Background: Moyamoya disease (MMD) is considered a progressive disease with an ongoing risk of recurrent stroke. However, there is a lack of long-term observational data to quantify the extent of the stroke risk.
Methods: This study aimed to provide insight into the long-term stroke risk in MMD and explore possible risk factors for stroke. Records from all patients diagnosed with MMD in 13 clinical departments from 6 different Danish hospitals between 1994 and 2017 were retrospectively reviewed until 2021.
Results: The cohort comprised 50 patients (33 females and 17 males). Patients were followed up for a median of 9.4 years, with more than 10 years of follow-up for 24 patients. Ten patients had 11 new stroke events-6 ischemic strokes and 5 brain hemorrhages. Events occurred at a median of 7 years and up to 25 years after diagnosis. The overall Kaplan-Meier 5-year stroke risk was 10%. Patients with bypass performed had significantly fewer events than conservatively treated patients (HR 0.25, 95% confidence interval (CI) 0.07-0.91, p < 0.05). All but one event occurred in females, a difference that reached statistical significance.
Conclusions: The study provides data on the extent of the risk of recurrent stroke in MMD. Bypass surgery patients had fewer stroke events than those treated conservatively. There was a trend toward a higher stroke risk in females.
Data Access Statement: The data supporting this study's findings are available from the corresponding author upon reasonable request.
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http://dx.doi.org/10.1177/17474930231216037 | DOI Listing |
JAMA Intern Med
January 2025
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Importance: Evidence on cardiovascular benefits and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors is mainly from placebo-controlled trials. Therefore, the comparative effectiveness and safety of individual SGLT-2 inhibitors remain unknown.
Objective: To compare the use of canagliflozin or dapagliflozin with empagliflozin for a composite outcome (myocardial infarction [MI] or stroke), heart failure hospitalization, MI, stroke, all-cause death, and safety outcomes, including diabetic ketoacidosis (DKA), lower-limb amputation, bone fracture, severe urinary tract infection (UTI), and genital infection and whether effects differed by dosage or cardiovascular disease (CVD) history.
JAMA Neurol
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Importance: Trials have not demonstrated superiority of alteplase or tenecteplase vs standard care in patients with mild stroke and have raised safety concerns. Prourokinase is an alternative fibrinolytic that may have a favorable safety profile, and the benefit-risk profile of prourokinase in mild stroke is unknown.
Objective: To investigate the efficacy and safety of prourokinase in mild ischemic stroke within 4.
Stem Cells Dev
January 2025
Department of Clinical Pharmacy and Pharmacy Practices, Faculty of Pharmacy, University Malaya, Kuala Lumpur, Malaysia.
Hypertension, commonly known as high blood pressure, is a significant health issue that increases the risk of cardiovascular diseases, stroke, and renal failure. This condition broadly encompasses both primary and secondary forms. Despite extensive research, the underlying mechanisms of systemic arterial hypertension-particularly primary hypertension, which has no identifiable cause and is affected by genetic and lifestyle agents-remain complex and not fully understood.
View Article and Find Full Text PDFRadiology
January 2025
From the Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany (L.M., G.B., P.S., J.F., C.P.S.); Dept of Diagnostic and Interventional Neuroradiology, Hosp Bremen-Mitte, Bremen, Germany (M.A., P.P.); Interventional Neuroradiology Section, Dept of Radiology, Donostia Univ Hosp, Donostia-San Sebastián, Spain (Á.L., J.Á.L.); Clinic for Radiology, Section for Interventional Radiology, Univ of Münster and Univ Hosp Münster, Münster, Germany (W.S., H.K., C.P.S.); Dept of Neuroradiology, Westpfalz-Klinikum, Kaiserslautern, Germany (W.N.); Dept of Neuroradiology, Otto-von-Guericke-Universitätsklinikum Magdeburg, Magdeburg, Germany (D.B., M.T.); Inst for Diagnostic and Interventional Radiology and Neuroradiology, Univ Hosp Essen, Essen, Germany (H.S., C.D.); Dept of Neuroradiology, Univ of Cologne, Cologne, Germany (C.K., C.Z.); Dept of Neuroradiology, Univ Hosp Aachen, Aachen, Germany (C.W., M. Möhlenbruch); Dept of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical Univ Munich, Munich, Germany (M.R.H.P., C.M.); Inst of Neuroradiology, Univ Hosps, LMU Munich, Munich, Germany (H.Z.); Dept of Diagnostic and Interventional Neuroradiology, Univ Medical Ctr Goettingen, Goettingen, Germany (M. Ernst, A.J.); Interventional Neuroradiology, Dept of Radiology, Hosp Clínico San Carlos, Madrid, Spain (M.M.G., C.P.G.); Dept of Neuroradiology, Hosp Universitario La Paz, Madrid, Spain (P.N., A.F.P.); Div of Neurology, Dept of Medicine (L.Y., B.T.), and Div of Interventional Radiology, Dept of Diagnostic Imaging (A.G.), National Univ Health System, Singapore; Yong Loo Lin School of Medicine, National Univ of Singapore, Singapore (L.Y., B.T., A.G.); Inst of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany (E.S., M. Miszczuk); Dept of Neuroradiology, Clinic and Policlinic of Radiology, Univ Hosp Halle/Saale, Halle, Germany (S.S.); Dept of Radiology and Neuroradiology, Stadtspital Zürich, Zürich, Switzerland (P.S.); Dept of Diagnostic and Interventional Neuroradiology, Univ Hosp Basel, Basel, Switzerland (P.S., M.P.); Depts of Interventional Neuroradiology (J.Z.P.) and Neurology (G.P.), Hosp Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Dept of Neuroradiology, Karolinska Univ Hosp and Dept of Clinical Neuroscience, Karolinska Inst, Stockholm, Sweden (F.A., T.A.); Dept of Medical Imaging, AZ Groeninge, Kortrijk, Belgium (T.A.); Dept of Radiology, Comenius Univ's Jessenius Faculty of Medicine and Univ Hosp, Martin, Slovakia (K.Z.); Dept of Radiology, Aretaieion Univ Hosp, National and Kapodistrian Univ of Athens, Athens, Greece (P.P.); Dept of Neuroradiology, Univ Hosp Marburg, Marburg, Germany (A.K.); Dept of Neuroradiology, Univ Hosp of Bonn, Bonn, Germany (F.D.); and Dept of Neuroradiology, Alfried Krupp Krankenhaus, Essen, Germany (M. Elsharkawy).
Background Symptomatic acute occlusions of the internal carotid artery (ICA) below the circle of Willis can cause a variety of stroke symptoms, even if the major intracranial cerebral arteries remain patent; however, outcome and safety data are limited. Purpose To compare treatment effects and procedural safety of endovascular treatment (EVT) and best medical treatment (BMT) in patients with symptomatic acute occlusions of the ICA below the circle of Willis. Materials and Methods This retrospective, multicenter cohort study from 22 comprehensive stroke centers in Europe and Asia includes patients treated between January 1, 2008, and December 31, 2022.
View Article and Find Full Text PDFFront Neurol
January 2025
Department of Vascular Neurosurgery, New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China.
Objective: Carotid artery stenosis, primarily caused by atherosclerosis, is a major risk factor for ischemic stroke. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established interventions to reduce stroke risk and restore cerebral blood flow. However, the effect of these treatments on circadian rhythms, and their influence on stroke recovery, remains underexplored.
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