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Comparative Effectiveness of Individual Sodium-Glucose Cotransporter 2 Inhibitors.
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.
A systematic review of current national hospital-based stroke registries monitoring access to evidence-based care and patient outcomes.
Eur Stroke J
January 2025
Stroke and Elderly Care Medicine, University of Edinburgh, Edinburgh, UK.
Background: National stroke clinical quality registries/audits support improvements in stroke care. In a 2016 systematic review, 28 registries were identified. Since 2016 there have been important advances in stroke care, including the development of thrombectomy services.
View Article and Find Full Text PDFHypercoagulable states in young adults with ischemic stroke in a Stroke Belt state: a retrospective study.
Front Neurol
January 2025
Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
We theorize that the southeastern United States has a higher stroke mortality rate and higher recurrent ischemic stroke rate than the rest of the United States due to (1) an increased prevalence of hypercoagulable states among young adults in the region, (2) failure to diagnose hypercoagulable states as the cause of ischemic stroke in young adults, and (3) underutilization of anticoagulation for ischemic stroke secondary prevention in young adults with hypercoagulable states. In an attempt to investigate this hypothesis, we conducted a retrospective chart review of 311 inpatients with first-ever ischemic stroke from age 18 to 55 years at an Oklahoma academic medical center from 1 July 2011 to 30 April 2017. Using Chi-squared test, we compared the stroke etiologic diagnosis of the attending neurologist at discharge-when hypercoagulable profile results were rarely available-to the diagnosis of a vascular neurologist postdischarge who had access to all available etiologic test results.
View Article and Find Full Text PDFEnhancing Thromboembolic Risk Prediction in Non-valvular Atrial Fibrillation: The Critical Role of Transesophageal Echocardiography (TEE).
Cureus
December 2024
Cardiology, Avicenna Military Hospital, Marrakesh, MAR.
Introduction Atrial fibrillation (AF), the most common cardiac arrhythmia, poses challenges in predicting thromboembolic risk. While the CHADS-VASc (congestive heart failure, hypertension, age ≥ 75 years (doubled), type 2 diabetes mellitus, previous stroke, transient ischemic attack, or thromboembolism (doubled), vascular disease, age 65-74 years, and sex category) score remains essential, its limitations include failure to identify left atrial (LA) thrombus in some patients. Transesophageal echocardiography (TEE) provides superior detection of LA thrombi and thrombogenic factors compared to transthoracic echocardiography (TTE), improving risk stratification, especially in intermediate-risk groups.
View Article and Find Full Text PDFComparing efficacy and safety of low-dose versus standard-dose antiplatelet therapy in stroke patients: a meta-analysis.
Front Pharmacol
January 2025
Department of Pharmacy, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Background: Stroke is the leading cause of disability globally, with antiplatelet therapy being crucial for secondary prevention but also increasing bleeding risks. This requires careful dosage adjustments to balance thrombosis and bleeding risks.
Objective: This study compared the efficacy and safety of low-dose versus standard-dose antiplatelet therapy in stroke patients.
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