Publications by authors named "Victor Obach"

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).

View Article and Find Full Text PDF
Article Synopsis
  • Anti-CGRP monoclonal antibodies are effective treatments for preventing migraines, but patients show varied responses, influenced by specific clinical factors.
  • A study involving over 5,800 patients identified key predictors of treatment response at 6 months, including older age, unilateral pain, absence of depression, fewer monthly migraine days, and lower disability levels.
  • The findings highlight that higher migraine frequency and greater baseline disability negatively impact treatment effectiveness, which can inform future patient management and reimbursement policies.
View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Galcanezumab has shown efficacy and effectiveness in the treatment of episodic and chronic migraine (CM), however, the population represented in randomized clinical trials (RCTs) differs from the population observed in real-world setting. To describe the long-term effectiveness and tolerability of galcanezumab in clinical practice in patients excluded from RCTs.

Methods: Multicenter prospective cohort study of consecutive patients with chronic and high-frequency episodic migraine (HFEM) with prior failure to three or more migraine preventive drugs, treated with galcanezumab and followed up for 12 months.

View Article and Find Full Text PDF

Background: Occult atrial fibrillation (AF) is one of the major causes of embolic stroke of undetermined source (ESUS). Knowing the underlying etiology of an ESUS will reduce stroke recurrence and/or unnecessary use of anticoagulants. Understanding cardioembolic strokes (CES), whose main cause is AF, will provide tools to select patients who would benefit from anticoagulants among those with ESUS or AF.

View Article and Find Full Text PDF

During the first hours after stroke onset, neurological deficits can be highly unstable: some patients rapidly improve, while others deteriorate. This early neurological instability has a major impact on long-term outcome. Here, we aimed to determine the genetic architecture of early neurological instability measured by the difference between the National Institutes of Health Stroke Scale (NIHSS) within 6 h of stroke onset and NIHSS at 24 h.

View Article and Find Full Text PDF

Objectives: After an acute ischemic stroke, patients with a large CT perfusion (CTP) predicted infarct core (pIC) have poor clinical outcome. However, previous research suggests that this relationship may be relevant for subgroups of patients determined by pretreatment and treatment-related variables while negligible for others. We aimed to identify these variables.

View Article and Find Full Text PDF

Background And Objectives: The presence of postinterventional subarachnoid hyperdensities (SA-HD) is a relatively common finding after mechanical thrombectomy (MT). We aimed to assess the incidence, characteristics, clinical relevance, and predictors of SA-HD after MT as categorized through the use of postinterventional dual-energy CT (DE-CT).

Methods: A single-center consecutive series of patients with acute stroke treated with MT was retrospectively reviewed.

View Article and Find Full Text PDF

Background And Purpose:  In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors.

Methods:  Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019.

View Article and Find Full Text PDF
Article Synopsis
  • Stroke is a leading cause of death and disability, with reperfusion therapies being the only acute treatment; however, recent trials suggest a longer time window for these therapies may increase severe complications like parenchymal hematoma (PH).
  • The study aimed to identify genetic risk factors associated with PH in order to find potential preventive or treatment targets and explored genetic links to other conditions.
  • A genome-wide association study (GWAS) identified a significant variant (rs79770152) and a suggestive one (rs13297983) related to PH, revealing genetic overlaps with Alzheimer's disease and other brain conditions.
View Article and Find Full Text PDF
Article Synopsis
  • Haemorrhagic transformation is a serious complication of a treatment called recombinant tissue-plasminogen activator for stroke, with parenchymal haematoma leading to severe health issues.
  • The study aimed to identify genetic variations that increase the risk of developing parenchymal haematoma after thrombolytic therapy in patients with acute ischaemic stroke using a large genome-wide meta-analysis of nearly 2,000 individuals.
  • A specific single nucleotide polymorphism (rs76484331) within the ZBTB46 gene was significantly associated with parenchymal haematoma, suggesting the gene may play a critical role in this dangerous complication following stroke treatment.
View Article and Find Full Text PDF

Background And Purpose: Large-scale observational studies of acute ischemic stroke (AIS) promise to reveal mechanisms underlying cerebral ischemia. However, meaningful quantitative phenotypes attainable in large patient populations are needed. We characterize a dynamic metric of AIS instability, defined by change in National Institutes of Health Stroke Scale score (NIHSS) from baseline to 24 hours baseline to 24 hours (NIHSS - NIHSS = ΔNIHSS), to examine its relevance to AIS mechanisms and long-term outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • Early neurological instability after stroke is linked to genetic factors, with 8.7% of variability in patient recovery explained by common genetic variations, indicating a distinct genetic architecture from stroke risk itself.!* -
  • The study identified seven significant genetic loci associated with early changes in neurological deficits, their collective influence accounting for 2.1% of variability, while additional factors likely play a role.!* -
  • Findings suggest that excitotoxicity, involving specific genes expressed in neurons, may contribute to the early instability observed post-stroke, marking a new area for research in acute ischemic stroke outcomes.!*
View Article and Find Full Text PDF

Objectives: Recent small subcortical infarcts (RSSI) are considered an acute manifestation of cerebral small vessel disease. Paramagnetic signals in perforating arteries supplying RSSI may be detected on T2*-relaxation derived sequences on MRI and is defined as susceptibility vessel sign (SVS). We aimed to study the prevalence of SVS in patients with RSSI, and explore whether its identification is related to cerebral small vessel disease markers.

View Article and Find Full Text PDF

Background: The evolution of the symptomatic intracranial occlusion during transfers from primary stroke centers (PSCs) to comprehensive stroke centers (CSCs) for endovascular treatment (EVT) is not widely known. Our aim was to identify factors related to partial or complete recanalization (REC) at CSC arrival in patients with a documented large vessel occlusion (LVO) in PSC transferred for EVT evaluation to better define the workflow at CSC of this group of patients.

Methods: We conducted an observational, multicenter study from a prospective, government-mandated, population-based registry of stroke patients with documented LVO at PSC transferred to CSC for EVT from January 2017 to June 2019.

View Article and Find Full Text PDF

Background And Aims: Emergent stent placement may be required during neurothrombectomy. Our aim was to investigate the incidence, predictors and clinical relevance of early extracranial carotid stent occlusion following neurothrombectomy.

Methods: We retrospectively analyzed a cohort of 761 consecutive neurothrombectomies performed at our center between May 2010 and August 2018, from whom a total of 106 patients had acute internal carotid artery occlusions.

View Article and Find Full Text PDF

Background And Purpose: Acute onset aphasia may be due to stroke but also to other causes, which are commonly referred to as stroke mimics. We hypothesized that, in patients with acute isolated aphasia, distinct brain perfusion patterns are related to the cause and the clinical outcome. Herein, we analyzed the prognostic yield and the diagnostic usefulness of computed tomography perfusion (CTP) in patients with acute isolated aphasia.

View Article and Find Full Text PDF

Several pretreatment variables such as elevated glucose and hypoperfusion severity are related to brain hemorrhage after endovascular treatment of acute stroke. We evaluated whether elevated glucose and severe hypoperfusion have synergistic effects in the promotion of parenchymal hemorrhage (PH) after mechanical thrombectomy (MT). We included 258 patients MT-treated who had a pretreatment computed tomography perfusion (CTP) and a post-treatment follow-up MRI.

View Article and Find Full Text PDF

Background: Single-center studies have suggested that the early clinical course after mechanical thrombectomy (MT) in patients with ischemic stroke is a clinical predictor of long-term outcome.

Objective: To analyze the prognostic value of clinical improvement within 24 hours in a population-based multicenter cohort.

Methods: From a total of 3792 patients with acute ischemic stroke in Catalonia (CICAT registry), 1951 patients were treated with MT.

View Article and Find Full Text PDF

Background And Purpose: The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center.

Methods: On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19.

View Article and Find Full Text PDF

About half of acute stroke patients treated with mechanical thrombectomy (MT) do not show clinical improvement despite successful recanalization. Early arterial reocclusion (EAR) may be one of the causes that explain this phenomenon. We aimed to analyze the incidence and clinico-radiological correlations of EAR after successful MT.

View Article and Find Full Text PDF
Article Synopsis
  • Acenocoumarol is a blood thinner that shows different dosage needs among individuals due to genetic differences, specifically variants in CYP2C9 and VKORC1 genes.
  • Researchers conducted a study on 78 Spanish stroke patients using a genome-wide association study to identify genetic variants linked to acenocoumarol dosage and complications like stroke recurrence and intracranial hemorrhage.
  • They found 14 genetic variants related to dosage, with specific ones linked to stroke recurrence (6 variants) and intracranial hemorrhage (4 variants), emphasizing the importance of pharmacogenetic studies for improving anticoagulant therapy safety and effectiveness.
View Article and Find Full Text PDF

Background and Purpose- Peripheral immune cells are activated after stroke and may in turn influence the fate of ischemic brain tissue, thus exerting a dual role in ischemic stroke. We evaluated the contribution of neutrophil and lymphocyte counts to hemorrhagic complications and functional outcome in stroke patients treated with mechanical thrombectomy (MT) with varying degrees of collateral circulation and reperfusion. Methods- We retrospectively analyzed 433 consecutive ischemic stroke patients treated with MT.

View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: