Publications by authors named "Stefan Kiechl"
Introduction: The progression of diabetes status in post-stroke patients remains under-investigated, particularly regarding new treatments for type II diabetes mellitus (DM II), like glucagon-like peptide 1 receptor agonists (GLP-1-RA) and sodium-glucose co-transporter-2 (SGLT-2) inhibitors, which have not been studied in the post-stroke setting.
Patients And Methods: Eight hundred eighty-four consecutive ischemic stroke patients recruited to our prospective STROKE-CARD Registry were assessed concerning their glycemic status at baseline (normoglycemia, prediabetes, DM II) and change over time within 1 year follow-up. Multivariate logistic regression was performed to identify factors associated with transitioning from normoglycemia to prediabetes or DM II.
Background: The pathogenesis of spontaneous cervical artery dissection remains unclear, and no established predictors of recurrence exist. Our goal was to investigate the potential association between cervical artery tortuosity, a characteristic of patients with connective tissue disorder, and spontaneous cervical artery dissection.
Methods: The ReSect study (Risk Factors for Recurrent Cervical Artery Dissection) is an observational study that invited all spontaneous cervical artery dissection patients treated at the Innsbruck University Hospital between 1996 and 2018 for clinical and radiological follow-up.
Article Synopsis
- - Post-stroke dysphagia affects many patients, with 22% showing swallowing difficulties upon hospital admission, which lessens slightly by discharge (16.2% still affected).
- - Research involving 882 ischemic stroke patients found that over half (52.2%) experienced post-stroke fatigue, and those with dysphagia had significantly higher rates of fatigue (68.4% vs. 49.0%).
- - Dysphagia not only increases fatigue risk but remains an independent factor even after considering other influences, highlighting the need for tailored interventions to improve patient outcomes and quality of life after stroke.
Introduction: Dysphagia is common after acute ischemic stroke and entails considerable morbidity and mortality. Here, we investigated the impact of intensified care on swallowing recovery after stroke.
Patients And Methods: In this secondary analysis of STROKE-CARD, a randomized intervention trial of intensified post-stroke care, dysphagia was assessed by speech therapists at admission for acute ischemic stroke, at hospital discharge, and after 12-months.
Background: Pre-existing comorbidities increase the likelihood of post-stroke dysphagia. This study investigates comorbidity prevalence in patients with dysphagia after ischemic stroke.
Methods: The data of patients with acute ischemic stroke from two large representative cohorts (STROKE-CARD trial 2014-2019 and STROKE-CARD registry 2020-2022 - both study center Innsbruck, Austria) were analyzed for the presence of dysphagia at hospital admission (clinical swallowing examination).
Article Synopsis
- The study investigates the link between high-sensitivity cardiac troponin T (hs-cTnT) levels and cardiovascular disease (CVD) risk in patients who have experienced acute ischemic stroke or transient ischemic attack.
- Out of 1,687 patients analyzed, 80.7% had detectable hs-cTnT, showing a clear correlation: for every 1-SD increase in hs-cTnT, the risk of CVD events increased significantly.
- Findings indicate that higher hs-cTnT levels are associated with increased risks for specific outcomes like stroke, CVD death, and overall mortality, underscoring its potential as a marker for CVD risk in this patient population.
Article Synopsis
- Non-polyglutamine CACNA1A variants are linked to a diverse range of symptoms including developmental delay, migraines, epilepsy, psychiatric issues, and chronic cerebellar signs, with most patients showing symptoms from childhood.
- In a study over 20 years, 41 patients were monitored, revealing that 66% required interval therapy, which effectively managed their episodic symptoms.
- The findings suggest that non-polyglutamine CACNA1A disease presents differently as patients age, and that targeted prophylaxis can significantly alleviate their symptoms.
Background: Pain is a frequent yet poorly characterized symptom of multiple system atrophy (MSA). Understanding the factors influencing pain and its burden is crucial for improving the symptomatic treatment and quality of life of MSA individuals.
Objective: This study aimed at assessing the prevalence, characteristics, and current treatment strategies for pain in MSA.
Background: Intravenous thrombolysis (IVT) is an approved treatment for patients with acute ischemic stroke irrespective of sex. However, the current literature on sex differences in functional outcomes following IVT is inconsistent. So far, a number of studies-including a previous analysis based on data from the Austrian Stroke Unit Registry (ASUR)-detected significant sex-related differences in functional outcome, while others did not report any differences between women and men.
View Article and Find Full Text PDFNeuroglia critically shape the brain´s response to ischemic stroke. However, their phenotypic heterogeneity impedes a holistic understanding of the cellular composition of the early ischemic lesion. Here we present a single cell resolution transcriptomics dataset of the brain´s acute response to infarction.
View Article and Find Full Text PDFObjective and subjective cognitive outcomes one year after COVID-19.
Ann Clin Transl Neurol
September 2024
Objective: This study aimed to evaluate subjective cognitive, physical, and mental health symptoms as well as objective cognitive deficits in COVID-19 patients 1 year after infection.
Methods: This was a cross-sectional study. Seventy-four patients, who contracted a SARS-CoV-2 infection in 2020, underwent an in-person neuropsychological assessment in 2021.
Background: Cardiovascular disease (CVD), including coronary heart disease and cerebrovascular disease, is already amongst the leading causes of morbidity and mortality worldwide, but its burden continues to rise. Over time, relevant risk factors for CVD have been identified, many of which are modifiable. More recently, the relationship of sleep and CVD has been of interest, specifically increased rates of disrupted and disordered sleep, which have been found to be associated with CVD.
View Article and Find Full Text PDFArticle Synopsis
- Researchers studied the inflammatory response in 173 patients with acute ischaemic stroke by measuring 65 cytokines and chemokines in their plasma, finding varied profiles based on inflammatory levels.
- Stroke patients showed higher levels of compounds like HGF and SDF-1α and lower IL-4 compared to those with spontaneous cervical artery dissection, suggesting different inflammatory responses.
- The analysis revealed that stroke from large artery atherosclerosis, cardioembolism, and small vessel occlusion leads to a greater inflammatory response than spontaneous cervical artery dissection, with stable cytokine levels over time.
Aims: The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals.
Methods And Results: The updated LIFE-CVD (i.
Background: Subthalamic deep brain stimulation (STN-DBS) reduces antiparkinsonian medications in Parkinson's disease (PD) compared with the preoperative state. Longitudinal and comparative studies on this effect are lacking.
Objective: To compare longitudinal trajectories of antiparkinsonian medication in STN-DBS treated patients to non-surgically treated control patients.
Introduction: This study aimed to emphasize the importance of cranial nerve (CN) palsies in spontaneous cervical artery dissection (sCeAD).
Methods: A search term-based literature review was conducted on "cervical artery dissection" and "cranial nerve palsy." English and German articles published until October 2023 were considered.
Article Synopsis
- Early studies suggested that iron accumulation occurs in Friedreich's ataxia (FA), but data from actual patients was limited, prompting further investigation into systemic iron metabolism and regulation in FA patients.
- The study involved 40 FA patients and matched healthy controls, analyzing serum iron parameters, hormones, and iron distribution in blood cells, while also using MRI to assess iron stores in organs like the liver and spleen.
- Results indicated that FA patients had lower serum iron levels and certain iron-related proteins correlated inversely with genetic severity; there was also an unexpected discovery of iron deficiency and altered iron distribution within cells, suggesting that systemic iron-lowering treatments might not be ideal for FA patients.
Article Synopsis
- The study aimed to explore sex-related differences in the clinical presentation and progression of multiple system atrophy (MSA) using literature and a retrospective cohort analysis.
- A total of 46 publications were reviewed, revealing comparable survival rates between men and women, though some suggested women might have an advantage due to less severe symptoms at onset.
- Findings from a cohort analysis showed that women were more likely to experience depression and use specific medications, while men had higher occurrences of severe orthostatic hypotension and supine hypertension, emphasizing the need for sex consideration in MSA treatment and research.
We present a case with prolonged Lorlatinib-related dyslipidemia causing internal carotid artery stenosis, putting the patient at risk of cerebrovascular events. Through intensified lipid-lowering treatment and dose reduction of Lorlatinib, LDL-C levels decreased markedly. Surprisingly, the left sided internal carotid artery stenosis dissolved accordingly.
View Article and Find Full Text PDFArticle Synopsis
- The study explores a new method for assessing cervical vessel tortuosity, which could help in diagnosing subclinical connective tissue disorders, using magnetic resonance angiography (MRA) images from patients with spontaneous cervical artery dissection (sCeAD).
- Two independent users were able to segment arteries with less than 0.5% variability, demonstrating that the new method is reliable and more accurate than traditional visual assessments of vessel tortuosity.
- This approach has potential implications for clinical practice and future research on the relationship between cervical artery issues and connective tissue disorders.
Background And Purpose: Dysphagia is associated with poor outcome, higher mortality, reduced quality of life, and social isolation. We investigate the relationship between swallowing impairment and symptoms of anxiety and depression after ischemic stroke.
Methods: Consecutive patients with ischemic stroke participating in the prospective STROKE-CARD Registry study from 2020 to 2022 were assessed for dysphagia on hospital admission (clinical swallowing assessment) and for persistence until discharge and 3-month follow-up (SINGER Independency Index).
Generation of the human induced pluripotent stem cell line (IBKMOLi003-A) from PBMCs of a vascular Ehlers-Danlos syndrome (vEDS) patient carrying the heterozygous nonsense mutation c.430C > T (p.Q105*) in the COL3A1 gene.
Stem Cell Res
March 2024
Article Synopsis
- Ehlers-Danlos syndrome (EDS) is a rare genetic disorder affecting connective tissues, marked by symptoms like joint hypermobility and fragile tissues.
- A patient with vascular EDS (vEDS), the rarest subtype of EDS, was found to have a specific mutation in the COL3A1 gene crucial for collagen production.
- Researchers created induced pluripotent stem cells (iPSCs) from the patient’s blood cells, which showed normal characteristics and can be used for detailed studies on the disease's mechanisms.
Background: Dyslipidemia is an independent risk factor for coronary heart disease (CHD). Standard lipid panel cannot capture the complexity of the blood lipidome (ie, all molecular lipids in the blood). To date, very few large-scale epidemiological studies have assessed the full spectrum of the blood lipidome on risk of CHD, especially in a longitudinal setting.
View Article and Find Full Text PDFBackground And Purpose: Biological sex is known to have an impact on quality metrics of acute stroke. We aimed to determine whether COVID positivity accentuates this effect and constitutes worse outcome.
Methods: The present analysis was based on the Global COVID-19 Stroke Registry, a retrospective, international, cohort study of consecutive ischemic stroke patients receiving intravenous thrombolysis and/or endovascular thrombectomy between 1 March 2020 and 30 June 2021.