Assocation Between a Brain Care Score Derived from Participant Responses and Incident Stroke from the COSMOS Study.

Objective: The Brain Care Score (BCS), previously validated to predict the risk of age-related brain diseases, incorporates 12 modifiable risk factors, including blood pressure and laboratory measurements. In the U.S.

Extracranial-intracranial bypass for symptomatic intracranial arterial occlusion: a meta-analysis of individual patient data.

Patients with symptomatic atherosclerotic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions face a high risk of recurrent ischaemic stroke despite best medical therapy. Previous trials of extracranial-intracranial (EC-IC) bypass surgery showed no benefit for stroke prevention in this population, but they may have been underpowered. This study evaluates the efficacy of EC-IC bypass surgery in reducing the risk of the composite outcome of stroke or death within 30 days or ipsilateral ischaemic stroke beyond 30 days through 2 years.

Cerebral Small-Vessel Disease Markers on Magnetic Resonance Imaging as Predictors of Recurrent Vascular Events and Death in Ischemic Stroke: A Systematic Review and Meta-Analysis.

Background: Cerebral small-vessel disease encompasses a spectrum of magnetic resonance imaging features reflecting microvascular pathology in ischemic stroke. Among these, white matter hyperintensities (WMHs) and cerebral microbleeds (CMBs) are the most widely studied. While both are well established as risk factors for cognitive decline in patients with acute ischemic stroke (AIS), their prognostic value for vascular events and death after AIS remains unclear.

Petechial hemorrhage in mechanical thrombectomy for distal and medium-vessel occlusions: technical considerations and outcomes.

Objective: Mechanical thrombectomy (MT) is well established for large-vessel occlusion (LVO) strokes, but its safety in distal and medium-vessel occlusions (DMVOs) requires further investigation. This study analyzed the relationship between procedural approaches, petechial hemorrhage (PetH), and clinical outcomes in DMVO thrombectomy, with particular attention to technical considerations and the complex interplay between tissue injury and hemorrhagic complications.

Methods: A retrospective cohort study was conducted on DMVO stroke patients treated with MT at 37 stroke centers worldwide from 2016 to 2024.

The Heart-Brain Axis: Key Concepts in Neurocardiology.

The heart-brain axis involves complex interactions between the cardiovascular and nervous systems via a network of cortical and subcortical structures working with the autonomic nervous system and intracardiac nervous system. Heart-brain interactions may be divided into 2 broad categories: cardiac effects of neurological disease and neurological effects of cardiac disease. The pathogenesis of neurogenic cardiac effects is thought to involve a neurogenic cascade where sudden shifts in autonomic balance lead to an exaggerated catecholamine release.

Associations Between Trust in Healthcare Professionals and Perceptions of Modifiability of Dementia and Stroke Risks Through Maintaining or Changing Lifestyle Habits.

PurposeTo investigate the trust levels in health information sources from a United States (U.S.) sample, and to examine the relationships between trust in healthcare professionals (HCPs) and perceptions of modifiability of dementia and stroke risks through maintaining or changing lifestyle habits.

The Brain Care Score and its associations with cardiovascular disease and cancer.

Background: The Brain Care Score (BCS) was developed in partnership with patients and practitioners to convey actionable knowledge to individuals everywhere that can motivate change in health-related behaviors and thereby reduce the risk of dementia, stroke, and late-life depression (LLD). Because diseases outside the brain share modifiable risk factors with dementia, stroke, and LLD, we investigated the associations of the BCS with other common age-related diseases, including cardiovascular disease (CVD) and cancer.

Methods: Among all UK Biobank (UKB) participants with complete BCS data, we performed Cox proportional hazard regression analyses between the BCS at baseline and incident CVD (ischemic heart disease, stroke, and heart failure) and the three most common cancer types (lung, colorectal, and breast cancer), adjusted for sex and stratified by age.

Knowledge and practice of healthy behaviors for dementia and stroke prevention in a United States cohort.

At least 45% of dementia and 60% of stroke cases are due to modifiable risk factors and could in part be prevented through healthy behavior. This cross-sectional study clustered and characterized a U.S.

Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome.

Background: At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.

Methods: A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023.

Return to Work After Ischemic Stroke in Young Adults: A Multicenter Cohort Study, Systematic Review, and Meta-Analysis.

Background: Ischemic stroke incidence in young adults is increasing globally, with return to work (RTW) a key rehabilitation goal. We aimed to assess the overall proportions of and factors associated with RTW following young adult ischemic stroke.

Methods And Results: We performed a retrospective cohort study of all patients with ischemic stroke aged 18 to 50 years at 2 tertiary hospitals in Singapore from 2020 to 2022.

Primary Prevention of Cardiovascular Disease in Asia: Opportunities and Solutions: A Narrative Review.

Importance: Asia faces a rapidly rising burden of cardiovascular disease (CVD). Preventive cardiology efforts may help address the CVD epidemic.

Observations: Solutions to address the CVD burden include a cardiovascular risk assessment framework, improving health screening efforts, better cardiovascular risk factor management, novel innovation strategies encompassing targeted lifestyle measures, and strengthening governmental efforts.

Reliability and Validity of Self-Reported Risk Factors for Stroke and Dementia.

Background: Stroke and dementia are leading causes of mortality and can be prevented through risk factor management. Risk factor assessment requires laboratory or physical measurements. We aimed to determine whether self-reported risk factors serve as reliable proxies and predict stroke- and dementia-related mortality.

Primary Prevention of Cardiovascular Disease in Asia: Challenges: A Narrative Review.

Importance: Asia is home to 60% of the world's population, including the world's 2 most populous countries, India (1.1B) and China (1.2B).

Severity of Chronic Kidney Disease as Assessed by the Kidney Failure Risk Equation Is Associated With Incident Acute Ischemic Stroke.

Aim: Stroke is a leading cause of death and disability, with substantial healthcare implications. Chronic kidney disease (CKD) is similarly impactful, and emerging evidence links CKD to a higher stroke risk. Despite this, stroke risk assessment in CKD patients remains limited.

Predicting Atrial Fibrillation After Stroke by Combining Polygenic Risk Scores and Clinical Features.

Background: Because treatment with anticoagulants can prevent recurrent strokes, identification of patients at risk for incident atrial fibrillation (AF) after stroke is crucial. We aimed to investigate whether the addition of AF polygenic risk scores (PRSs) to existing clinical risk predictors could improve prediction of AF after stroke.

Methods: Patients diagnosed with ischemic stroke at the Massachusetts General Hospital between 2003 and 2017 were included.

Exploring in Ischemic Stroke and Moyamoya Disease: From Cellular Models to Clinical Insights.

Advances in stroke genetics have highlighted the critical role of rare genetic variants in cerebrovascular diseases, with emerging as a key player in ischemic stroke and Moyamoya disease (MMD). Initially identified as the primary susceptibility gene for MMD, -notably the p.R4810K variant-has been strongly linked to intracranial artery stenosis (ICAS) and various ischemic stroke subtypes, particularly in East Asian populations.

Efficacy of GLP-1 Receptor Agonists on Weight Loss, BMI, and Waist Circumference for Patients With Obesity or Overweight: A Systematic Review, Meta-analysis, and Meta-regression of 47 Randomized Controlled Trials.

Objective: To provide an updated synthesis on effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on weight, BMI, and waist circumference incorporating newer randomized controlled trials (RCTs), particularly in individuals with overweight or obesity.

Research Design And Methods: We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published from inception to 4 October 2024. The search was limited to RCTs evaluating the use of GLP-1 RAs for mean differences from baseline in weight, BMI, and waist circumference in adults with obesity or overweight with or without diabetes.

Outcomes of mechanical thrombectomy for medium vessel occlusion in acute ischemic stroke patients with ASPECTS 4-5 vs. 6-7: a retrospective, multicenter, and multinational study.

Introduction: Mechanical thrombectomy (MT) efficacy in medium vessel occlusion (MeVO) stroke, particularly in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS), remains less explored.

Methods: This retrospective study analyzed data from 443 AIS patients treated with MT for MeVO and low ASPECTS (4-7) at 37 centers across North America, Asia, and Europe, from September 2017 to July 2021. Patients were categorized into ASPECTS of 4-5 and 6-7.

Ischemic Stroke in Women: Understanding Sex-Specific Risk Factors, Treatment Considerations, and Outcomes.

Ischemic stroke is a major cause of mortality and disability and has become a significant public health concern among women. Overall, women have more ischemic stroke events than men, in part due to their longer life span, and also suffer from more severe stroke-related disabilities compared to men. Women are also more likely than men to present with atypical non-focal neurological symptoms, potentially leading to delayed diagnosis and treatment.

Anti-diabetic effects of GLP-1 receptor agonists on obese and overweight patients across diabetes status, administration routes, treatment duration and baseline characteristics: A systematic review.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for anti-obesity indications. However, little is known of the comparative effect of GLP-1 RAs and their glycemic impact across the different routes of administration, diabetic statuses and durations of prescription. PubMed, EMBASE and CENTRAL were searched from inception to 13 February 2024.

The bile acid chenodeoxycholic acid associates with reduced stroke in humans and mice.

Bile acids are liver-derived signaling molecules that can be found in the brain, but their role there remains largely unknown. We found increased brain chenodeoxycholic acid (CDCA) in mice with absent 12α-hydroxylase (Cyp8b1), a bile acid synthesis enzyme. In these Cyp8b1, and in Wt mice administered CDCA, stroke infarct area was reduced.

Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis.

Purpose: Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality.

Methods: We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans.

Effects of glucagon-like peptide-1 receptor agonists on blood pressure in overweight or obese patients: a meta-analysis of randomized controlled trials.

Introduction: Glucagon-like peptide-1 receptor agonists are novel medications with proven efficacy in treating type 2 diabetes mellitus, and are increasingly being used for weight loss. They may potentially have benefit in treating metabolic disorders; however, evidence is sparse with regards to treating high blood pressure (BP). We performed a systematic review, meta-analysis and meta-regression investigating the efficacy of GLP-1 RAs in lowering BP in obese or overweight patients.

Ethnic Differences in the Safety and Efficacy of Tenecteplase Versus Alteplase for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Background And Purpose: Tenecteplase is a thrombolytic agent with pharmacological advantages over alteplase and has been shown to be noninferior to alteplase for acute ischemic stroke in randomized trials. However, evidence pertaining to the safety and efficacy of tenecteplase in patients from different ethnic groups is lacking. The aim of this systematic review and metaanalysis was to investigate ethnicity-specific differences in the safety and efficacy of tenecteplase versus alteplase in patients with acute ischemic stroke.