Predicting stroke in patients without atrial fibrillation

Steensig, Kamilla; Olesen, Kevin Kris Warnakula; Thim, Troels; Nielsen, Jens Cosedis; Madsen, Morten; Jensen, Svend Eggert; Jensen, Lisette Okkels; Kristensen, Steen Dalby; Lip, Gregory Y.H.; Mæng, Michael

doi:10.1111/eci.13103

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…This finding was in line with the evidence in the literature, as 87% of stroke cases are ischemic and 13% hemorrhagic 19 , 20 . In addition, this finding is in agreement with the low levels of disabilities found in our sample, which is more commonly observed after ischemic events 21 , and which indicates a strong probability of good recovery from the stroke. The majority of our sample comprised older men (≥40 years) who smoked and presented comorbid hypertension and diabetes.…”

Section: Discussionsupporting

confidence: 92%

The association between sleep disturbances and tooth loss among post-stroke patients

Vago

Frange

Oliveira

et al. 2022

Arq. Neuro-Psiquiatr.

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Background: Loss of teeth has been associated with neurological and sleep disorders. It is considered to be a predictor of stroke and leads to modifications of airway patency and predisposition to obstructive sleep apnea. Objective: To investigate sleep quality, risk of obstructive sleep apnea and excessive sleepiness among post-stroke patients with tooth loss attending the Neurovascular Clinic of the Federal University of São Paulo. Methods: The prevalence rates of different types of stroke were assessed among 130 patients with different degrees of tooth loss, along with the presence of sleep disturbances, risk of obstructive sleep apnea and excessive daytime sleepiness. Results: The prevalence of ischemic stroke was 94.6%, with either no significant disability or slight disability. Our sample had poor sleep quality, and a high risk of obstructive sleep apnea, but without excessive daytime sleepiness. Half of our sample had lost between 9 and 31 teeth, and more than 25% had edentulism. The majority used full removable dental prostheses, and more than half of these individuals slept without removing the prosthesis. Conclusions: We found high prevalence of poor sleep quality and high risk of obstructive sleep apnea among post-stroke patients with tooth loss. This indicates the need for further studies on treating and preventing sleep disturbances in stroke patients with tooth loss.

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Section: Discussionsupporting

confidence: 92%

The association between sleep disturbances and tooth loss among post-stroke patients

Vago

Frange

Oliveira

et al. 2022

Arq. Neuro-Psiquiatr.

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“…Limitations of reperfusion therapies include a narrow temporal window and numerous contraindications particularly prevalent in the elderly. 3 Furthermore, despite the strong epidemiological link with cerebrovascular accidents, 4 , 5 the specific molecular mechanisms that explain the effect of ageing on stroke outcome remain obscure. The lack of effective age‐tailored therapies reflects this knowledge gap.…”

Section: Introductionmentioning

confidence: 99%

TNF‐α antagonism rescues the effect of ageing on stroke: Perspectives for targeting inflamm‐ageing

Liberale

Bonetti

Puspitasari

et al. 2021

Eur J Clin Investigation

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Aims Epidemiologic evidence links ischemic stroke to age, yet the mechanisms that underlie the specific and independent effects of age on stroke remain elusive, impeding the development of targeted treatments. This study tested the hypothesis that age directly aggravates stroke outcomes and proposes inflamm‐aging as a mediator and potential therapeutic target. Methods 3 months‐ (young) and 18‐20 months‐old (old) mice underwent transient middle cerebral artery occlusion (tMCAO) for 30 minutes followed by 48 hours of reperfusion. Old animals received weekly treatment with the TNF‐α neutralizing antibody adalimumab over 4 weeks before tMCAO in a separate set of experiments. Plasma levels of TNF‐ α were assessed in patients with ischemic stroke and correlated with age and outcome. Results Old mice displayed larger stroke size than young ones with increased neuromotor deficit. Immunohistochemical analysis revealed impairment of the blood‐brain barrier in old mice, i.e. increased post‐stroke degradation of endothelial tight junctions and expression of tight junctions‐digesting and neurotoxic matrix metalloproteinases. At baseline, old animals showed a broad modulation of several circulating inflammatory mediators. TNF‐α displayed the highest increase in old animals and its inhibition restored the volume of stroke, neuromotor performance, and survival rates of old mice to the levels observed in young ones. Patients with ischemic stroke showed increased TNF‐α plasma levels which correlated with worsened short‐term neurological outcome as well as with age. Conclusions This study identifies TNF‐α as a causative contributor to the deleterious effect of aging on stroke and points to inflamm‐aging as a mechanism of age‐related worsening of stroke outcomes and potential therapeutic target in this context. Thus, this work provides a basis for tailoring novel stroke therapies for the particularly vulnerable elderly population.

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“…As a tradition, the Council of the European Society of Clinical Investigation (ESCI) will award at the next meeting in Bari, Italy (27‐29 May 2020), the best clinical research article published in the European Journal of Clinical Investigation (EJCI) from November 2018 to October 2019. In the final selection round, five outstanding articles were selected based on scientific impact, quality and novelty . Among the finalists, we read with interest the research article by Gomez‐Delgado et al , which was elected as the winner of the 2019 ESCI Award for the Best Clinical Basic Research Article.…”

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confidence: 99%

“…In the final selection round, five outstanding articles were selected based on scientific impact, quality and novelty. [1][2][3][4][5] Among the finalists, we read with interest the research article by Gomez-Delgado et al, 5 which was elected as the winner of the 2019 ESCI Award for the Best Clinical Basic Research Article. This study reported how Mediterranean diet (MedDiet) improved postprandial hypertriglyceridemia (ppHTG) in patients with coronary heart disease (CHD) carrying the apolipoproteins E (ApoE) rs 439401 single-nucleotide polymorphism (SNP) with the T allele.…”

mentioning

confidence: 99%