observed trend was not evident among female participants. Furthermore, subgroup analysis revealed a more pronounced correlation between CI and carotid plaque instability in individuals with a fasting blood glucose (FBG) of ≥ 7 mmol/L and an unhealthy lifestyle characterized by physical inactivity and current smoking.</p><p><strong>Conclusions: </strong>Our findings demonstrated that CI was significantly associated with carotid plaque and recommend CI as a promising indicator for the initial screening of atherosclerotic plaques in the future.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108193"},"PeriodicalIF":2.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824679","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":"Correlation between impaired brachial flow-mediated dilation and hemorrhagic transformation after acute reperfusion therapy.","authors":"Sangil Park, Dong Hoon Shin, Young Bae Lee, Sang Hee Ha, Bum Joon Kim","doi":"10.1016/j.jstrokecerebrovasdis.2024.108191","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108191","url":null,"abstract":"<p><strong>Objective: </strong>Hemorrhagic transformation (HT) represents a critical complication of reperfusion therapy, often resulting in unfavorable functional outcomes. Our objective was to explore the correlation between endothelial function, assessed through flow-mediated dilation (FMD), and the occurrence of HT in patients undergoing acute reperfusion therapy.</p><p><strong>Materials and methods: </strong>In our retrospective analysis, we investigated patients with emergent large vessel occlusion (ELVO) who underwent acute reperfusion therapy and assessment through FMD, calculated as %FMD = (peak diameter - baseline diameter)/baseline diameter×100. HT was categorized according to the European Cooperative Acute Stroke Study (ECASS) definition. Through multivariate analysis, we explored factors associated with HT, considering stroke mechanisms, and delved into the relationship between FMD and HT.</p><p><strong>Results: </strong>A total of 172 patients were included in this study, with 45.3% experiencing HT. Factors associated with HT included high initial National Institute of Health Stroke Scale (NIHSS) scores [7 (5-10) vs. 10 (8-14); P <0.001], receiving tissue plasminogen activator (tPA) (21.3 vs. 39.7%; P<0.001), undergoing endovascular therapy (EVT) 10.6 vs. 26.9%; P <0.001), and impaired %FMD (6.2±2.5 vs. 4.9±1.8; P = 0.022). In a subgroup analysis of patients with cardioembolism, receiving EVT was significantly associated with HT (reference: tPA only; adjusted odds ratio [aOR] = 7.000; 95% confidence interval, 1.173-41.759; P = 0.033). In those with large artery atherosclerosis (LAA), a higher initial NIHSS score (aOR = 1.274; 1.082-1.499; P = 0.004) and impaired %FMD (aOR = 0.632; 0.402-0.995; P = 0.047) were independently associated with HT.</p><p><strong>Conclusions: </strong>Endothelial dysfunction, indicated by impaired %FMD, emerges as a potential predictor of HT following acute reperfusion therapy, particularly in patients with LAA.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108191"},"PeriodicalIF":2.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820227","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":"Magnitude of effect of low dose colchicine, a newly food and drug administration approved treatment for stroke prevention.","authors":"Erica Escalera, Jeffrey L Saver","doi":"10.1016/j.jstrokecerebrovasdis.2024.108186","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108186","url":null,"abstract":"<p><strong>Background: </strong>As the Food and Drug Administration in June 2023 approved low dose colchicine for primary prevention of stroke and other cardiovascular events, an updated meta-analysis of stroke outcomes in randomized trials would help inform clinical practice.**** METHODS: Systematic, study-level meta-analysis of randomized clinical trials of long-term colchicine in patients with established atherosclerotic cardiovascular disease (ASCVD, preponderantly primary prevention for stroke) or following non-cardioembolic ischemic stroke/transient ischemic attack (secondary prevention). Heterogeneity was assessed with the I² statistic and Cochrane's Q and potential bias assessed with the Risk of Bias 2.0 scale.</p><p><strong>Results: </strong>Six randomized control trials met selection criteria, enrolling 14,987 patients (7495 colchicine, 7492 placebo), with median follow-up 26.3 months. Colchicine dosage in all trials was 0.5 mg once-daily. Across all trials, colchicine treatment produced a 28 % relative risk reduction in stroke (1.77 % vs 2.54 %, risk ratio (RR)=0.72, 95 %CI: 0.58-0.89; p = 0.003) and a comparable relative reduction on major adverse cardiovascular events. There was potential heterogeneity by subgroup (p_interaction = 0.06), with a stronger relative reduction for stroke in the five ASCVD trials (RR=0.48, 95 %CI:0.30-0.77; p = 0.003) than the non-cardioembolic ischemic stroke/TIA population (RR=0.80, 95 %CI:0.63-1.02; p = 0.07). Colchicine was associated with a small, non-significant increase in all-cause mortality (RR: 1.09; 95 %Cl: 0.85-1.40, p = 0.49) but not cardiovascular death (RR: 0.92; 95 %Cl: 0.65-1.29, p = 0.61).</p><p><strong>Conclusion: </strong>Low-dose colchicine treatment decreases stroke and major adverse cardiovascular event risk in patients with ASCVD and potentially in patients following a non-cardioembolic ischemic stroke/TIA. Among every 1000 patients treated over 2 years, approximately 6.6 strokes and 24 major adverse cardiovascular events are avoided.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108186"},"PeriodicalIF":2.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819699","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 of glymphatic clearance function with imaging markers and risk factors of cerebral small vessel disease.","authors":"Jie Yang, Yujian Liu, Yuanying Ma, Wei Zhang, Limei Han, Hao Feng, Meining Chen, Jianquan Zhong","doi":"10.1016/j.jstrokecerebrovasdis.2024.108187","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108187","url":null,"abstract":"<p><strong>Background: </strong>Cerebral small vessel disease (CSVD) is a common disease in the elderly, and its pathogenesis is still being explored. Glymphatic clearance function can be evaluated by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. This study aims to investigate the changes in glymphatic clearance function in CSVD patients and its relationship with imaging markers and risk factors of CSVD.</p><p><strong>Methods: </strong>The DTI-ALPS index of all participants was calculated. The DTI-ALPS index was compared between the patient group and healthy controls (HCs) group. Pearson correlation analysis was used to analyze the relation between the DTI-ALPS index and CSVD imaging markers, and to explore the effect of mean diffusivity (MD) as a covariate. Regression analysis was used to investigate the correlation between DTI-ALPS index and risk factors.</p><p><strong>Results: </strong>The DTI-ALPS index in the bilateral hemispheres of CSVD patients was significantly lower than that in the HCs group (p < 0.001). The DTI-ALPS index in the bilateral hemisphere of CSVD patients was negatively correlated with the grade of EPVS in basal ganglia. There was a significant negative correlation between the left DTI-ALPS index and lacunas, the right DTI-ALPS index and DWMHs. After removing the covariate MD, there was no significant correlation between the DTI-ALPS index and CSVD imaging markers. The DTI-ALPS index was associated with gender, diabetes, drinking and smoking.</p><p><strong>Conclusions: </strong>The CSVD patients have glymphatic clearance dysfunction, which may be related to the imaging features and CSVD risk factors. Meanwhile, it's recommended to consider removing MD as mixed signal.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108187"},"PeriodicalIF":2.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820212","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":"Long-term cerebrovascular outcomes of patients undergoing percutaneous patent foramen ovale closure in observational studies: a systematic review and meta-analysis.","authors":"Areeba Asghar, Luxshikka Canthiya, Ani Khachatrian, Varnita Vishwanath, Eduardo Flores-Umanzor, Ashley Farrell, Yeva Sahakyan, Jonah Himelfarb, Eric M Horlick, Lusine Abrahamyan","doi":"10.1016/j.jstrokecerebrovasdis.2024.108189","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108189","url":null,"abstract":"<p><strong>Objectives: </strong>Patent foramen ovale (PFO) closure is recommended for patients who experience a cryptogenic stroke attributable to PFO. Although few randomized control trials (RCTs) have captured long-term effectiveness of PFO closure, observational data has been abundant. This is the first systematic review of observational studies determining incidence of long-term adverse outcomes in adults who underwent transcatheter PFO closure, with comparisons to findings from RCTs.</p><p><strong>Methods: </strong>Medline, Cochrane, and Embase databases were searched from inception to October 2023. Only observational studies with ≥4 years of mean or median follow-up were included. A meta-analysis was conducted to calculate the incidence of recurrent stroke after PFO closure.</p><p><strong>Results: </strong>After reviewing 2,432 records, 13 prospective and 12 retrospective cohort studies were included. Average follow-up lengths ranged from 4 to 12.3 years, and sample sizes from 75 to 1,533 participants. The average age ranged between 43.5-63.0, and 24.0-72.8% patients had an atrial septal aneurysm. The incidence of stroke was 0.34 per 100 person-years (I² = 67%). This was similar to rates from four RCTs that were used for comparison (0.35 per 100 person-years, I²= 51%). There was a significant improvement in heterogeneity once the study with one of the largest follow-up was removed.</p><p><strong>Conclusions: </strong>Real-world PFO closure studies with long-term follow-up report similar outcomes as RCTs which is important considering the exclusion of several important populations from trials. Future observational studies should include more rigorous reporting of follow-up strategies and explore different long-term adverse outcomes.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108189"},"PeriodicalIF":2.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820237","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":"Magnesium sulfate in the management of acute ischemic stroke: A review of the literature and future directions.","authors":"Maximillian S Feygin, Alex Brenner, Omar Tanweer","doi":"10.1016/j.jstrokecerebrovasdis.2024.108188","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108188","url":null,"abstract":"<p><strong>Background: </strong>The management of acute ischemic stroke (AIS) was revolutionized within the last 15 years with the introduction of mechanical thrombectomy (MT) to standard of care. Despite the success of mechanical thrombectomy (MT) in achieving high recanalization rates for large vessel occlusion, functional independence post-treatment remains suboptimal. The current limitations of MT prompt evaluation of the role of adjunctive pharmacologic neuroprotective therapies to prevent excitotoxicity, cellular apoptosis, and inflammation that cause irreversible neuronal damage during AIS. Magnesium (MgSO₄) provides an attractive neuroprotectant profile, having many different effects, and is inexpensive, readily available, and has a long-established safety and tolerability profile in the management of myocardial infarction and eclampsia.</p><p><strong>Observations: </strong>This gap between technical success and patient outcomes is largely due to the inability to fully protect brain tissue from infarction during ischemia. MgSO₄ has shown promise in preclinical studies for its neuroprotective properties, including blocking NMDA receptors, increasing cerebral blood flow, and stabilizing ion channels. However, clinical trials, such as FAST-MAG and IMAGES, failed to demonstrate significant benefits when MgSO₄ was administered intravenously, due to delayed drug administration or delivery to target tissue. These trials highlighted the need for faster, more targeted drug delivery. Intra-arterial (IA) administration of MgSO₄ via the catheter used in MT could address these limitations by delivering high doses directly to ischemic brain tissue, potentially enhancing neuroprotection while reducing systemic exposure. Preclinical studies and some clinical trials have demonstrated the safety and feasibility of IA, but not IA MgSO₄. Further investigation is needed to assess its efficacy.</p><p><strong>Conclusions: </strong>While past trials have not succeeded, IA administration of neuroprotective agents like MgSO₄ may improve functional outcomes in stroke patients post-MT. Ongoing and future studies will determine if this approach can effectively complement reperfusion strategies, potentially ushering in a new era of stroke care.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108188"},"PeriodicalIF":2.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819608","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":"Low-dose colchicine for stroke prevention: A systematic overview of systematic reviews and meta-analyses.","authors":"Giovani Noll, Wyllians Vendramini Borelli, Gabriel Paulo Mantovani, Sheila Cristina Ouriques Martins, Luciano A Sposato","doi":"10.1016/j.jstrokecerebrovasdis.2024.108167","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108167","url":null,"abstract":"<p><strong>Background: </strong>Stroke incidence remains a significant concern despite optimized prevention strategies. Colchicine shows potential for improving stroke prevention globally.</p><p><strong>Aims: </strong>To summarize efficacy and safety estimates from systematic reviews and meta-analyses (SRMAs) of randomized controlled trials (RCTs) comparing colchicine to usual care or placebo for stroke prevention.</p><p><strong>Methods: </strong>We conducted an overview of SRMAs according to the Preferred Reporting Items for Overviews of Reviews guidelines through a systematic search in Pubmed, Embase, and the Cochrane Library. Statistical analysis was performed using RevMan Web. Heterogeneity was assessed with I² statistics.</p><p><strong>Results: </strong>Thirty-two studies were included. Colchicine significantly reduced stroke recurrence (RR 0.46; 95 % CI 0.41-0.52; p < 0.0001; I² = 0 %; OR 0.44, 95 % CI 0.36-0.55; p < 0.0001; I² = 0 %) but increased gastrointestinal adverse events (RR 1.54, 95 % CI 1.33-1.79; p < 0.0001; I² = 63 %; OR 1.60, 95 % CI 1.08-2.38; p = 0.0007; I² = 82 %). Most SRMAs (93.75 %) showed reduced stroke incidence (RR 0.26-0.54), while 65.22 % reported increased gastrointestinal events (RR 1.05-2.66). No significant differences were observed in mortality, infection or cancer rates. Overall quality was appraised as high in 28.12 %, moderate in 6.25 %, low in 40.06 %, and critically low in 25 % of SRMAs. Data were primarily derived from seven RCTs with low risk of bias.</p><p><strong>Conclusions: </strong>Moderate-quality evidence supports colchicine's benefits and reasonable safety for preventing stroke among high-risk populations. However, stroke was not the primary endpoint in analyzed studies. RCTs directly assessing colchicine for stroke prevention are warranted.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108167"},"PeriodicalIF":2.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803388","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":"Endovascular thrombectomy for acute ischemic stroke complicated with systemic light chain amyloidosis: Two case reports.","authors":"Yongjie Bai, Bingjie Sun, Jiahui Su","doi":"10.1016/j.jstrokecerebrovasdis.2024.108181","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108181","url":null,"abstract":"<p><p>Systemic light chain amyloidosis (AL) is a non-proliferative plasma cell disease characterized by the deposition of fragments of immunoglobulin light or heavy chain in tissues. There has been no relevant report on the treatment of vascularization during the acute stage of acute ischemic stroke (AIS) complicated with AL. This paper presented two cases of AIS complicated with AL that were treated with intravenous thrombolysis (IVT) and mechanical thrombectomy (MT). The combination of aspiration thrombectomy and IVT might be feasible for patients with AIS complicated with AL.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108181"},"PeriodicalIF":2.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803335","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}