Publications by authors named "Vanacker P"
Background And Objectives: Covert brain infarcts (CBIs) in patients with first-ever ischemic stroke (IS) and atrial fibrillation (AF) are associated with an increased risk of stroke recurrence. We aimed to assess whether CBIs modify the treatment effect of early vs late initiation of direct oral anticoagulants (DOACs) in patients with IS and AF.
Methods: We conducted a post hoc analysis of the international, multicenter, randomized-controlled ELAN trial, which compared early (<48 hours after ischemic stroke for minor and moderate stroke, 6-7 days for major stroke) vs late (>48 hours for minor, 3-4 days for moderate, 12-14 days for major stroke) initiation of DOACs in patients with IS and AF.
Article Synopsis
- * Symptoms typically develop hours to days following the trauma or after procedures like bone reduction.
- * MRI scans can reveal diffuse neurological damage, and in this case, symptoms emerged in the recovery ward with a complete blockage in the left middle cerebral artery due to fat particles.
Article Synopsis
- Achieving first-pass recanalization (FPR) during thrombectomy is crucial for better clinical outcomes in acute ischemic stroke patients, making it important to understand the factors that cause FPR failures.
- This study examined the relationship between thrombus composition and the success rates of FPR by analyzing thrombi from 267 stroke patients.
- Results showed that thrombi leading to successful FPR had more red blood cells and less fibrin and extracellular DNA, suggesting that certain thrombus characteristics can influence the likelihood of achieving FPR.
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.
Pet food production is a fast-growing industry. While extruded dry pet food is the favored pet food due to its convenience of use, it may have poorer palatability than other pet foods such as wet pet foods. However, palatability plays a pivotal role in meeting nutritional requirements or providing therapeutic benefits in cats and dogs, as it ensures food acceptance.
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- Researchers studied how the composition of blood clots (thrombi) affects their breakdown by r-tPA, a treatment for acute ischemic stroke.
- They found that thrombi with more red blood cells are easier to dissolve than those with higher levels of DNA and von Willebrand Factor.
- Adding DNase-1 or N,N'-diacetyl-l-cystine to r-tPA treatments significantly improved the breakdown of harder-to-treat thrombi.
Aims: The aim of this study is to determine the feasibility, detection rate, and therapeutic implications of large-scale smartphone-based screening for atrial fibrillation (AF).
Methods And Results: Subjects from the general population in Belgium were recruited through a media campaign to perform AF screening during 8 consecutive days with a smartphone application. The application analyses photoplethysmography traces with artificial intelligence and offline validation of suspected signals to detect AF.
Article Synopsis
- The study investigates the best treatment approach for patients with mechanical heart valves experiencing acute ischemic strokes while on vitamin K antagonists, comparing bridging therapy with full dose heparin to nonbridging therapy without heparin.
- Data was collected from multiple centers via retrospective registries, with a focus on outcomes such as stroke, bleeding, and embolism after 90 days using propensity score matching to ensure accurate comparisons.
- Results indicated that while bridging therapy was associated with a higher incidence of adverse events, both strategies presented risks, with bridging patients showing a marginally increased risk for ischemic and bleeding complications compared to the nonbridging group.
Article Synopsis
- * Through focus group discussions with decision-makers, the study identifies seven inter-related barriers and recommendations for implementing population health management, emphasizing the necessity for shared responsibilities, improved data infrastructure, and community engagement.
- * The authors conclude that an urgent collaborative effort is needed from all stakeholders in Belgium to create a unified vision for population health management, which could lead to effective secondary prevention strategies for cardiovascular diseases.
Background: The effect of early as compared with later initiation of direct oral anticoagulants (DOACs) in persons with atrial fibrillation who have had an acute ischemic stroke is unclear.
Methods: We performed an investigator-initiated, open-label trial at 103 sites in 15 countries. Participants were randomly assigned in a 1:1 ratio to early anticoagulation (within 48 hours after a minor or moderate stroke or on day 6 or 7 after a major stroke) or later anticoagulation (day 3 or 4 after a minor stroke, day 6 or 7 after a moderate stroke, or day 12, 13, or 14 after a major stroke).
Objective: Lipid-lowering drugs are among the most widely used drugs in cardiovascular prevention. Statins are often abandoned due to side effects, or under dosed, leading to unreached LDL-cholesterol goals and increased occurrence of cardiovascular events.
Methods: We included hospitalized patients with an ischemic stroke or transient ischemic attack.
Osteoarthritis is a frequently occurring joint disorder in veterinary practice. Current treatments are focused on pain and inflammation; however, these are not able to reverse the pathological condition. Mesenchymal stem cells (MSCs) could provide an interesting alternative because of their immunomodulatory properties.
View Article and Find Full Text PDFIntroduction: Ischemic stroke is the second cause of death and leading cause of severe disability worldwide. A reduced features set of CT-DRAGON (age, NIHSS on admission and pre-stroke mRS) predicts 90-day functional outcome after stroke in a single center. The current study was designed to validate this adapted CT-DRAGON score in three major Belgian hospitals, in the framework of future case-mix adjustment.
View Article and Find Full Text PDFBackground And Objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).
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- Recent studies showed a rise in cerebral venous thrombosis (CVT) cases during the COVID-19 pandemic, prompting this evaluation of hospitalization and mortality rates comparing the pandemic year (2020) to the year prior (2019).
- A cross-sectional study analyzed data from 171 stroke centers worldwide, focusing on CVT admissions and associated mortality from January 2019 to May 2021, revealing no significant differences in overall CVT volume or mortality between 2019 and 2020.
- However, the first five months of 2021 saw a notable increase in CVT admissions compared to 2019 and 2020, with higher mortality rates linked to COVID-19-positive patients and instances of vaccine-induced immune
Article Synopsis
- A study was conducted on patients with atrial fibrillation who had an ischemic stroke while using nonvitamin K antagonist oral anticoagulants to determine rates and risk factors for recurrent ischemic and bleeding events.
- Over an average follow-up of about 15 months, 15.5% of the 1,240 patients experienced 207 events, including ischemic strokes and major bleeding incidents, with specific risk factors identified for each type of event.
- The rates of ischemic and bleeding events did not significantly differ between patients who changed their anticoagulant treatment and those who continued with it.
Article Synopsis
- - The study of ischemic stroke thrombi has become important, particularly with the rise of endovascular procedures, allowing researchers to analyze the actual thrombus material from patients.
- - Stroke thrombi are complex and made up of various biochemical and cellular elements, which may pose challenges in treatment but also provide new insights into stroke management.
- - Understanding the characteristics of thrombus composition could improve outcomes in stroke treatment, including the success of thrombectomy procedures and overall patient care.
A worldwide decline in stroke hospitalizations during the COVID-19 pandemic has been reported. Information on stroke care during the pandemic in Belgium is lacking. This study aims to analyze the impact of COVID-19 on acute stroke care in eight Belgian stroke centers.
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.
Background: Mechanical removal of a thrombus by thrombectomy can be quite challenging. For reasons that are not fully understood, some thrombi require multiple passes to achieve successful recanalization, whereas other thrombi are efficiently removed in a single pass. Since first pass success is associated with better clinical outcome, it is important to better understand the nature of thrombectomy resistant thrombi.
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- The study aimed to evaluate the risks of recurrent ischemic events and severe bleeding in patients with acute posterior ischemic stroke (PS) and atrial fibrillation (AF) in relation to oral anticoagulant therapy (OAT) and timing of initiation.
- Researchers compared outcomes in 473 patients with PS to 1997 patients with anterior stroke (AS), focusing on events within 90 days of the initial stroke.
- Findings indicated that both PS and AS patients had similar risks of ischemic or hemorrhagic events at 90 days, regardless of when OAT was initiated.
Background: Studies on the use of non-vitamin K antagonist oral anticoagulants in unselected patients with atrial fibrillation (AF) show that clinical characteristics and dosing practices differ per region, but lack data on edoxaban.
Methods: With data from Edoxaban Treatment in routiNe clinical prActice for patients with AF in Europe (ETNA-AF-Europe), a large prospective observational study, we compared clinical characteristics (including the dose reduction criteria for edoxaban: creatinine clearance 15-50 ml/min, weight ≤60 kg, and/or use of strong p‑glycoprotein inhibitors) of patients from Belgium and the Netherlands (BeNe) with those from other European countries (OEC).
Results: Of all 13,639 patients in ETNA-AF-Europe, 2579 were from BeNe.
Background: Studies on the use of non-vitamin K antagonist oral anticoagulants in unselected patients with atrial fibrillation (AF) show that clinical characteristics and dosing practices differ per region, but lack data on edoxaban.
Methods: With data from Edoxaban Treatment in routiNe clinical prActice for patients with AF in Europe (ETNA-AF-Europe), a large prospective observational study, we compared clinical characteristics (including the dose reduction criteria for edoxaban: creatinine clearance 15-50 mL/min, weight ≤60 kg, and/or use of strong p-glycoprotein inhibitors) of patients from Belgium and the Netherlands (BeNe) with those from other European countries (OEC).
Results: Of all 13,639 patients in ETNA-AF-Europe, 2579 were from BeNe.