Cerebrovascular Diseases最新文献

{"title":"The association of glaucoma with ischemic stroke and functional outcome after ischemic stroke from the perspective of causality.","authors":"Qiang He, Wenjing Wang, Dingkang Xu, Yang Xiong, Chuanyuan Tao, Lu Ma, Chao You","doi":"10.1159/000535757","DOIUrl":"https://doi.org/10.1159/000535757","url":null,"abstract":"<p><strong>Introduction: </strong>Glaucoma may be related to ischemic stroke (IS) and poor outcomes after IS in observational studies, while the causal association remains unclear.</p><p><strong>Methods: </strong>We obtained single nucleotide polymorphisms (SNPs) related to glaucoma from the gene-wide association study (GWAS) conducted by the FinnGen consortium. The GWAS included a total of 13,614 cases and 295,540 controls. The summary-level of datasets regarding IS were collected from the MEGASTROKE consortium, including 34,217 cases and 406,111 controls. Furthermore, we acquired summary statistics datasets for functional outcomes following IS from the GWAS meta-analysis conducted by the GISCOME consortium, which involved 6,021 individuals. The genetic association estimates for functional outcomes at 90 days after IS were evaluated by the modified Rankin Score (mRS), including 3,741 cases with good functional outcomes (mRS=0-2) and 2,280 subjects with poor functional outcomes post-stroke (mRS=3-6). Inverse variance weighting (IVW) was used as the primary method, complemented by sensitivity analyses for pleiotropy and increasing robustness.</p><p><strong>Results: </strong>Genetically, glaucoma is associated with an increased risk of IS (odds ratio [OR]=1.08, 95% confidence interval [CI] = 1.02-1.14, P = 0.0039), as well as poor prognosis after IS with adjustment for severity (OR=1.64; 95% CI=1.27-2.13, P=0.0001) and functional outcome after IS (OR=1.45, 95% CI=1.12-1.87, P=0.0038). Through sensitivity analyses, we confirmed the robustness of the results. In addition, we did not identify any causal association between IS, functional outcome after IS, and glaucoma in reverse analysis.</p><p><strong>Conclusion: </strong>Our study provides evidence suggesting a potential genetic causal relationship between glaucoma and an increased risk of IS, as well as a poor functional outcome following IS. Future studies are necessary to confirm these findings.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Versus Standard-Dose Alteplase in Bridging Therapy for Large Vessel Stroke: A Systematic Review and Meta-Analysis.","authors":"Ta-Wei Yang, Ya-Han Lee, Wei-Cheng Lo, I-Ting Chen, Han-Chun Lin, Ming-Hua Chen, Chiao-Hua Lee, Yuan-Pin Hsu, Ka-Wai Tam","doi":"10.1159/000535569","DOIUrl":"https://doi.org/10.1159/000535569","url":null,"abstract":"<p><p>INTRODUCTION The efficacy and safety of low- and standard-dose alteplase for acute ischemic stroke (AIS) have not been consistently compared in previous studies. Nevertheless, the distinctions in the effects of low- and standard-dose alteplase, particularly within the context of bridging therapy (BT) for large vessel occlusion (LVO), warrant further exploration. This study compared clinical outcomes between BT with low- and standard-dose alteplase in patients with LVO-related AIS. METHODS We performed a search for randomized controlled trials and prospective or retrospective cohort studies investigating the clinical outcomes of BT in AIS in the PubMed, Embase, and Cochrane Library databases from inception to November 2022. The outcomes of interest were 90-day functional independence, successful recanalization, symptomatic intracerebral hemorrhage (sICH) and mortality; these outcomes were compared between patients who received BT with low- (primarily 0.6 mg/kg) and standard-dose alteplase (0.9 mg/kg). We used the standard-dose group as the reference and calculated the odds ratio (OR) and its 95% confidence interval (CI) from the raw numbers. Meta-analysis and ethnicity-based subgroup analysis (Asian and non-Asian) were performed. RESULTS Five observational studies, published after 2017 and including 408 patients, were included. The meta-analysis results demonstrated that compared with BT with standard-dose alteplase, BT with low-dose alteplase did not improve 90-day functional independence (odds ratio, [OR] 1.02; 95% confidence interval [CI], 0.58-1.80). Nevertheless, BT with low-dose alteplase was associated with a comparable successful recanalization rate (OR, 1.35; 95% CI, 0.68-2.67) and similar sICH incidence (OR 0.36; 95% CI, 0.10-1.36), and mortality (OR, 0.64; 95% CI, 0.27-1.54) compared with BT with standard-dose alteplase; however, the above three results were nonsignificant. In the ethnicity-based subgroup analyses, no differences were noted between Asian and non-Asian participants. CONCLUSIONS In patients with LVO-related AIS, BT with low- or standard-dose alteplase may provide similar efficacy, with no significant differences in sICH incidence and mortality. Additional well-designed prospective studies are required to confirm this result.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and effect of a coordinated Community Health Worker (CHW) Intervention (C-CHW-I) model for the stroke survivors in Kerala, South India.","authors":"P N Sylaja, Veena Babu, Sivasambath S, Feba Zechariah, Sivalekshmi Gireesan, Geethu Ganesan, Biju Soman, Gurpreet Singh, Jeemon Panniyamakal, Bipin Gopal","doi":"10.1159/000536077","DOIUrl":"https://doi.org/10.1159/000536077","url":null,"abstract":"<p><strong>Introduction: </strong>Structured models for secondary prevention of stroke in community settings are scarce. We aimed to develop and evaluate a model for improving medication adherence and enhanced risk factor monitoring.</p><p><strong>Methods: </strong>We developed a multimodal C-CHW-I model for stroke survivors. Following training, all patients received a minimum of three CHW home visits, and once in 3-month telephone-call and health education for six months by CHWs. Seven blocks from 16 blocks of the study area were randomised to additionally receive an SMS alert for six months to reinforce CHW involvement. The primary outcomes were medication adherence and risk factor monitoring, and the secondary outcome was risk factor control.</p><p><strong>Results: </strong>The mean age of the study population was 64+12 years, 765(85%) had ischaemic stroke. In the overall study cohort receiving the CHW intervention, mean medication adherence significantly improved from 3.56(0.88) at baseline to 3.78(0.61) at 6 months; p<0.001. Overall risk factor monitoring improved from 42.7% to 49.7%, and mean (standard deviation) systolic blood pressure (SBP) significantly reduced from 138(21) mmHg to 132(15) mmHg at 6-months; p<0.001. In patients additionally receiving SMS-based intervention, a statistically significant improvement in medication adherence was seen at 3 months (3.76+0.64 versus 3.61+0.81; p=0.008) however no difference persisted at 6 months. The proportion of smokers and alcohol users reduced in both groups with a trend to greater reduction in the intervention group (smokers:5.9% versus 2.8% (p=0.446) and alcohol users: 1.6% versus 1.4%(p=0.474)). At six months, the SBP did not differ (SBP (132.1(16.2) in the SMS group versus 133.2(15.8) mmHg in the control group, p=0.409).</p><p><strong>Conclusion: </strong>Our model improved medication adherence and risk factor monitoring of stroke survivors in community settings, and this can reduce stroke burden in the community.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Cerebral Small Vessel Disease on the Features of Hematoma and Hematoma Expansion in Intracerebral Hemorrhage.","authors":"Chih-Hao Chen, Shuo-Fu Chen, Hsin-Hsi Tsai, Ya-Fang Chen, Sung-Chun Tang, Jiann-Shing Jeng","doi":"10.1159/000531152","DOIUrl":"10.1159/000531152","url":null,"abstract":"<p><strong>Introduction: </strong>Several early noncontrast CT (NCCT) signs of spontaneous intracerebral hemorrhage (ICH) can predict hematoma expansion (HE). However, the associations of underlying cerebral small vessel disease (SVD) on early NCCT signs and HE have been less explored.</p><p><strong>Methods: </strong>We conducted an analysis of all patients with spontaneous supratentorial ICH and received follow-up imaging between 2016 and 2020 at a stroke center. The early NCCT signs were categorized as shape or density signs. HE was defined as an increase in hematoma volume ≥6 mL or 33% from baseline. The severity of SVD was assessed by both a 3-point CT-based and a 4-point magnetic resonance imaging (MRI)-based SVD score. Regression models were used to examine the associations between SVD score and hematoma volume, NCCT signs, and HE.</p><p><strong>Results: </strong>A total of 328 patients (median age: 64 years; 38% female) were included. The median baseline ICH volume was 8.6 mL, with 38% of the patients had shape signs and 52% had density signs on the initial NCCT. Higher MRI-SVD scores were associated with smaller ICH volumes (p = 0.0006), fewer shape (p = 0.001), or density signs (p = 0.0003). Overall, 16% of patients experienced HE. A higher MRI-SVD score was inversely associated with HE (adjusted odds ratio 0.71, 95% CI: 0.53-0.96). Subgroup analysis revealed that this association was primarily observed in patients who were younger (&lt;65 years), male, had deep hemorrhage, or did not meet the criteria for cerebral amyloid angiopathy diagnosis.</p><p><strong>Conclusions: </strong>In patients with spontaneous ICH, a more severe SVD was associated with smaller hematoma volume, fewer NCCT signs, and a lower risk of HE. Further research is required to investigate why a higher burden of severely diseased cerebral small blood vessels is associated with less bleeding.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"136-143"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in Ischemic Stroke Payments in the USA: A Medicare Beneficiary Study.","authors":"Ana Paula Beck da Silva Etges, Ana Claudia de Souza, Porter Jones, Harry Liu, Xiaoran Zhang, Miriam Marcolino, Carisi Anne Polanczyk, Sheila Ouriques Martins, Gisele Sampaio, Vasileios Arsenios Lioutas","doi":"10.1159/000533513","DOIUrl":"10.1159/000533513","url":null,"abstract":"<p><strong>Introduction: </strong>The growing cost of stroke care has created the need for outcome-oriented and cost-saving payment models. Identifying imbalances in the current reimbursement model is an essential step toward designing impactful value-based reimbursement strategies. This study describes the variation in reimbursement fees for ischemic stroke management across the USA.</p><p><strong>Methods: </strong>This Medicare Fee-For-Service claims study examines USA beneficiaries who suffered an ischemic stroke from 2021Q1 to 2022Q2 identified using the Medicare-Severity Diagnosis-Related Groups (MS-DRGs). Demographic national and regional US data were extracted from the Census Bureau. The MS-DRG codes were grouped into four categories according to treatment modality and clinical complexity. Our primary outcome of interest was payments made across individual USA and US geographic regions, assessed by computing the mean incremental payment in cases of comparable complexity. Differences between states for each MS-DRG were statistically evaluated using a linear regression model of the logarithmic transformed payments.</p><p><strong>Results: </strong>227,273 ischemic stroke cases were included in our analysis. Significant variations were observed among all DRGs defined by medical complexity, treatment modality, and states (p &lt; 0.001). Differences in mean payment per case with the same MS-DRG vary by as high as 500% among individual states. Although higher payment rates were observed in MS-DRG codes with major comorbidities or complexity (MCC), the variation was more expressive for codes without MCC. It was not possible to identify a standard mean incremental fee at a state level. At a regional level, the Northeast registered the highest fees, followed by the West, Midwest, and South, which correlate with poverty rates and median household income in the regions.</p><p><strong>Conclusions: </strong>The payment variability observed across USA suggests that the current reimbursement system needs to be aligned with stroke treatment costs. Future studies may go one step further to evaluate accurate stroke management costs to guide policymakers in introducing health policies that promote better care for stroke patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"298-306"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10285006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Influence of Ethnicity on Computed Tomography Perfusion Parameter Thresholds in Acute Ischaemic Stroke.","authors":"Yohanna Kusuma, Benjamin Clissold, Peter Riley, Paul Talman, Andrew Wong, Leonard Yeo Leong Litt, Mursyid Bustami, Lyna Soertidewi Kiemas, Indah Aprianti Putri, M Arief R Kemal, Reza A Arpandy, Melita Melita, Bernard Yan, Paul Yielder","doi":"10.1159/000533384","DOIUrl":"10.1159/000533384","url":null,"abstract":"<p><strong>Introduction: </strong>Tissue at risk, as estimated by CT perfusion utilizing Tmax+6, correlates with final infarct volume (FIV) in acute ischaemic stroke (AIS) without reperfusion. Tmax thresholds are derived from Western ethnic populations but not from ethnic Asian populations. We aimed to investigate the influence of ethnicity on Tmax thresholds.</p><p><strong>Methods: </strong>From a clinical-imaging registry of Australian and Indonesian stroke patients, we selected a participant subgroup with the following inclusion criteria: AIS under 24 h and absence of reperfusion therapy. Clinical data included demographics, time metrics, stroke severity, pre-morbid, and 3-month Modified Rankin Score. Baseline computed tomography perfusion and MRI &lt;72 h were performed. Volumes of Tmax utilizing different thresholds and FIVs were calculated. Spearman correlation was used to evaluate relationship involving ordinal variables and calculate the optimal Tmax threshold against FIV in both populations.</p><p><strong>Results: </strong>Two hundred patients were included in the study sample, 100 in Jakarta and 100 in Geelong. The median National Institutes of Health Stroke Scale (IQR) were 6 (3-11) and 3 (1-5), respectively. The median Tmax+6 (IQR) was 0 (0-46.5) in Jakarta group and 0 (0-7.5) in Geelong group. The median FIV (IQR) was 0 (0-30.5) and 0 (0-5.5). Tmax+8 s in Jakarta population against FIV showed Spearman's coefficient ρ = 0.72, representing the optimal Tmax threshold. Tmax+6 s showed Spearman's coefficient ρ = 0.51 against FIV in the Geelong population.</p><p><strong>Conclusion: </strong>Tmax thresholds approximating FIV were possibly different in the Asian when compared with the non-Asian populations. Future studies are required to extend and confirm the validity of our findings.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"245-251"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9944842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Mechanical Thrombectomy in Elderly and Non-Elderly Patients with Large Vessel Occlusion Stroke: Systematic Review and Meta-Analysis.","authors":"Aisha Ali, Fernando D Testai, Gabriela Trifan","doi":"10.1159/000533204","DOIUrl":"10.1159/000533204","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical thrombectomy (MT) is recommended for large vessel occlusion (LVO) stroke. However, most of the studies that investigated the superiority of MT over best medical management (BMM) alone included preponderantly non-elderly patients. Thus, there is uncertainty in relation to the efficacy of MT in the elderly. We aim to compare the effect of BMM to BMM plus MT among elderly and non-elderly patients with LVO.</p><p><strong>Methods: </strong>We performed a systematic search of medical databases from inception to April 2023 to identify randomized studies that reported the functional outcome at 90 days by age for patients with LVO treated with MT versus BMM. Patients were divided into elderly (&gt;70 or &gt;80 years, depending on the cutoff used in each study) and non-elderly. Outcomes were defined as excellent (modified Rankin Scale [mRS] ≤1), good (mRS ≤3), poor (mRS ≥5), or death. Effect sizes were calculated by using random effects meta-analyses. Results were represented by odds ratio (OR) and their 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>A total of 2,195 patients were included in the analysis (≥70 years, 7 trials, n = 696; ≥80 years, 2 trials, n = 139). Non-elderly patients treated with MT had higher odds of excellent outcome (OR: 3.05; 95% CI: 2.23-4.18) and good outcome (OR: 2.70; 95% CI: 1.94-3.74), and lower odds of poor outcome (OR: 0.54; 95% CI: 0.40-0.72) and death (OR: 0.63; 95% CI: 0.41-0.96). Similarly, elderly patients treated with MT had higher odds of excellent (OR: 2.39; 95% CI: 1.05-5.45) and good outcomes (OR: 2.18; 95% CI: 1.43-3.33) and lower odds of poor outcome (OR: 0.48; 95% CI: 0.33-0.70) and mortality (OR: 0.50; 0.26-0.95). When outcomes were analyzed by age subgroups, MT was associated with higher odds of good outcome in patients ≥70 years (OR: 1.95, 95% CI: 1.26-3.03) and ≥80 years (OR: 4.43, 95% CI: 1.02-19.23).</p><p><strong>Conclusion: </strong>MT increases the likelihood of achieving a good outcome in elderly and non-elderly patients without increasing the risk of severe disability or death. MT, when otherwise clinically indicated, should be considered over BMM alone in both age groups.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"372-381"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress of Ultrasound Techniques in the Evaluation of Carotid Vulnerable Plaque Neovascularization.","authors":"Penghui Zeng, Qing Zhang, Xiaowen Liang, Min Zhang, Dan Luo, Zhiyi Chen","doi":"10.1159/000534372","DOIUrl":"10.1159/000534372","url":null,"abstract":"<p><strong>Background: </strong>The rupture and detachment of unstable plaques in the carotid artery can cause embolism in the cerebral artery, leading to acute cerebrovascular events. Intraplaque neovascularization (IPN) is a very important contributor to carotid plaque instability, and its evolution plays a key role in determining the outcome of vulnerable plaques. Ultrasound techniques, represented by contrast-enhanced ultrasound (CEUS) and superb microvascular imaging (SMI), are reported to be non-invasive, rapid, and effective techniques for the semi-quantitative or quantitative evaluation for IPN. Although ultrasound techniques have been widely applied in the detection of carotid plaque stability, it has been limited owing to the lack of unified IPN quantitative standards.</p><p><strong>Summary: </strong>This review summarizes the application and semi-quantitative/quantitative diagnostic standards of ultrasound techniques in evaluating IPN and looks forward to the prospects of the future research. With the development of novel techniques like artificial intelligence, ultrasound will offer appropriate selections for achieving more accuracy diagnosis.</p><p><strong>Key messages: </strong>A large number of studies have used CEUS and SMI to detect IPN and perform semi-quantitative grading to predict the occurrence of diseases such as stroke and to accurately assess drug efficacy based on rating changes. These studies have made great progress at this stage, but more accurate and intelligent quantitative imaging methods should become the future development goal.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"479-487"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41182136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of GFAP in Nasal Exudate in the Differential Diagnosis between Ischemic Stroke and Intracerebral Hemorrhage.","authors":"Carmen García-Cabo, Pablo Rioboó-Legaspi, Lorena Benavente-Fernández, Estefanía Costa-Rama, María Teresa Fernández-Abedul, Sergio Calleja-Puerta","doi":"10.1159/000534693","DOIUrl":"10.1159/000534693","url":null,"abstract":"<p><strong>Background: </strong>Differential diagnosis between ischemic stroke (IS) and intracerebral hemorrhage (ICH) is a great challenge. Recently, the discovery of cerebral lymphatic drainage toward the nostrils suggested nasal exudate (NE) as a new source for measuring biomarkers from neural damage.</p><p><strong>Objectives: </strong>In this study, we sought to confirm whether glial fibrillary acidic protein (GFAP) levels in NE could identify ICH.</p><p><strong>Methods: </strong>GFAP in nasal exudate (nGFAP) was studied in 5 IS and 5 ICH patients. All patients underwent neurological examination, brain computed tomography, laboratory tests, and measurement of nGFAP and serum GFAP.</p><p><strong>Results: </strong>We found higher concentrations in ICH patients (p = 0.02). The area under the ROC curve for IS/ICH discrimination was 0.840, with a cut-off point of 0.06 pg/mg for 100% sensitivity and 80% specificity.</p><p><strong>Conclusions: </strong>These findings suggest that nGFAP could be a useful biomarker for differential diagnosis between IS and ICH and opens a potential field of study for other biomarkers in NE in neurological disorders.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"515-518"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50160813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intake of Marine n-3 Polyunsaturated Fatty Acids and Risk of Hemorrhagic Stroke and Its Subtypes: A Danish Follow-Up Study.","authors":"Katrin Hjelmgaard, Christian Sørensen Bork, Søren Lundbye-Christensen, Pernille Lühdorf, Flemming Winther Bach, Erik Berg Schmidt, Kim Overvad, Stine Krogh Venø","doi":"10.1159/000533506","DOIUrl":"10.1159/000533506","url":null,"abstract":"<p><strong>Introduction: </strong>A diet rich in marine n-3 polyunsaturated fatty acids (PUFAs) may lower the risk of coronary heart disease and ischemic stroke. However, the association between intake of marine n-3 PUFAs and risk of hemorrhagic stroke has only been sparsely explored. We aimed to investigate the associations between intake of the major marine n-3 PUFAs, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum, in relation to incident hemorrhagic stroke and its subtypes, intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH).</p><p><strong>Methods: </strong>We analyzed data from the Danish Diet, Cancer and Health Cohort, which was established between 1993 and 1997. Information on dietary intake of marine n-3 PUFAs was obtained through a validated food frequency questionnaire. Potential hemorrhagic stroke cases were identified by linkage to the Danish National Patient Register and subsequently validated. Hazard ratios obtained by Cox proportional hazard regression analyses were used as measures of association.</p><p><strong>Results: </strong>A total of 394 subjects among 55,519 individuals developed hemorrhagic stroke during a median follow-up period of 13.5 years. In multivariable analyses including adjustment for established risk factors, we observed weak and statistically nonsignificant inverse associations between intake of EPA, DHA, and EPA + DHA and the rate of incident hemorrhagic stroke. In analyses of hemorrhagic stroke subtypes, we found indications of lower rates of ICH among participants in the highest quartile of EPA, DHA, and EPA + DHA compared with those in the lowest quartile and indications of lower rates of SAH in the highest quartile of EPA intake compared to the lowest quartile, but the findings were statistically nonsignificant.</p><p><strong>Conclusions: </strong>Inversely statistically nonsignificant associations were found between EPA, DHA, and EPA + DHA and hemorrhagic stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"536-546"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134648505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}