Publications by authors named "Korompoki E"
Adequate secondary prevention in survivors of intracerebral hemorrhage (ICH) who also have atrial fibrillation (AF) is a long-standing clinical dilemma because these patients are at increased risk of recurrent ICH as well as of ischemic stroke. The efficacy and safety of oral anticoagulation, the standard preventive medication for ischemic stroke patients with AF, in ICH patients with AF are uncertain. PRESTIGE-AF is an international, phase 3b, multi-center, randomized, open, blinded end-point assessment (PROBE) clinical trial that compared the efficacy and safety of direct oral anticoagulants (DOACs) with no DOAC (either no antithrombotic treatment or any antiplatelet drug).
View Article and Find Full Text PDFBackground: There is paucity of data on the long-term outcomes after acute ischemic posterior circulation stroke (PCS). Additionally, the long-term prognostic value of the New England Medical Center-Posterior Circulation Registry (NEMC-PCR) classification of PCS has not been studied.
Patients And Methods: All consecutive patients with PCS registered in the Athens Stroke Registry between 01/1993 and 12/2012 were prospectively followed for up to 10 years and included in the analysis.
Article Synopsis
- * Common causes of IS during ECMO include thromboembolic events and reduced blood flow to the brain, which can be hard to diagnose due to patients' severe conditions and sedation.
- * Diagnosis involves immediate brain imaging, such as CT and CT angiography, while treatment typically requires mechanical thrombectomy instead of thrombolytic therapy due to ongoing anticoagulation, necessitating close collaboration between radiologists and the ECMO team.
Background: Emerging evidence indicates a frequent occurrence of atrial fibrillation (AF) detection among patients with established causes of ischemic stroke unrelated to AF. This systematic review and meta-analysis aimed to evaluate AF detection rates in stroke patients with large or small vessel disease, considering the AF detection modality and duration of cardiac rhythm monitoring.
Aims: We conducted a comprehensive search of PubMed and Scopus databases up to 2 March 2024, to identify randomized controlled trials, non-randomized prospective studies, and retrospective studies assessing the frequency of AF detection in stroke patients with large or small vessel disease.
Article Synopsis
- Pulse wave velocity (PWV) serves as a strong indicator of arterial stiffness and is a better predictor of cardiovascular events compared to traditional risk factors, especially in the context of acute ischemic stroke (AIS).
- The meta-analysis reviewed studies on AIS patients, showing a higher PWV is linked to poorer functional outcomes and higher long-term risks such as mortality and stroke recurrence.
- Findings suggest that monitoring PWV can enhance risk assessment and management in patients with vascular aging, indicating the importance of incorporating this measure into clinical practice.
Background: Atrial fibrillation (AF) can be known before the stroke (KAF) or be newly detected after stroke (AFDAS). It is unknown whether the outcome of stroke differs between KAF and AFDAS. We performed a propensity-matched analysis to investigate the outcome of patients with AFDAS and their counterparts with KAF.
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- The study focused on the prevalence and associated factors of carotid atherosclerosis in stroke patients with atrial fibrillation (AF), finding that 34.6% of patients had this condition.
- Among 2,955 patients analyzed, 6.9% had carotid stenosis of 50% or more, and 5.7% experienced carotid occlusion, with age and previous vascular conditions being significant risk factors.
- The research concluded that atherosclerosis in multiple arterial beds is a strong predictor of significant carotid stenosis, indicating a high level of cardiovascular risk in these patients.
There is limited evidence on the outcomes and safety of mechanical thrombectomy (MT) among patients with acute ischemic stroke (AIS) in the context of cardiac diseases. Our study reviews MT in AIS within the context of cardiac diseases, aiming to identify existing and emerging needs and gaps. PubMed and Scopus were searched until December 31, 2023, using a combination of cardiological diseases and "mechanical thrombectomy" or "endovascular treatment" as keywords.
View Article and Find Full Text PDFEarly vascular aging in acute ischemic stroke: A systematic review and meta-analysis.
J Stroke Cerebrovasc Dis
August 2024
Background: While arterial stiffening is a known risk factor for cardiovascular diseases, it remains unclear whether there is an early vascular aging (EVA) in patients who have experienced acute ischemic stroke (AIS). This systematic review and meta-analysis aims to investigate whether patients with AIS exhibit EVA through pulse wave velocity (PWV) measurements shortly after the stroke onset, shedding light on the relationship between arterial stiffness, hypertension, and stroke.
Methods: Thirteen case-control studies were included, comparing PWV measurements between AIS patients and non-AIS individuals.
Patent foramen ovale (PFO) is frequently identified in young patients with cryptogenic ischaemic stroke. Potential stroke mechanisms include paradoxical embolism from a venous clot which traverses the PFO, in situ clot formation within the PFO, and atrial arrhythmias due to electrical signalling disruption. The purpose of this guideline is to provide recommendations for diagnosing, treating, and long-term managing patients with ischaemic stroke and PFO.
View Article and Find Full Text PDFOne in six ischaemic stroke patients has an embolic stroke of undetermined source (ESUS), defined as a stroke with unclear aetiology despite recommended diagnostic evaluation. The overall cardiovascular risk of ESUS is high and it is important to optimize strategies to prevent recurrent stroke and other cardiovascular events. The aim of clinicians when confronted with a patient not only with ESUS but also with any other medical condition of unclear aetiology is to identify the actual cause amongst a list of potential differential diagnoses, in order to optimize secondary prevention.
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- - The SUN4P project investigates stroke healthcare quality in Greece by analyzing patient data from nine hospitals for first-ever strokes between 2019-2021.
- - Out of 892 patients studied, the majority had ischemic strokes, with only a small percentage receiving treatment in specialized acute stroke units; yet, a high percentage received follow-up medications upon discharge.
- - This study marks the first comprehensive data collection on stroke care quality in Greece, aiming to enhance treatment standards and outcomes for stroke patients nationwide.
Article Synopsis
- A recent ESC stroke position paper suggests using a holistic care management approach, known as the ABC pathway, to enhance cardiovascular outcomes for stroke patients.
- An analysis from the Athens Stroke Registry focused on 2,513 patients with first-time ischemic strokes, showing only 6.2% fully adhered to the ABC pathway, while 7.6% had no adherence.
- Patients who fully adhered to the ABC pathway experienced significantly lower risks of stroke recurrence, major cardiovascular events, and death, indicating benefits of this integrated care approach post-stroke.
Objective: Severe coronavirus disease 19 (COVID-19) is characterized by a dysregulated inflammatory response, with humoral immunity playing a central role in the disease course. The objective of this study was to assess the immune response and the effects of vaccination in recovered individuals with variable disease severity up to one year following natural infection.
Methods: A prospective cohort study was conducted including patients with laboratory-confirmed COVID-19.
Background And Purpose: The aim of our study is to present, for the first time, the clinical, radiological, and neurocognitive characteristics of Greek adult patients with Moyamoya disease (MMD).
Methods: We analyzed prospectively collected data of 12 patients referred to our department from 2004 to 2019. All patients underwent a thorough diagnostic work up, including extensive clinical, neuroradiological, and neurocognitive assessment.
Article Synopsis
- The study assessed the one-year total cost of strokes in Greece, focusing on patients with first-ever acute strokes admitted to hospitals within 48 hours of symptom onset.
- It found that the total annual cost of stroke care was EUR 343.1 million in 2021, averaging EUR 10,722 per patient, with an estimated cost-effectiveness of EUR 23,308 per Quality Adjusted Life Year (QALY).
- Key costs included 53.3% direct healthcare expenses and significant productivity losses, totaling EUR 160.2 million from work absences, premature retirement, and caregiving, emphasizing the need for improved stroke care and effective interventions.
Article Synopsis
- * In Greece, early restriction measures resulted in a milder Covid-19 surge, allowing for a study comparing stroke admissions before and during the pandemic.
- * The study found no significant differences in stroke severity or patient characteristics between the two periods, but there was a notable delay in the time from symptom onset to CT scan during the pandemic (p=0.03).
Background: The effect of SARS-CoV-2 infection in blood lipids of homozygous familial hypercholesterolemia (HoFH) has not been explored.
Case Summary: We report a case of a 43-year-old male patient with -/-LDLR HoFH with previous history of premature coronary artery disease, coronary artery bypass graft (CABG) and surgical repair of aortic valve stenosis. He presented with an abrupt decrease of his blood lipid levels during acute infection with SARS-CoV2 and subsequently a rebound increase above pre-infection levels, refractory to treatment including LDL-apheresis, statin, ezetimibe and lomitapide up-titration to maximum tolerated doses.
Article Synopsis
- The study aimed to determine if early cardiac rhythm control benefits patients with acute ischemic stroke and paroxysmal atrial fibrillation (PAF) compared to those with sustained atrial fibrillation (AF).
- Researchers followed 297 patients who had their first stroke and confirmed PAF to analyze outcomes like mortality, stroke recurrence, and major adverse cardiovascular events (MACE) over a median period of 28 months.
- The results indicated that patients with self-terminating PAF had significantly lower risks of death, stroke recurrence, and MACE compared to those with sustained AF, suggesting that early rhythm control may have benefits.
Article Synopsis
- The study investigates how aortic stiffness and pressure wave reflections relate to long-term outcomes in stroke patients, using data from the Athens Stroke Registry.
- It analyzed 552 patients and found that high aortic stiffness is independently linked to increased mortality and cardiovascular events, but not necessarily to stroke recurrence or functional disability.
- The combination of high aortic stiffness and low pressure wave reflections significantly raises the risk of adverse outcomes, highlighting their combined importance in post-stroke patient management.
Background: COVID-19 has been frequently associated with an increased risk of thrombotic complications. There have also been reports of an increased likelihood of stroke, although its true incidence in patients with COVID-19 is currently unknown.
Methods: Electronic databases PubMed and Scopus were searched from inception up to July 30, 2021 to identify randomized controlled studies in patients with confirmed COVID-19 undergoing one or more interventions.
Introduction: Heart failure (HF) is a major public health issue associated with significantly increased risk of stroke. It remains uncertain whether oral anticoagulation (OAC) in patients with heart failure and sinus rhythm (HF-SR) could improve prognosis.
Methods: We performed a systematic search of PubMed and Embase databases for randomized controlled clinical trials assessing oral anticoagulants versus antiplatelets or placebo in patients with HF or ventricular dysfunction/cardiomyopathy without clinical HF and SR.