Publications by authors named "Sung I Sohn"
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.
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.
Article Synopsis
- Intravenous thrombolysis (IVT) and endovascular therapy (EVT) are effective treatments for acute stroke, but their safety and efficacy in patients with atrial fibrillation (AF) are debated.
- A study analyzed data from two multicenter studies to compare outcomes of AF patients with acute ischemic stroke treated with reperfusion therapies versus those who weren't.
- Results showed that AF patients treated with reperfusion therapies had better functional outcomes and lower mortality rates compared to those who received conservative treatment.
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
Background And Purpose: The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO).
Methods: This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds.
Article 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: There is limited information on the delivery of acute stroke therapies and secondary preventive measures and clinical outcomes over time in young adults with acute ischemic stroke. This study investigated whether advances in these treatments improved outcomes in this population.
Methods: Using a prospective multicenter stroke registry in Korea, young adults (aged 18-50 years) with acute ischemic stroke hospitalized between 2008 and 2019 were identified.
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.
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- 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.
Article Synopsis
- Recent research indicates a lack of interchangeability between modified Rankin Scale measures of functional outcomes and mortality measures in assessing hospital performance for acute ischemic stroke patients.
- The study evaluated 8292 hospitalized stroke patients and used various metrics like 1-month and 1-year mortality to assess hospital outcomes.
- Findings revealed no significant correlation between hospitals’ rankings based on functional outcomes and those based on mortality rates, suggesting that these measures evaluate different aspects of hospital performance.
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: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown.
Aims: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes.
Methods: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data.
Admission hyperglycemia, stroke subtypes, outcomes in acute ischemic stroke.
Diabetes Res Clin Pract
February 2023
Aims: Whether admission hyperglycemia is differentially associated with early vascular outcomes in acute ischemic stroke (AIS) depending on stroke subtype has been incompletely delineated.
Methods: In a multicenter, prospective stroke registry, patients with AIS were categorized based on admission glucose levels into normoglycemia, moderate hyperglycemia, and severe hyperglycemia (<140mg/dl, 140-179mg/dl, and ≥180mg/dl, respectively) groups. Multivariate analysis assessed the interaction between the hyperglycemia and ischemic stroke subtypes of large artery atherothrombosis (LAA), cardioembolism (CE), and small vessel occlusion (SVO) and early vascular outcomes (3-month stroke, all-cause mortality, and composite of stroke, MI, and all-cause mortality).
Article Synopsis
- The study investigated the prevalence of 15 genetic variants associated with stroke in a large, unselected cohort of young patients, highlighting that heritability might not be low among this demographic.
- Out of 1,033 patients, 12.7% were found to have clinically relevant genetic variants, predominantly in the RNF213, ABCC6, and NOTCH3 genes, with variation in frequency based on stroke subtype and age group.
- Notably, most patients with these variants did not exhibit typical neuroimaging features of the related disorders, indicating the need for further research on the clinical significance of these genetic findings.
Article Synopsis
- A study analyzed data from over 14,000 ischemic stroke patients to investigate early neurologic deterioration (END) due to stroke progression or recurrence, finding that 11.6% of patients experienced this complication.
- Among those with END, active management was applied to 64.2% of patients, using various strategies like volume expansion and changes in medication to address the issue.
- Patients receiving active management showed significantly better outcomes, with increased rates of functional independence and reduced disability three months post-stroke compared to those who did not receive active management.
Background: We aimed to evaluate covert brain infarction (CBI), frequently encountered during the diagnostic work-up of acute ischemic stroke, as a risk factor for stroke recurrence in patients with atrial fibrillation (AF).
Methods: For this prospective cohort study, from patients with acute ischemic stroke hospitalized at 14 centers between 2017 and 2019, we enrolled AF patients without history of stroke or transient ischemic attack and divided them into the CBI (+) and CBI (-) groups. The 2 groups were compared regarding the 1-year cumulative incidence of recurrent ischemic stroke and all-cause mortality using the Fine and Gray subdistribution hazard model with nonstroke death as a competing risk and the Cox frailty model, respectively.
Article Synopsis
- This study investigated how low-density lipoprotein cholesterol (LDL-C) levels impact recovery after intravenous thrombolysis (IVT) in stroke patients, based on whether they used statins before the stroke.
- Among the 4711 patients analyzed, those with low to intermediate LDL-C levels did not show improved outcomes compared to those with high LDL-C, indicating that overall LDL-C levels alone are not linked to recovery at 3 months post-treatment.
- However, for patients who took statins before their stroke, lower LDL-C levels were associated with better recovery outcomes, suggesting that statin use may influence how LDL-C affects recovery after an ischemic stroke.
Underweight predicts poststroke cardiovascular events in patients without atrial fibrillation.
J Stroke Cerebrovasc Dis
October 2022
Background And Purpose: The purpose of this study was to determine whether underweight is associated with poststroke cardiovascular events and whether such association is different according to the presence of atrial fibrillation (AF).
Methods: Patients with acute stroke or transient ischemic attack who were prospectively registered in a multicenter stroke database from April 2008 to July 2020 were analyzed, excluding those aged 75 or older and those who were overweight. We prospectively captured major adverse cardiovascular events (MACE) within one year after stroke.
Background Previous literature about the effect of heart rate on poststroke outcomes is limited. We attempted to elucidate (1) whether heart rate during the acute period of ischemic stroke predicts subsequent major clinical events, (2) which heart rate parameter is best for prediction, and (3) what is the estimated heart rate cutoff point for the primary outcome. Methods and Results Eight thousand thirty-one patients with acute ischemic stroke who were hospitalized within 48 hours of onset were analyzed retrospectively.
View Article and Find Full Text PDFBackground: Stroke of other determined etiology (OE) includes patients with an uncommon cause of stroke. We described the general characteristics, management, and outcomes of stroke in OE and its subgroups.
Methods: This study is a retrospective analysis of a prospective, multicenter, nationwide registry, the Clinical Research Center for Stroke-Korea-National Institutes of Health registry.
Background Although the effect of blood pressure on poststroke outcome is well recognized, the long-term trajectory of blood pressure after acute ischemic stroke and its influence on outcomes have not been studied well. Methods and Results We analyzed systolic blood pressure (SBP) measurements in 5514 patients with acute ischemic stroke at ≥2 of 7 prespecified time points during the first year after stroke among those enrolled in a multicenter prospective registry. Longitudinal SBPs were categorized using a group-based trajectory model.
View Article and Find Full Text PDFBackground And Purpose: Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia.
Methods: This multicenter, prospective, single-arm trial involved 27 centers in South Korea.
Background It remains unclear whether physicians' attitudes toward timely management of elevated blood pressure affect the risk of stroke recurrence. Methods and Results From a multicenter stroke registry database, we identified 2933 patients with acute ischemic stroke who were admitted to participating centers in 2011, survived at the 1-year follow-up period, and returned to outpatient clinics ≥2 times after discharge. As a surrogate measure of physicians' attitude, individual treatment intensification (TI) scores were calculated by dividing the difference between the frequencies of observed and expected medication changes by the frequency of clinic visits and categorizing them into 5 groups.
View Article and Find Full Text PDFObjective: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods.
Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.
Detecting early infarct (EI) plays an essential role in patient selection for reperfusion therapy in the management of acute ischemic stroke (AIS). EI volume at acute or hyper-acute stage can be measured using advanced pre-treatment imaging, such as MRI and CT perfusion. In this study, a novel multi-task learning approach, EIS-Net, is proposed to segment EI and score Alberta Stroke Program Early CT Score (ASPECTS) simultaneously on baseline non-contrast CT (NCCT) scans of AIS patients.
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