Publications by authors named "Yuesong Pan"

Background: Covert brain infarction (CBI) is common and poses a potential and non-negligible burden of disease worldwide. The prevalence and risk factors for CBI have been reported inconsistently in previous studies.

Aims: This study aims to ascertain the prevalence and risk factors of CBI and its imaging phenotypes in community-dwelling adults.

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Background: Stroke-induced transient immune suppression is believed to contribute to post-stroke infections. The β-adrenergic receptor antagonist, propranolol, has been shown to prevent stroke-associated pneumonia (SAP) via reversing post-stroke immunosuppression in preclinical studies and in retrospective analysis in stroke patients. However, whether propranolol can reduce the risk of SAP has not been tested in prospective, randomised controlled trials.

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Background: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk transient ischemic attack stratified by risk profile.

Methods: This is a secondary post hoc analysis of the INSPIRES (Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracranial or Extracranial Atherosclerosis) randomized clinical trial that enrolled patients 35 to 80 years old with acute mild ischemic stroke or high-risk transient ischemic attack between 2018 and 2022.

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Background: Biological age (BA), an integrated measure of physiological aging, has a clear link to stroke. There is a paucity of long-term longitudinal studies about the association between accelerated biological age and stroke prognosis in patients with previous strokes, and the differences in the predictive ability of various BA indicators calculated from clinical biochemistry biomarkers for future stroke outcomes are still unknown. To evaluate the role of three accelerated BA indicators for short- and long-term prognosis of patients with ischemic stroke or transient ischemic attack (TIA), and to identify the most appropriate predictor.

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Objectives: Our study aims to examine the value of endovascular therapy (EVT) and its comparison to medical management (MM) in ischaemic stroke patients accompanied by large artery atherosclerosis (LAA) and non-LAA METHODS: modified Rankin scale score (mRS) was evaluated at 90 days post the stroke attack and was considered as the primary outcome. Other outcomes measured in this study included score changes of 0-2 and 0-3 on the mRS. The occurrence of symptomatic intracranial haemorrhage at 24 hours after EVT was also measured as a safety endpoint.

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Background And Objectives: Randomized trials have proven the benefit of endovascular therapy (EVT) for acute large ischemic stroke. This study was to characterize the effect of time to treatment on benefit of EVT vs medical management (MM) among patients with large ischemic stroke.

Methods: This was a post hoc analysis of the Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core randomized trial.

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Background: Non-insulin-based insulin resistance (IR) indices, simple and reliable surrogates for IR calculated without insulin level, have been reported to be associated with cardiovascular and cerebrovascular diseases.

Methods: Participants without diabetes from the cross-sectional baseline survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in present study. Non-insulin-based IR indices, including triglyceride and glucose (TyG) index, triglyceride glucose-body mass (TyG-BMI) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index, were calculated and stratified into quartiles.

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Background: Both high-sensitive C-reactive protein (hsCRP) and CYP2C19 genotypes are independent predictors of clinical outcomes after ischemic stroke. We aim to evaluate the association of CYP2C19 loss-of-function alleles (LoFA) carrying status with the effects of dual/single antiplatelet therapy at different hsCRP levels using the CHANCE trial.

Methods: Subjects with both of CYP2C19 major alleles information (*2, *3, and *17) and hsCRP measurements were enrolled from the prespecified subgroup.

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Background: The time to maximum (Tmax) profile based on computed tomography perfusion (CTP) provides a quantitative assessment of cerebral hemodynamic compromise. We aimed to delineate the Tmax profile in stroke patients with symptomatic intracranial atherosclerotic stenosis (ICAS) and to investigate its predictive role in stroke recurrence after optimal medical treatment.

Methods: Consecutive patients with ischemic stroke within 30 days attributed to 50%-99% ICAS were prospectively enrolled.

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Objectives: Different classification of multiple acute infarctions (MAIs) existed in minor posterior circulation stroke (PCS). We aimed to explore the association between different patterns of MAIs and long-term prognosis in minor PCS.

Materials And Methods: We derived data from Chinese Intracranial Atherosclerosis (CICAS) study.

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Aim: D-dimer, lipoprotein (a) (Lp(a)), and high-sensitivity C-reactive protein (hs-CRP) are known predictors of vascular events; however, their impact on the stroke prognosis is unclear. This study used data from the Third China National Stroke Registry (CNSR-III) to assess their combined effect on functional disability and mortality after acute ischemic stroke (AIS).

Methods: In total, 9,450 adult patients with AIS were enrolled between August 2015 and March 2018.

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Background: The purpose of this study was to explore the relationship between atrial fibrillation (AF), cerebral small vessel disease (CSVD), and ischemic stroke.

Methods: Data were extracted from China's Third National Stroke Registry (CNSR-III), which registered 15,166 patients in China. A total of 12,180 ischemic stroke patients were included excluding those diagnosed with TIA or without MRI.

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Introduction: Oculomotor and gait dysfunctions are closely associated with cognition. However, oculo-gait patterns and their correlation with cognition in cerebral small vessel disease (CSVD) remain unclear.

Methods: Patients with CSVD from a hospital-based cohort (n = 194) and individuals with presumed early CSVD from a community-based cohort (n = 319) were included.

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Article Synopsis
  • This study aimed to compare the effectiveness and safety of two treatments, tenecteplase and alteplase, for patients with acute ischemic stroke, focusing on those with diabetes and high blood sugar at admission.
  • It analyzed data from 1382 participants in China, finding no significant differences in functional outcomes or risks of bleeding between the two treatments for both diabetic and non-diabetic patients.
  • The results suggest that tenecteplase is as safe and effective as alteplase for stroke treatment, regardless of a patient's glucose levels.
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Background: Prediction of short-term outcomes in young patients with acute ischemic stroke (AIS) may assist in making therapy decisions. Machine learning (ML) is increasingly used in healthcare due to its high accuracy. This study aims to use a ML-based predictive model for poor 3-month functional outcomes in young AIS patients and to compare the predictive performance of ML models with the logistic regression model.

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Article Synopsis
  • - The study focuses on the safety and effectiveness of using intra-arterial (IA) tenecteplase in patients with large vessel occlusion (LVO) stroke who have already undergone successful reperfusion, as many still face dependency or death after three months.
  • - Conducted as a multicenter, open-label, and prospective randomized controlled trial, it aims to enroll up to 256 patients who will be split evenly between receiving IA tenecteplase and best medical management post-reperfusion.
  • - The main goal is to improve outcomes at 90 days measured by the modified Rankin Scale, while monitoring for safety through potential complications like intracranial hemorrhage.
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Background: Previous studies have indicated that a subset of patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) experience spontaneous recanalization (SR), but the prognosis and factors associated with SR in these individuals are not well characterized.

Methods: We conducted a post hoc secondary analysis of the Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients with a Large Infarct Core (ANGEL-ASPECT) trial. SR in the medical management group was defined as a modified arterial occlusive lesion (AOL) grade of 2 or 3 on computed tomography angiography (CTA) or magnetic resonance angiography (MRA) at 36 hours (±12 hours).

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Article Synopsis
  • Lipoprotein-associated phospholipase A activity (Lp-PLA-A) is crucial for understanding inflammation and risk of stroke, especially in patients with symptomatic intracranial atherosclerotic disease (sICAD).
  • A study involving 1,908 patients analyzed the relationship between Lp-PLA-A levels and the incidence of artery-to-artery embolism (AAE), revealing higher rates of cortical infarction as Lp-PLA-A levels increased.
  • Results showed that patients in higher Lp-PLA-A quartiles had significantly higher odds of AAE and cortical infarction, with odds ratios ranging from 1.33 to 1.48 compared to those in the lowest quartile.
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Background And Objectives: Clopidogrel-aspirin initiated within 72 hours of symptom onset is effective in patients with mild ischemic stroke or transient ischemic attack (TIA) in the Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial. Uncertainties remain about the duration of the treatment effect. This study aimed to assess duration of benefit and risk of clopidogrel-aspirin in these patients.

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Article Synopsis
  • - Increased research in neuroscience aims to understand how brain structure and function work together to influence cognitive behaviors, especially in the context of aging.
  • - A new index called the Coupling in Brain Structural connectome and Functional connectome (C-BSF) was developed to measure the relationship between brain structure and function in older adults, utilizing advanced imaging techniques from two large cohorts.
  • - Findings show that structure-function coupling is strongest in the visual network and that weaker coupling correlates with older age and poorer cognitive performance, suggesting important connections between aging, brain function, and cognitive abilities.
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Importance: Prior trials showed that dual antiplatelet therapy could reduce the risk of early new stroke in patients with acute mild ischemic stroke or transient ischemic attack (TIA) within 24 hours of symptom onset. However, it is currently uncertain whether dual antiplatelet therapy can reduce the risk of early new stroke in patients with a more delayed initiation time window.

Objective: To evaluate the efficacy and safety of clopidogrel and aspirin among patients with mild ischemic stroke or TIA when initiated within 24 hours, from more than 24 hours to 48 hours, and from more than 48 hours to 72 hours.

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Importance: The China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2) suggests that early antihypertensive treatment did not reduce the risk of dependency or death in acute ischemic stroke (AIS), compared with delayed treatment. Single subcortical infarction (SSI) is an important stroke subtype, and the association of antihypertensive timing with clinical outcomes is unclear.

Objective: To investigate the association of early vs delayed antihypertensive treatment with clinical outcomes in patients with SSI, stratified by the presence of parent artery disease (PAD) stenosis.

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Background: This study aimed to investigate the relationship between overall obesity, central obesity and brain volumes, as well as to determine the extent to which cardiometabolic and inflammatory measures act as mediators in the association between body mass index (BMI), waist-hip ratio (WHR) and brain volumes.

Methods: In the context of counterfactual framework, mediation analysis was used to explore the potential mediation in which cardiometabolic and inflammatory measures may mediate the relationship between BMI, WHR, and brain volumes.

Results: Among 2413 community-dwelling participants, those with high BMI or WHR levels experienced an approximately brain ageing of 4 years.

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Objectives: Endovascular therapy (EVT) now penetrates the once obscure realm of large infarct core volume acute ischaemic stroke (LICV-AIS). This research aimed to investigate the potential correlation between different anaesthetic approaches and post-EVT outcomes in LICV-AIS patients.

Methods: Between October 2020 and May 2022, the China ANGEL-Alberta Stroke Programme Early CT Score (ASPECT) trial studied patients with LICV-AIS, randomly assigning them to the best medical management (BMM) or BMM with EVT.

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