Publications by authors named "Kwangyeol Park"
Purpose: To validate JLK-LVO, a software detecting large vessel occlusion (LVO) on computed tomography angiography (CTA), within a multicenter dataset.
Methods: From 2021 to 2023, we enrolled patients with ischemic stroke who underwent CTA within 24-hour of onset at six university hospitals for validation and calibration datasets and at another university hospital for an independent dataset for testing model calibration. The diagnostic performance was evaluated using area under the curve (AUC), sensitivity, and specificity across the entire study population and specifically in patients with isolated middle cerebral artery (MCA)-M2 occlusion.
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.
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.
View Article and Find Full Text PDFBackground: 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.
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.
Impact of non-traditional lipid profiles on 1-year vascular outcomes in ischemic stroke patients with prior statin therapy and LDL-C < 100 mg/dL.
Sci Rep
October 2024
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.
Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry.
J Korean Med Sci
September 2024
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.
Introduction: The study aims to use power spectrum changes in subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI), preclinical stages of Alzheimer's disease (AD), for future biomarker studies in early AD diagnosis.
Methods: We recruited 23 SCD and 32 aMCI subjects and conducted comparative analysis using relative power spectral density (PSD). Automated preprocessing and statistical analysis were performed using iSync Brain® (iMediSync Inc.
Introduction: Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL), involving repetitive visual training in blind visual fields, may effectively restore visual field sensitivity in cortical blindness. This current multicenter, double-blind, randomized, controlled clinical trial investigated the efficacy and safety of VPL-based digital therapeutics (Nunap Vision [NV]) for treating poststroke VFDs.
View Article and Find Full Text PDFTrends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment.
J Am Heart Assoc
May 2024
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.
Background And Purpose: Patients with cluster headache (CH) exhibit impaired health-related quality of life (HRQoL). However, there have been few studies related to the HRQoL of patients with CH from Asian backgrounds. This study aimed to determine the impact of CH on HRQoL and to identify the factors affecting HRQoL in patients with CH during cluster periods.
View Article and Find Full Text PDFArticle 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 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 PDFObjective: Functional and morphologic changes in extracranial organs can occur after acute brain injury. The neuroanatomic correlates of such changes are not fully known. Herein, we tested the hypothesis that brain infarcts are associated with cardiac and systemic abnormalities (CSAs) in a regionally specific manner.
View Article and Find Full Text PDFArticle 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.
Introduction: The D-dimer to fibrinogen ratio (DFR) is a good indicator of clot-producing activity in thrombotic disease, but its clinical usefulness in stroke patients with nonvalvular atrial fibrillation (NVAF) has not been studied. We evaluated the association between the DFR and early neurological deterioration (END) in acute ischemic stroke (AIS) patients with NVAF.
Methods: We included consecutive AIS patients with NVAF between 2013 and 2015 from the registry of a real-world prospective cohort from 11 large centers in South Korea.
Background: Thrombi retrieved from patients with acute ischemic stroke may contain prognostic information.
Objective: To investigate the relationship between the immunologic phenotype of thrombi and future vascular events in patients with a stroke.
Methods: This study included patients with acute ischemic stroke who underwent endovascular thrombectomy at Chung-Ang University Hospital in Seoul, Korea, between February 2017 and January 2020.
Moderate-Intensity Rosuvastatin Plus Ezetimibe Versus High-Intensity Rosuvastatin for Target Low-Density Lipoprotein Cholesterol Goal Achievement in Patients With Recent Ischemic Stroke: A Randomized Controlled Trial.
J Stroke
May 2023
Background And Purpose: Moderate-intensity statin plus ezetimibe versus high-intensity statin alone may provide a greater low-density lipoprotein cholesterol (LDL-C) reduction in patients with recent ischemic stroke.
Methods: This randomized, open-label, controlled trial assigned patients with recent ischemic stroke <90 days to rosuvastatin/ezetimibe 10/10 mg once daily (ROS10/EZT10) or to rosuvastatin 20 mg once daily (ROS20). The primary endpoint was LDL-C reduction ≥50% from baseline at 90 days.
Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic stroke with presumed atherosclerotic OrigiN (DURATION) trial: Rationale and design.
Int J Stroke
October 2023
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: Only limited data are available regarding the treatment status and response to cluster headache in an Asian population. Therefore, this study aimed to provide a real-world treatment pattern of cluster headache and the response rate of each treatment in an Asian population.
Methods: Patients with cluster headache were recruited between September 2016 and January 2019 from 16 hospitals in Korea.
Efficacy and safety of oxiracetam in patients with vascular cognitive impairment: A multicenter, randomized, double-blinded, placebo-controlled, phase IV clinical trial.
Contemp Clin Trials
March 2023
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.
Background: Elevated metabolic activity of amygdala is known to be related to atherosclerotic cardiovascular event by increasing inflammatory cell production from bone marrow. We tried to identify the factors of metabolic activity in the amygdala, vertebrae, liver, spleen, and internal carotid artery related to the future vascular events after stroke.
Methods: A total of 110 patients with acute stroke were included (72±10 years of age, 39% women) and underwent whole-body F-fluorodeoxyglucose (FDG) positron emission tomography between August 1, 2015 and February 28, 2020.