Publications by authors named "Ayoola Ademola"
Background: About 25% of patients with acute ischemic stroke have lacunar infarct on follow-up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase.
View Article and Find Full Text PDFPurpose: Our objectives were to identify characteristics of response shift studies using patient-reported outcomes (PROMs) that explain variability in (1) the detection and (2) the magnitude of response shift effects.
Methods: We conducted a systematic review of quantitative studies published before June 2023. First, two-level multivariable logistic regression models (effect- and sample-levels) were used to explain variability in the probability of finding a response shift effect.
Objectives: To ensure sufficient resources to care for patients with COVID-19, healthcare systems delayed non-urgent surgeries to free capacity. This study explores the consequences of delaying non-urgent surgery on surgical care and healthcare resource use.
Design: This is a population-based retrospective cohort study.
Background And Objectives: In recent years, researchers have sought to address the challenges of obtaining informed consent for participation in acute stroke trials. We studied outcomes related to the use of deferral of consent in the phase 3 Alteplase Compared to Tenecteplase (AcT) trial.
Methods: As part of our protocol, we captured methods of consent, participant withdrawals, door-to-randomization times, and door-to-needle times.
Article Synopsis
- The study examines the safety and effectiveness of intravenous tenecteplase compared to alteplase in treating patients with acute ischemic strokes in the posterior circulation.
- A post-hoc analysis of over 1,500 patients found no significant differences in outcomes between the two treatments in terms of recovery, symptomatic intracerebral hemorrhage, and mortality.
- Both medications showed similar rates of successful reperfusion and recanalization, suggesting that tenecteplase can be as effective as alteplase for this type of stroke without increased risks.
Background And Purpose: The safety and efficacy of tenecteplase in patients with ischemic stroke due to medium vessel occlusion (MeVO) are not well studied. We aimed to compare tenecteplase with alteplase in stroke due to MeVO.
Methods: Patients with baseline M2-middle cerebral artery (MCA), M3/M4-MCA, P2/P3/P4-posterior cerebral artery (PCA), A2/A3/A4-anterior cerebral artery (ACA) occlusions from the Alteplase Compared to Tenecteplase (AcT) trial were included.
Background: Early ischemic change and collateral extent are colinear with ischemic core volume (ICV). We investigated the relationship between a combined score using the Alberta Stroke Program Early Computed Tomography Score and multiphase computed tomography angiography (mCTA) collateral extent, named mCTA-ACE score, on functional outcomes in endovascular therapy-treated patients.
Methods: We performed a post hoc analysis of a subset of endovascular therapy-treated patients from the Alteplase Compared to Tenecteplase trial which was conducted between December 2019 and January 2022 at 22 centers across Canada.
Background: We investigated the impact of workflow times on the outcomes of patients treated with endovascular thrombectomy (EVT) in the late time window.
Methods: Individual patients' data who underwent EVT in the late time window (onset to imaging >6 hours) were pooled from seven registries and randomized clinical trials. Multiple time intervals were analyzed.
Article Synopsis
- In the AcT trial, researchers examined how effective and safe intravenous tenecteplase is compared to alteplase for treating patients with minor ischaemic strokes, specifically those with low NIHSS scores (≤5).
- The study included 378 patients, showing that 51.8% of those treated with tenecteplase achieved good functional outcomes compared to 47.5% with alteplase, but the differences in outcomes were not statistically significant.
- Safety results indicated no major differences between the two treatments in terms of severe complications like symptomatic intracranial hemorrhage or mortality within 90 days.
Background: Recent evidence from thrombolysis trials indicates the noninferiority of intravenous tenecteplase to intravenous alteplase with respect to good functional outcomes in patients with acute stroke. We examined whether the health-related quality of life (HRQOL) of patients with acute stroke differs by the type of thrombolysis treatment received. In addition, we examined the association between the modified Rankin Scale score 0 to 1 and HRQOL and patient-reported return to prebaseline stroke functioning at 90 days.
View Article and Find Full Text PDFBackground: Understanding sex differences in stroke care is important in reducing potential disparities. Our objective was to explore sex differences in workflow efficiency, treatment efficacy, and safety in the AcT trial (Alteplase Compared to Tenecteplase).
Methods: AcT was a multicenter, registry-linked randomized noninferiority trial comparing tenecteplase (0.
Background: The AcT (Alteplase Compared to Tenecteplase) randomized controlled trial showed that tenecteplase is noninferior to alteplase in treating patients with acute ischemic stroke within 4.5 hours of symptom onset. The effect of time to treatment on clinical outcomes with alteplase is well known; however, the nature of this relationship is yet to be described with tenecteplase.
View Article and Find Full Text PDFBackground: Carotid tandem lesions ((TL) ⩾70% stenosis or occlusion) account for 15-20% of acute stroke with large vessel occlusion.
Aims: We investigated the safety and efficacy of intravenous tenecteplase (0.25 mg/kg) versus intravenous alteplase (0.
Purpose: The objective of this systematic review was to describe the prevalence and magnitude of response shift effects, for different response shift methods, populations, study designs, and patient-reported outcome measures (PROM)s.
Methods: A literature search was performed in MEDLINE, PSYCINFO, CINAHL, EMBASE, Social Science Citation Index, and Dissertations & Theses Global to identify longitudinal quantitative studies that examined response shift using PROMs, published before 2021. The magnitude of each response shift effect (effect sizes, R-squared or percentage of respondents with response shift) was ascertained based on reported statistical information or as stated in the manuscript.
Article Synopsis
- The study investigates whether tenecteplase, an alternative to alteplase, is equally safe and effective for treating patients with acute ischemic stroke caused by large vessel occlusion (LVO).
- Conducted as part of the ACT trial in Canada, this analysis involved 1,600 patients with disabling strokes enrolled from 22 stroke centers over a span of two years, where they were randomly assigned to receive either medication.
- The primary outcome measured was the likelihood of achieving a modified Rankin scale score of 0-1 at 90 days, with secondary outcomes including mortality rates, rates of symptomatic intracerebral hemorrhage, and successful reperfusion rates.
Background: Subgroup analyses are widely used to evaluate the heterogeneity of treatment effects in randomized clinical trials. However, there is a limited investigation of the quality of prespecified and reported subgroup analyses in stroke trials. This study evaluated the credibility of subgroup analyses in stroke trials.
View Article and Find Full Text PDFBackground: Intravenous thrombolysis with alteplase bolus followed by infusion is a global standard of care for patients with acute ischaemic stroke. We aimed to determine whether tenecteplase given as a single bolus might increase reperfusion compared with this standard of care.
Methods: In this multicentre, open-label, parallel-group, registry-linked, randomised, controlled trial (AcT), patients were enrolled from 22 primary and comprehensive stroke centres across Canada.
Article Synopsis
- The study examined sex-related differences in outcomes for men and women who received endovascular treatment for acute stroke, specifically in late-presenting patients.
- Analysis was conducted using individual patient data from the SOLSTICE Consortium, comparing characteristics like age, functional independence after 90 days, mortality rates, and complications between the sexes.
- Results showed no significant differences in adjusted outcomes between men and women, although men had a higher likelihood of mortality and symptomatic intracranial hemorrhage, and women were generally older with fewer tandem occlusions.
Background: International guidelines recommend education, exercise, and dietary weight management as core treatments to manage osteoarthritis (OA) regardless of disease severity or co-morbidity. Evidence supports the clinical effectiveness of OA management programs, but the cost-effectiveness of core treatments remains unclear. We will systematically review, synthesize, and assess the literature in economic evaluations of core treatments (education, exercise, and dietary weight management) for the management of hip and/or knee OA.
View Article and Find Full Text PDFObjective: To assess the use of ketotifen fumarate (KF) to reduce posttraumatic contractures after elbow fractures and/or dislocations.
Design: Randomized clinical trial.
Setting: Three hospitals in Calgary, Canada, including one Level 1 trauma center.
Mast cells contain an abundance of tryptase, and preclinical models have shown elevated serum mast cell tryptase (SMCT) in the setting of posttraumatic joint contractures. Therefore, SMCT emerged as a potential biomarker to help recognize patients with more severe injuries and a higher likelihood of developing contractures. The objective of this study is to assess SMCT levels in participants with varying severity of elbow fractures and/or dislocations.
View Article and Find Full Text PDFBackground: Injuries and resulting stiffness around joints, especially the elbow, have huge psychological effects by reducing quality of life through interference with normal daily activities such as feeding, dressing, grooming, and reaching for objects. Over the last several years and through numerous research results, the myofibroblast-mast cell-neuropeptide axis of fibrosis had been implicated in post-traumatic joint contractures. Pre-clinical models and a pilot randomized clinical trial (RCT) demonstrated the feasibility and safety of using Ketotifen Fumarate (KF), a mast cell stabilizer to prevent elbow joint contractures.
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