Oxiracetam and physical activity in preventing cognitive decline after stroke: A multicenter, randomized controlled trial.

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.

Update of the Korean Clinical Practice Guidelines for Stroke: Blood Pressure Management.

Hypertension is a major risk factor for stroke, and appropriate management of blood pressure (BP) is crucial for both prevention and treatment. Since the 2009 publication of the Clinical Practice Guideline (CPG) by the Korean Stroke Society (KSS), significant advances have been made in BP management for stroke patients, particularly in cases involving intracerebral hemorrhage and in the context of endovascular reperfusion therapy for ischemic stroke. In light of recent evidence, the CPG Committee of the KSS initiated an update of the guidelines for BP management in acute stroke.

Association Between Age and Endovascular Treatment Outcomes: Binational Registry of 9934 EVT Cases From Korea and Taiwan.

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.

Temporal Trends in Public Stroke Awareness in Korea, 2009 to 2023.

Background: No large-scale survey on public stroke awareness has been conducted in Korea since 2009. This study assessed temporal trends in awareness of stroke warning signs (WSs) and risk factors (RFs) from 2009 to 2023. We hypothesized that stroke awareness remains inadequate and that changes in information sources have influenced the depth of knowledge.

Procedure Time of Endovascular Thrombectomy as Performance Measure of Acute Stroke Treatment.

Purpose: Procedure time (PT), defined as the time between groin access and vessel recanalization, is a recently recognized predictor of outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). However, the factors affecting PT and its potential value as a performance measure of AIS treatment remain unexplored.

Materials And Methods: Using the Korean Stroke Registry, we compared patients who underwent EVT for AIS from 2018 to 2022 based on 60 minutes PT.

Deep learning-based automatic segmentation of cerebral infarcts on diffusion MRI.

We explored effects of (1) training with various sample sizes of multi-site vs. single-site training data, (2) cross-site domain adaptation, and (3) data sources and features on the performance of algorithms segmenting cerebral infarcts on Magnetic Resonance Imaging (MRI). We used 10,820 annotated diffusion-weighted images (DWIs) from 10 university hospitals.

Characteristics of High-Performance Low-Volume Hospitals in Acute Stroke Care.

Background: High patient volumes are associated with better stroke management and outcomes. However, in sparsely populated regions, patients with stroke frequently rely on low-volume hospitals for acute care. This study evaluates the performance of high-performing hospitals among low-volume hospitals and identifies factors contributing to their high performance despite treating fewer stroke cases.

Temporal patterns of occult cancer incidence following acute ischemic stroke: A comparative study by stroke etiology.

Backgrounds And Aims: This study investigates the temporal patterns of occult cancer incidence among survivors of acute ischemic stroke (AIS), with a focus on variations by underlying stroke etiology.

Patients And Methods: We analyzed data from a prospective, multicenter stroke registry and a national claims database, identifying AIS patients hospitalized between 2011 and 2013. Patients were categorized by stroke etiology into two groups: unidentified stroke etiology (USE) and identified stroke etiology (ISE).

Association of Age, Sex and Education With Access to the Intravenous Thrombolysis for Acute Ischemic Stroke.

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.

Persistent Beta-Blocker Therapy Reduces Long-Term Mortality in Patients With Acute Ischemic Stroke With Elevated Heart Rates.

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.

Temporal Trends in Stroke Management and Outcomes Between 2011 and 2020 in South Korea: Results From a Nationwide Multicenter Registry.

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.

Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke.

Background And Purpose: Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.

Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment.

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.

Influence of prestroke glycemic status on outcomes by age in patients with acute ischemic stroke and diabetes mellitus.

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.

Temporal trends of sex differences in acute reperfusion therapy and early outcomes of acute ischemic stroke in South Korea: 10-year analysis of the nationwide stroke registry.

Background: Sex differences in stroke outcomes are notable, with women experiencing higher incidence rates, greater disability-adjusted life years, and poorer recovery compared to men, even after adjusting for age and comorbidities. Despite the disproportionate burden in women, studies have reported that women are less likely to receive appropriate stroke treatment than men.

Aim: This study investigated temporal trends of sex differences in acute reperfusion therapy and early outcomes in patients with acute ischemic stroke over 10 years in South Korea.

Regional disparities in prehospital delay of acute ischemic stroke: The Korean Stroke Registry.

Background: Late hospital arrival keeps patients with stroke from receiving recanalization therapy and is associated with poor outcomes. This study used a nationwide acute stroke registry to investigate the trends and regional disparities in prehospital delay and analyze the significant factors associated with late arrivals.

Methods: Patients with acute ischemic stroke or transient ischemic attack between January 2012 and December 2021 were included.

Efficacy of Endovascular Thrombectomy in Acute Basilar Artery Occlusion with Low PC-ASPECTS: A Nationwide Prospective Registry-Based Study.

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.

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.