Publications by authors named "Jee-Hyun Kwon"
Introduction: This multicenter, double-blind, placebo-controlled trial, commissioned by South Korea's Ministry of Food and Drug Safety, evaluated the effect of oxiracetam for preventing post-stroke cognitive impairment (PSCI) and explored potential interaction with physical activity using neuroimaging.
Patients And Methods: Patients at high risk of PSCI, reporting subjective cognitive decline ⩾3 months after stroke, were randomized 1:1 to receive oxiracetam or placebo for 36 weeks. Physical activity was tracked via wrist-worn actigraphy.
Exploring the efficacy and safety of dual antiplatelet therapy in patients with embolic stroke of undetermined source according to stroke risk stratification: Propensity-score matched analysis.
J Stroke Cerebrovasc Dis
August 2025
Introduction: Dual antiplatelet therapy (DAPT) is widely used for embolic stroke of undetermined source (ESUS) despite limited evidence regarding its efficacy and safety. This study compared DAPT and single antiplatelet therapy (SAPT) in patients with ESUS during hospitalization (first 7 days) and up to 30 days post-stroke, identifying subgroups that benefit most from DAPT.
Methods: We retrospectively analyzed data from 4,505 patients with ESUS enrolled in a multicenter registry from 2014 to 2019.
Background: As populations age, there is an increasing need to optimize endovascular treatment (EVT) and to understand country-specific differences in East Asia. We harmonized stroke registries from Korea and Taiwan to enable comparisons of patient characteristics and outcomes, with a particular focus on the impact of age.
Methods: Multicenter prospective stroke registries in Korea (CRCS-K [Clinical Research Collaboration for Stroke in Korea]) and Taiwan (TREAT-AIS [Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke]) were harmonized to form a unified data set of patients undergoing EVT.
Importance: Effective treatments for restoring visual field defects (VFDs) in patients with stroke necessitate validation through randomized clinical trials.
Objective: To evaluate the efficacy and safety of a personalized digital therapeutic based on visual perceptual learning for treating poststroke VFDs.
Design, Setting, And Participants: A multicenter randomized clinical trial was conducted from October 19, 2022, to November 8, 2023, at 12 hospitals in South Korea.
Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients.
Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea.
Background: Elevated heart rate in patients with acute ischemic stroke is associated with increased risk of mortality. Beta-blocker therapy is well known to reduce heart rate.
Methods And Results: This study was a post hoc analysis of patients with acute ischemic stroke with maximum heart rates ≥100 bpm.
Background: This study aims to evaluate temporal trends of advanced treatments and related clinical outcomes of ischemic stroke through a decade-long trend analysis, using data from a comprehensive, national, multicenter registry. We also seek to identify areas in need of improvement.
Methods And Results: This analysis involved patients with ischemic stroke or transient ischemic attack registered prospectively in the CRCS-K-NIH (Clinical Research Center for Stroke in Korea-National Institute of Health) registry between 2011 and 2020.
Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment.
J Am Heart Assoc
February 2025
Background: Research specifically addressing the efficacy of rosuvastatin versus atorvastatin in patients with ischemic stroke is insufficient. Using a large stroke registry, we investigated whether 2 commonly used statins, rosuvastatin and atorvastatin, differ in their effectiveness in reducing the risk of vascular events in patients with acute ischemic stroke.
Methods: We analyzed data from a nationwide stroke registry in South Korea between January 2011 and April 2022.
Importance: Nelonemdaz selectively antagonizes the 2B subunit of the N-methyl-d-aspartate glutamate receptor and scavenges free radical species.
Objective: To evaluate whether nelonemdaz enhances the clinical outcomes of patients with acute ischemic stroke undergoing emergent reperfusion therapy.
Design, Setting, And Participants: This multicenter double-blind placebo-controlled randomized phase 3 trial (December 25, 2021, to June 30, 2023, in South Korea) recruited patients with acute ischemic stroke who met the following criteria: National Institutes of Health Stroke Scale score greater than or equal to 8, Alberta Stroke Program Early Computed Tomography score greater than or equal to 4, and endovascular thrombectomy within 12 hours after stroke onset.
Background: This study aimed to explore the association between admission HbA1c and the risk of 1-year vascular outcomes stratified by age group in patients with acute ischemic stroke (AIS) and diabetes mellitus (DM).
Methods: This study analyzed prospective multicenter data from patients with AIS and DM. Admission HbA1C were categorized as:≤6.
Brain lesion and echocardiogenic predictors of newly detected atrial fibrillation in acute ischemic stroke.
Clin Neurol Neurosurg
November 2024
Article Synopsis
- * Researchers analyzed data from 850 AIS patients to compare characteristics among those with AF detected after the stroke, those with known AF, and those with cryptogenic stroke (CS).
- * Findings indicated that patients with AF detected after stroke (AFDAS) generally had more severe initial strokes and greater right insular cortex lesions, but lower rates of coronary heart disease compared to those with known AF.
Article Synopsis
- This study examined how non-traditional lipid profiles, specifically the LDL/HDL ratio, affect the risk of vascular events within a year in stroke patients already on statins and with low LDL-C levels.
- The analysis included 7028 patients with acute ischemic strokes and found a significant association between higher LDL/HDL ratios and increased risk of recurrent stroke, heart attack, or death after adjusting for other variables.
- The results suggest that even with low LDL-C levels due to statin use, monitoring the LDL/HDL ratio is important to assess residual risk after a stroke.
Article Synopsis
- The report offers updated statistics on stroke patients in South Korea from a nationwide registry, revealing a male-to-female ratio of 1.5, with average ages of 67 for men and 73 for women.
- Hypertension is the leading risk factor (67%), with notable rates of diabetes (35%) and smoking (21%), while atrial fibrillation is less common (19%) than in Western populations, indicating effective preventive measures.
- There has been a decline in intravenous thrombolysis use, unchanged timing for treatment, and despite favorable outcomes at 3 months, there is a pressing need for improvements in acute stroke care.
Article Synopsis
- - The study reviews how dual antiplatelet therapy (DAPT-AC) with aspirin and clopidogrel has been increasingly used among stroke patients who didn't qualify for major clinical trials, particularly after the CHANCE trial results became available in 2013.
- - Analysis of data from over 32,000 patients from 2008 to 2022 showed that the usage of DAPT-AC rose significantly from 33% in 2008 to 78% in 2022, while the use of other antiplatelet medications decreased.
- - Despite this increase in DAPT-AC usage, clinical outcomes, including stroke rates and mortality, improved only slightly, indicating ongoing efforts are needed to enhance recovery
Objective: We evaluated the efficacy of endovascular thrombectomy (EVT) on the functional outcome of patients with acute basilar artery occlusion and low posterior circulation acute stroke prognosis early computed tomography score (PC-ASPECTS).
Methods: We identified patients with acute ischemic stroke due to basilar artery occlusion and PC-ASPECTS of 6 or less, presenting within 24 h between August 2008 and April 2022. The primary outcome was a favorable functional outcome, defined as a modified Rankin Scale (mRS) score of 0-3 at 90 days.
Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusion.
J Clin Neurol
March 2024
Background And Purpose: The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO).
Methods: This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds.
Article Synopsis
- Ischemic strokes vary in type, which may affect how low-density lipoprotein (LDL) cholesterol levels relate to early health outcomes like stroke recurrence, heart attacks, and overall mortality.
- A study involving over 38,500 acute ischemic stroke patients found that those with the lowest LDL cholesterol levels (<70 mg/dl) had the highest rates of adverse outcomes within three months.
- The research revealed that the relationship between LDL cholesterol levels and mortality differed by stroke subtype, indicating that both high and low LDL levels present different risks depending on the stroke type.
Background: There is limited information on the delivery of acute stroke therapies and secondary preventive measures and clinical outcomes over time in young adults with acute ischemic stroke. This study investigated whether advances in these treatments improved outcomes in this population.
Methods: Using a prospective multicenter stroke registry in Korea, young adults (aged 18-50 years) with acute ischemic stroke hospitalized between 2008 and 2019 were identified.
Statin Treatment in Patients With Stroke With Low-Density Lipoprotein Cholesterol Levels Below 70 mg/dL.
J Am Heart Assoc
September 2023
Background It is unclear whether statin treatment could reduce the risk of early vascular events when baseline low-density lipoprotein cholesterol (LDL-C) levels are already low, at <70 mg/dL, at the time of the index stroke. Methods and Results This study was an analysis of a prospective, multicenter, nationwide registry of consecutive patients with first-ever acute ischemic stroke with baseline low-density lipoprotein cholesterol levels <70 mg/dL and without statin pretreatment. An inverse probabilities of treatment weights method was applied to control for imbalances in baseline characteristics.
View Article and Find Full Text PDFAdmission LDL-cholesterol, statin pretreatment and early outcomes in acute ischemic stroke.
J Clin Lipidol
December 2023
Article Synopsis
- The study examines the complex relationship between low LDL cholesterol (LDL-C) levels and early vascular outcomes in acute ischemic stroke patients, noting that lower LDL-C levels might lead to worse outcomes at first glance.
- Researchers analyzed over 32,500 patients and found a U-shaped relationship between LDL-C levels and three-month outcomes, with the highest events occurring in those with low LDL-C, but this trend wasn’t significant after adjustments were made.
- The findings suggest that statin pretreatment may mitigate the negative effects associated with low LDL-C levels, indicating the need for further research on this paradoxical relationship.
Comparison of Hospital Performance in Acute Ischemic Stroke Based on Mortality and Functional Outcome in South Korea.
Circ Cardiovasc Qual Outcomes
August 2023
Article Synopsis
- Recent research indicates a lack of interchangeability between modified Rankin Scale measures of functional outcomes and mortality measures in assessing hospital performance for acute ischemic stroke patients.
- The study evaluated 8292 hospitalized stroke patients and used various metrics like 1-month and 1-year mortality to assess hospital outcomes.
- Findings revealed no significant correlation between hospitals’ rankings based on functional outcomes and those based on mortality rates, suggesting that these measures evaluate different aspects of hospital performance.
Article Synopsis
- * It will involve 4,806 participants in a multicenter, randomized, open-label trial, comparing the outcomes of 12 months of DAPT versus 3 months followed by monotherapy for the next 9 months.
- * The primary outcome measures include the occurrence of strokes, heart attacks, and overall mortality over one year, while major bleeding events will be monitored as the primary safety concern.
Background: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown.
Aims: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes.
Methods: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data.
Article Synopsis
- Oxiracetam may help prevent cognitive decline post-stroke, and this trial evaluates its effectiveness alongside exercise to see if physical activity influences treatment outcomes.
- The study is a phase IV trial involving 500 patients, assessing changes in cognitive function through various measures while participants take either oxiracetam or a placebo for 36 weeks.
- Researchers will analyze data, including brain activity and physical activity levels, to explore the relationship between exercise, medication, and cognitive recovery following a stroke.