High-Density Lipoprotein Cholesterol Levels and their impact on outcomes in acute ischemic stroke patients treated with mechanical thrombectomy.

Background: High-density lipoprotein cholesterol (HDL-C) is traditionally considered protective in cardiovascular disease, but its role in acute ischemic stroke (AIS) remains unclear, particularly in patients undergoing mechanical thrombectomy (MT). This study aimed to assess the association between HDL-C levels and clinical outcomes in AIS patients treated with MT for anterior circulation large vessel occlusion (LVO).

Methods: We conducted a multicentre, observational, post-hoc analysis of AIS patients treated with MT between January 2016 and March 2023 across three stroke centres.

Anticoagulation Strategies Following Breakthrough Ischemic Stroke While on Direct Anticoagulants: A Meta-Analysis.

Background And Objectives: The management of anticoagulation after ischemic stroke while on direct oral anticoagulants (DOACs) is controversial. We performed an aggregate-data meta-analysis to compare anticoagulation strategies against each other to define the effect of switch to warfarin, switch to another DOAC, change in dosage, and add-on antiplatelet for the prevention of recurrent stroke, intracranial hemorrhage (ICH), any stroke, and mortality.

Methods: The study protocol was deposited with PROSPERO (CRD42025639057).

Implementing Blood Biomarkers in Stroke Research and Clinical Practice.

Blood-based biomarkers reflecting the severity of brain injury showed manifold promising applications in the management of patients with stroke. To date, NfL (neurofilament light chain) and GFAP (glial fibrillary acidic protein) represent the markers with the most support from the literature, but novel biomarker candidates are emerging. In this commentary, we discuss the potential benefits that blood biomarkers would have as additional tools for physicians and stroke specialists in the assessment of stroke risk in the general population, in the acute and postacute phase of stroke management as well as during the longitudinal monitoring of patients during rehabilitation.

Oral anticoagulation versus no anticoagulation for stroke prevention in patients with intracranial haemorrhage and atrial fibrillation: an updated meta-analysis of randomised controlled trials.

Background: Oral anticoagulation (OAC) effectively reduces stroke risk in patients with atrial fibrillation (AF), but its use after intracranial haemorrhage (ICH) remains controversial due to bleeding concerns. This study aimed to update the evidence on the efficacy and safety of OAC in patients with AF with a history of ICH.

Methods: A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines.

Intravenous Thrombolysis in Patients With Recent Intake of Direct Oral Anticoagulants: A Target Trial Analysis and Comparison With Reversal Agent Use.

Background: Intravenous thrombolysis (IVT) in patients with recent ingestion of direct oral anticoagulants (DOACs) is a frequent challenge and remains controversial. The benefit of DOAC reversal before IVT is uncertain.

Methods: Using target trial methodology, we analyzed data from 28 comprehensive stroke centers.

Intravenous thrombolysis in the context of stroke and cancer.

Background: Cancer patients are at an increased risk for ischemic and hemorrhagic strokes. Ischemic stroke in this population often presents with distinctive features, such as cryptogenic etiology and multiple ischemic lesions, and is driven by cancer-associated coagulopathy, complicating management strategies.

Methods: We reviewed current literature on intravenous thrombolysis (IVT) for acute ischemic stroke in cancer patients through PubMed search with no time limits.

Real-world outcomes following dual antiplatelet therapy in mild-to-moderate ischemic stroke with anterior versus posterior circulation infarct: a READAPT study propensity matched analysis.

Background: Dual antiplatelet therapy (DAPT) is a cornerstone of secondary prevention in patients with minor ischemic stroke or high-risk transient ischemic attack. The effectiveness and safety of DAPT may differ between patients with posterior (PCI) and anterior circulation infarct (ACI).

Objectives: We aimed to compare short-term outcomes following DAPT between mild-to-moderate stroke patients with PCI versus ACI.

The impact of inflammatory markers on clinical outcomes in acute ischemic stroke patients following mechanical thrombectomy: A multicentre study.

Background: Inflammation contributes to brain injury in acute ischemic stroke, but its role among patients treated with mechanical thrombectomy (MT) for large vessel occlusion (LVO) has not been fully established. The aim of this study was to explore the relationship between functional prognosis and the neutrophil-to-lymphocyte ratio (NLR) and derived ratios in patients undergoing MT.

Methods: This is a multicentre retrospective analysis of 970 consecutive patients treated with MT.

Sex-based differences in inflammatory predictors of outcomes in patients undergoing mechanical thrombectomy: an inverse probability weighting analysis.

Background: Inflammatory biomarkers, key predictors of ischemic stroke prognosis, may exhibit sex-specific predictive patterns.

Objectives: This study investigates sex-based differences in inflammatory biomarkers as predictors of 90-day clinical outcomes in acute ischemic stroke patients undergoing mechanical thrombectomy (MT).

Design: Multicenter retrospective study.

Age-Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis.

Background: Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) stroke. However, a substantial proportion of patients experience poor functional outcomes despite successful reperfusion, namely futile recanalization (FR). This study aimed to evaluate the predictive value of inflammatory biomarkers, measured on admission and at 24 h, in identifying the risk of FR and to assess age-specific differences influencing this outcome.

Admission systolic blood pressure and short-term outcomes after dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack.

Background: Elevated baseline systolic blood pressure (SBP) was associated with poor outcomes following dual antiplatelet therapy (DAPT) in patients with non-cardioembolic minor ischemic stroke (MIS) or high-risk transient ischemic attack (TIA) in clinical trials.

Objectives: We aimed to assess the impact of admission SBP on the short-term outcomes after DAPT in patients with non-cardioembolic MIS or high-risk TIA.

Methods: We performed an inverse probability weighted (IPW) analysis from a prospective multicentric real-world study (READAPT) including patients with non-cardioembolic MIS (National Institute of Health Stroke Scale of 0-5) or high-risk TIA (ABCD2 ⩾4) who initiated DAPT within 48 h of symptom onset.

Impact of socioeconomic deprivation on mechanical thrombectomy outcomes after acute ischaemic stroke: findings from a London-based multicentre study.

Background: Mechanical thrombectomy (MT) improves outcomes in patients who had an acute ischaemic stroke due to large vessel occlusion (LVO). However, socioeconomic status (SES) can influence recovery and prognosis. This study investigated the effect of SES, assessed via the Index of Multiple Deprivation (IMD), on MT outcomes in a multicentre London cohort.

Effectiveness and safety of dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack and cancer: A secondary analysis of the READAPT study.

Introduction: Patients with ischemic stroke or transient ischemic attack (TIA) and cancer face unique risks of recurrent ischemic events and bleeding. It is unclear whether this increased risk is present even in patients with minor ischemic stroke or transient ischemic attack (TIA) receiving dual antiplatelet therapy (DAPT). This study aimed to evaluate the impact of cancer on the short-term outcomes after DAPT in patients with non-cardioembolic minor ischemic stroke or high-risk TIA.

How far are we from bringing intensive care bundle for intracerebral hemorrhage into the real-world setting? A 5-year population based-study.

Introduction: Comprehensive care bundles including rapid blood pressure management, anticoagulation reversal, neurosurgical consultation, control of blood glucose and body temperature, can improve short- and medium-term outcomes in patients with intracerebral hemorrhage (ICH). This study assessed how the acute management of ICH practices evolved in a real-world setting over five years characterized by global changes in ICH care.

Methods: This study analysed ICH cases from a population-based stroke registry between 2018 and 2022.

C-reactive protein elevation and subsequent atrial fibrillation detection after ischemic stroke treated with mechanical thrombectomy: An inverse probability weighting analysis.

Background And Aims: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke due to large vessel occlusion (LVO). Atrial fibrillation (AF) can be known before the stroke (or prevalent AF) or be newly detected after the stroke (post-stroke AF). Inflammation plays a critical role in the pathogenesis of post-stroke AF, making inflammatory markers valuable for early detection of post-stroke AF.

Impact of atrial fibrillation on outcomes in stroke patients with tandem occlusions treated with thrombectomy: A multicentre study.

Background: Tandem occlusions, involving simultaneous extracranial and intracranial artery blockages, represent a complex subtype of acute ischemic stroke treated with mechanical thrombectomy (MT). However, to date, the impact of atrial fibrillation (AF) on outcomes in this population remains unclear. This study aimed to evaluate the safety and efficacy of MT in patients with tandem occlusions, comparing those with AF to their counterparts without AF.

Prognostic Impact of Malnutrition Evaluated via Bioelectrical Impedance Vector Analysis (BIVA) in Acute Ischemic Stroke: Findings from an Inverse Probability Weighting Analysis.

The association between malnutrition and poor outcomes in stroke patients has, to date, been evaluated using composite scores derived from laboratory measurements. However, Bioelectrical Impedance Analysis (BIA) and its advanced application, Bioelectrical Impedance Vector Analysis (BIVA), offer a non-invasive, cost-efficient, and rapid alternative. These methods enable precise assessment of body composition, nutritional status, and hydration levels, making them valuable tools in the clinical evaluation of stroke patients.

Direct oral anticoagulants versus no anticoagulation for the prevention of stroke in survivors of intracerebral haemorrhage with atrial fibrillation (PRESTIGE-AF): a multicentre, open-label, randomised, phase 3 trial.

Background: Direct oral anticoagulants (DOACs) reduce the rate of thromboembolism in patients with atrial fibrillation but the benefits and risks in survivors of intracerebral haemorrhage are uncertain. We aimed to determine whether DOACs reduce the risk of ischaemic stroke without substantially increasing the risk of recurrent intracerebral haemorrhage.

Methods: PRESTIGE-AF is a multicentre, open-label, randomised, phase 3 trial conducted at 75 hospitals in six European countries.

Risk of Recurrent Stroke, Mortality, and Intracerebral Hemorrhage in Patients With Atrial Fibrillation Detected Before or After a Stroke.

Background And Objectives: The risk of recurrent ischemic stroke, intracranial hemorrhage, and mortality in people with atrial fibrillation detected after stroke (AFDAS) is still unclear compared with people with known atrial fibrillation (KAF). We systematically reviewed the literature to provide updated estimates for the risk of recurrent stroke, intracerebral hemorrhage, and mortality in AFDAS compared with KAF.

Methods: Our protocol was registered in PROSPERO (CRD42024583064).

Predictors of futile recanalization after intravenous thrombolysis in stroke patients transferred for endovascular treatment.

Some patients with large vessel occlusion (LVO) achieve insufficient clinical improvement (futile recanalization, FR) after intravenous thrombolysis (IVT) during inter-hospital transfer for thrombectomy, while others show good outcomes (effective recanalization, ER). This study assessed FR and ER rates among patients treated with IVT at non-thrombectomy primary stroke centers (PSCs) and aimed to identify predictors of FR. We analyzed data from two PSC registries (2016-2022).

Risk trajectory of cardiovascular events after an exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis.

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are known to increase the risk of cardiovascular (CV) events and mortality. However, the temporal trend of this risk has not fully elucidated. This systematic review and meta-analysis aims to quantify the risk of CV events after COPD exacerbations over different time periods.

Impact of Sex on Clinical Outcomes of Tandem Occlusion in Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy. A Propensity-Matched Analysis.

Background: Although mechanical thrombectomy (MT) represents the standard of care for ischemic stroke due to large-vessel occlusion (LVO), the impact of sex on outcomes in tandem occlusions remains unclear. We investigated sex-based differences in outcomes after MT for tandem occlusions.

Methods: This multicenter observational study included consecutive patients with tandem occlusion treated with MT across three stroke centers (2021-2023).

Prognostic serum biomarkers of synaptic, neuronal and glial injury in patients with acute ischemic stroke of the anterior circulation.

Background: We aimed to investigate the prognostic role of β-synuclein in comparison to that of neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) for predicting functional outcome after acute ischemic stroke (AIS).

Methods: We measured serum concentrations of β-synuclein, NfL and GFAP 24 h after hospital admission in 213 consecutive patients with moderate-to-severe AIS. We investigated the association between serum biomarkers and radiological/clinical characteristics, 3-months mortality and functional outcome on the modified Rankin Scale (mRS).