Publications by authors named "Marti-Fabregas J"
Introduction: The efficacy of intracranial rescue stenting (RS) following failed mechanical thrombectomy (MT) in large-vessel occlusion (LVO) stroke remains uncertain. We aimed to evaluate clinical outcomes of RS in patients with anterior circulation LVO stroke following unsuccessful MT.
Patients And Methods: We conducted a retrospective analysis using the Stroke Code Registry of Catalonia (January 2016-March 2022), a prospective, population-based registry including patients treated at 10 comprehensive stroke centers.
Article Synopsis
- Cerebral small vessel disease (SVD) can lead to various cerebrovascular issues, but research on sex differences in SVD is limited.
- This study analyzed data from over 20,000 patients with acute ischemic stroke to examine whether the presence and severity of cerebral microbleeds (CMB) and other SVD markers differ between males and females.
- Results showed that males had more frequent CMB while females had fewer lacunes but higher severe white matter hyperintensities, indicating distinct SVD characteristics based on sex.
Background: Ischemic stroke (IS) represents a significant health burden globally, necessitating a better understanding of its genetic underpinnings to improve prevention and treatment strategies. Despite advances in IS genetics, studies focusing on the Spanish population and sex-stratified analyses are lacking.
Methods: A case-control genome-wide association study was conducted with 9081 individuals (3493 IS cases and 5588 healthy controls).
Background And Objectives: Genome-wide association studies (GWASs) have only 2 loci associated with spontaneous intracerebral hemorrhage (ICH): for lobar and 1q22 for nonlobar ICH. We aimed to discover new loci through an analysis that combines correlated traits (multi-trait analysis of GWAS [MTAG]) and explore a gene-based analysis, transcriptome-wide association study (TWAS), and proteome-wide association study (PWAS) to understand the biological mechanisms of spontaneous ICH providing potential therapeutic targets.
Methods: We use the published MTAG of ICH (patients with spontaneous intraparenchymal bleeding) and small-vessel ischemic stroke.
Introduction: In patients with acute ischemic stroke (AIS) secondary to intracranial large vessel occlusion, optimal blood pressure (BP) management following endovascular treatment (EVT) has not yet been established. The randomized trial on Hemodynamic Optimization of Cerebral Perfusion after Successful Endovascular Therapy in Patients with Acute Ischemic Stroke (HOPE) (clinicaltrials.gov id: NCT04892511) aims to demonstrate whether hemodynamic optimization using different systolic BP targets following EVT according to the degree of final recanalization, is more effective than currently recommended BP management in improving functional outcomes of patients with AIS.
View Article and Find Full Text PDFBackground And Objectives: Whether the outcome of patients with spontaneous intracerebral hemorrhage (ICH) differs depending on the type of hospital where they are admitted is uncertain. The objective of this study was to determine influence of hospital type at admission (telestroke center [TSC], primary stroke center [PSC], or comprehensive stroke center [CSC]) on outcome for patients with ICH. We hypothesized that outcomes may be better for patients admitted to a CSC.
View Article and Find Full Text PDFBackground: Cerebral edema (CED) is associated with poorer outcome in patients with acute ischemic stroke (AIS). The aim of the study was to investigate the factors contributing to greater early CED formation in patients with AIS who underwent endovascular therapy (EVT) and its association with functional outcome.
Methods: We conducted a multicenter cohort study of patients with an anterior circulation AIS undergoing EVT.
Introduction: The benefits and risks of HMG-CoA reductase inhibitor (statin) drugs in survivors of intracerebral hemorrhage (ICH) are unclear. Observational studies suggest an association between statin use and increased risk of lobar ICH, particularly in patients with apolipoprotein-E (APOE) ε2 and ε4 genotypes. There are no randomized controlled trials (RCTs) addressing the effects of statins after ICH leading to uncertainty as to whether statins should be used in patients with lobar ICH who are at high risk for ICH recurrence.
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- This study looked at whether taking statins, a type of medicine, affects the chances of having a repeat stroke or bleeding in the brain for people who have certain brain issues called cerebral microbleeds (CMBs).
- They analyzed data from many hospitals and included over 16,000 patients, dividing them into those who took statins and those who didn't.
- The results showed that people who used statins had a lower risk of having another stroke but didn't show a clear difference in the risk of brain bleeding compared to those who didn't take statins.
Article Synopsis
- Scientists studied a medicine called r-tPA that helps treat strokes but can cause bleeding in the brain, making things worse for patients.
- They looked at certain genetic factors in the body that might affect this bleeding risk after using r-tPA.
- They found some specific genes that are linked to both blood clotting factors and the risk of bleeding, which could help in understanding how to treat patients better in the future.
Background: Patients with atrial fibrillation (AF) and intracerebral hemorrhage (ICH) are at high risk of ischemic and recurrent bleeding events. Therefore, the decision of restarting or avoiding anticoagulation is challenging. Left atrial appendage occlusion (LAAO) is an alternative for these patients.
View Article and Find Full Text PDFBackground And Purpose: In patients with acute ischaemic stroke (AIS), haemorrhagic transformation (HT) following endovascular treatment (EVT) is associated with poor functional outcome. However, the impact of asymptomatic HT, not linked to neurological deterioration in the acute phase, is unknown. We aimed to investigate the impact of asymptomatic PH1 (aPH1) and PH2 (aPH2) subtypes of HT on the functional outcome of patients treated with EVT.
View Article and Find Full Text PDFBackground: Whether presenting an episode of amaurosis fugax (AFx) increases the risk of ischemic stroke is controversial and there is a lack of consensus in the following management. We aimed to describe the clinical characteristics and prognosis of patients with AFx due to suspected transient retinal ischemia.
Methods: Observational, retrospective study of patients admitted in a Comprehensive Stroke Center with diagnosis of AFx due to suspected transient retinal ischemia between 2015 and 2020.
Article Synopsis
- Researchers analyzed ischaemic stroke (IS) cases that occurred within eight days of COVID-19 onset to determine if they have a unique genetic background compared to other stroke types.
- Using a method called SUPERGNOVA, they identified specific genomic regions related to large artery atherosclerosis (LAA) and cardioembolic stroke (CES) from a cohort of 73 IS-COV patients and 701 control subjects.
- The study found four genetic loci associated with CES and significant polygenic risk scores for LAA, suggesting IS-COV patients may share genetic traits with these stroke subtypes; more research is needed to see if these traits are specific to viral infection or common in the general population.
Importance: Prehospital transfer protocols are based on rapid access to reperfusion therapies for patients with ischemic stroke. The effect of different protocols among patients receiving a final diagnosis of intracerebral hemorrhage (ICH) is unknown.
Objective: To determine the effect of direct transport to an endovascular treatment (EVT)-capable stroke center vs transport to the nearest local stroke center.
Background: The Oxford Carotid Stenosis tool (OCST) and Essen Stroke Risk Score (ESRS) are validated to predict recurrent stroke in patients with and without carotid stenosis. The Symptomatic Carotid Atheroma Inflammation Lumen stenosis (SCAIL) score combines stenosis and plaque inflammation on fluorodeoxyglucose positron-emission tomography (FDG-PET). We compared SCAIL with OCST and ESRS to predict ipsilateral stroke recurrence in symptomatic carotid stenosis.
View Article and Find Full Text PDFObjectives: To study prehospital care process in relation to hospital outcomes in stroke-code cases first attended by 2 different levels of ambulance. To analyze factors associated with a satisfactory functional outcome at 3 months.
Material And Methods: Prospective multicenter observational cohort study.
Article Synopsis
- Gut microbiota can affect ischaemic stroke (IS) differently in men and women, but we don't know much about these differences yet.
- The study involved 89 IS patients and 12 healthy controls, and researchers looked at their gut bacteria to find differences between the sexes.
- They discovered that men with IS have more types of gut bacteria than women, and high levels of a specific type called Fusobacteriaceae in women are linked to a greater risk of IS.*
Introduction: Previous studies have reported differences in the management and outcome of women stroke patients in comparison with men. We aim to analyze sex and gender differences in the medical assistance, access to treatment and outcome of acute stroke patients in Catalonia.
Patients And Methods: Data were obtained from a prospective population-based registry of stroke code activations in Catalonia (CICAT) from January/2016 to December/2019.
Article Synopsis
- Cerebral microbleeds increase the risk of both ischemic stroke and intracranial hemorrhage, complicating treatment choices for patients with atrial fibrillation on various antithrombotic therapies.
- A study analyzed 7,839 patients, finding that microbleeds significantly raised the relative risk of intracranial hemorrhage (2.74 times) and ischemic stroke (1.29 times), particularly with combination therapies of anticoagulants and antiplatelets.
- For patients on combination therapy, those with multiple microbleeds faced a higher absolute risk of intracranial hemorrhage compared to ischemic stroke, indicating a need for more research to develop effective preventive strategies.
Owing to the high risk of recurrence, identifying indicators of carotid plaque vulnerability in atherothrombotic ischemic stroke is essential. In this study, we aimed to identify modified LDLs and antioxidant enzymes associated with plaque vulnerability in plasma from patients with a recent ischemic stroke and carotid atherosclerosis. Patients underwent an ultrasound, a CT-angiography, and an F-FDG PET.
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- International guidelines advise against using intravenous thrombolysis (IVT) in ischemic stroke patients who have recently taken direct oral anticoagulants (DOAC).
- A multicenter study examined the risk of symptomatic intracranial hemorrhage (sICH) in 832 patients who underwent IVT within 48 hours of DOAC use, compared to over 32,000 controls without recent DOAC intake.
- Results highlighted varied outcomes based on prior DOAC therapy, with focus on sICH incidence measured through established stroke scales, and included an analysis of DOAC levels and reversal treatments prior to IVT.