Non-Stenotic Carotid Plaques and Rate of DWI-positive MRI in Patients with Lower-Risk Transient or Persistent Minor Neurologic Events: DOUBT Sub Study.

Background & Purpose: Non-stenotic (< 50%) carotid plaques are increasingly recognized as a potential mechanism for ischemic stroke. We assessed the prevalence of such plaques in patients with low-risk neurologic events and evidence of DWI (Diffusion Weighted Imaging)-positive ischemia.

Methods: This is a post-hoc exploratory analysis from the DOUBT study, a prospective, observational, multicenter study of patients with low-risk transient or persistent minor focal neurological symptoms.

High-Power Short-Duration Radiofrequency Application for Faster and Safer Pulmonary Vein Isolation: The POWER-FAST III Trial.

Background: The optimal radiofrequency application (RFa) parameters for safe and durable pulmonary vein isolation (PVI) are debated. High-power short-duration (HPSD) has been used as an alternative to conventional power delivery (CPD).

Objectives: This study sought to compare HPSD 70 W/9-10 s (HPSD-70) with CPD 25-40 W in patients undergoing PVI.

Risk of Uveitis in Dengue Fever Patients: A Population-Based Cohort Study in Taiwan.

Dengue-related ocular complications were considered rare, but recent evidence points to a broader spectrum of manifestations, including uveitis. This study utilized the Taiwan National Health Insurance Research Database (NHIRD) to investigate the incidence of uveitis in dengue patients, aiming to fill this research gap. This population-based, retrospective cohort study utilized the Taiwan National Health Insurance Research Database (NHIRD) and included patients with and without Dengue fever.

Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis.

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.

Differences in coronary microcirculation measurements during regadenoson vs. adenosine - induced hyperemia.

Background: Little is known about the similarity of microcirculation assessment outcomes performed with regadenoson and adenosine. The aim of the current study was to compare coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) assessment using adenosine and regadenoson, and to evaluate predictors regarding the size of differences.

Methods: 44 patients were enrolled and diagnosed between 2021 and 2023.

High-Risk Embolic Sources on Cardiac Computed Tomography in Patients With Acute Ischemic Stroke: A Case-Control Study.

Background: Cardiac computed tomography (CT) is increasingly used to search for cardioembolic sources of acute ischemic stroke (AIS). We assessed the association between high-risk cardioembolic sources on cardiac CT and AIS.

Methods: We performed a case-control study using data from a prospective cohort including consecutive adult patients with suspected stroke who underwent cardiac CT acquired during the initial stroke imaging protocol between 2018 and 2020.

Beyond the Stroke: A Case Report of Multiple Sclerosis.

Multiple sclerosis is an inflammatory, autoimmune demyelinating condition and poses diagnostic challenges due to varied presentations. This case report presents a divergence from typical clinical presentations of multiple sclerosis (MS), as the initial presentation resembled symptoms of a brain stem stroke. Conventionally, MS suspicion arises in the presence of previous neurological deficits or signs of optic neuritis.

Dual antiplatelet therapy after minor strokes or high-risk TIA: Evidence from the Austrian stroke registry.

Background And Purpose: Three large, randomized trials demonstrated the benefit of short-term dual antiplatelet therapy (DAPT) versus monotherapy after non-cardioembolic minor stroke or high-risk transient ischemic attack (TIA). The aim of this study was to evaluate effects of DAPT versus monotherapy on functional outcomes and safety in a real-life setting.

Methods: Patients with minor stroke (NIHSS <4) or high-risk TIA (ABCD2 score ≥4) of non-cardioembolic origin without major vessel occlusion or revascularization therapy (thrombolysis or thrombectomy) treated between 2018 and 2023 were analyzed based on a prospective nationwide stroke unit registry.

Stroke recurrence and all-causemortality in CPAP-treated sleep-disordered-breathing patients.

Background: Obstructive sleep apnea (OSA) affects about 70% of stroke patients and is closely linked to stroke development. It is unclear whether treatment with continuous positive airway pressure (CPAP) reduces the risk of stroke recurrence or mortality in post-stroke patients, partly due to limited follow-up time and small sample sizes of previous studies. To close this knowledge gap, this study investigated changes in stroke recurrence and mortality among CPAP-treated post-stroke patients with sleep-disordered breathing.

Pulsed Field Ablation Using Focal Contact Force-Sensing Catheters for Treatment of Atrial Fibrillation: 1-Year Outcomes of the ECLIPSE AF Study.

Background: Pulsed field ablation (PFA) is a promising treatment for atrial fibrillation. We report 1-year freedom from atrial arrhythmia outcomes using monopolar PFA delivered through 3 commercial, contact force-sensing focal catheters.

Methods: ECLIPSE AF (NCT04523545) was a prospective, single-arm, multicenter study evaluating acute and chronic safety and performance using the CENTAURI system to deliver focal PFA with TactiCath SE, StablePoint, and ThermoCool ST.

The Effect of Cardiopulmonary Exercise Ability to Clinical Outcomes of Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention.

Objective: To analyze the relationship between the cardiopulmonary function and prognosis of patients with coronary heart disease after percutaneous coronary intervention (PCI).

Methods: A total of 153 patients with coronary heart disease who underwent PCI from January 2018 to April 2020 were enrolled in this study. Through careful assessment, cardiopulmonary exercise test (CPX) was performed 5 to 7 days after PCI.

Real-World safety and effectiveness of evolocumab in primary hypercholesterolemia and mixed dyslipidemia in Saudi Arabia.

Introduction: Evolocumab's short-term efficacy and safety were proven in phase-3 clinical trial, but its long-term safety and effectiveness in the Saudi population are yet to be studied. The aim of this study was to assess the long-term safety and effectiveness of evolocumab in Saudi patients with primary hypercholesterolemia or mixed dyslipidemia.

Method: A retrospective cohort study evaluated adult patients who had newly been prescribed evolocumab for hypercholesterolemia or mixed dyslipidemia.

Development of transient ischemic attack risk prediction model suitable for initializing a learning health system unit using electronic medical records.

Background: Patients with transient ischemic attack (TIA) face a significantly increased risk of stroke. However, TIA screening and early detection rates are low, especially in developing countries. This study aims to develop an inclusive and practical TIA risk prediction model using machine learning (ML) that performs well in both hospital and resource-limited clinic settings.

Characterizing TIA and stroke symptomatology in a population-based study: implications for and diagnostic value of FAST-based public education.

Background: Urgent medical treatment is crucial after stroke and transient ischemic attack (TIA), but hindered by extensive prehospital delays. Public education campaigns based on FAST (Face-Arm-Speech-Time) have improved response after major stroke, but not minor stroke and TIA. We aimed to provide strategies to improve public education on a national level, by characterizing TIA and stroke symptoms in a population-based cohort, and extrapolating findings to the general Dutch population.

Statins' effect on quality of life and functioning in older stroke patients: Systematic review and meta-analysis.

Background: Limited evidence exists on the efficacy and safety of statins in older ischemic stroke or transient ischemic attack patients, particularly in frail individuals. Studies often exclude frail patients, limiting insights on optimal treatments for the entire older population. This review aims to evaluate the effect of statins for secondary prevention on quality of life and functioning in older patients following an ischemic stroke or transient ischemic attack, as these outcomes are aligned with the treatment goals of this patient population.

Co-occurrence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients: a multicentre observational study.

Background: The co-occurrence of frailty, sarcopenia and malnutrition has been well studied in inpatient and nursing home settings, which are associated with a higher risk of all-cause mortality. However, multicentre data from community-dwelling outpatient settings are lacking. Therefore, we aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap, and the associated factors in community-dwelling older outpatients.

Much More Than a Stroke: Emery-Dreifuss Muscular Dystrophy Type 2 Revealed by Ischemic Stroke.

Emery-Dreifuss muscular dystrophy type 2 (EDMD2) is a rare autosomal dominant neuromuscular disorder caused by LMNA gene mutations and characterized by progressive skeletal muscle weakness and significant cardiac involvement. We report the case of a 45-year-old woman who presented with sudden-onset, left-sided hemiparesis and dysarthria. Initial imaging was unremarkable, and symptoms transiently improved, suggesting a transient ischemic attack.

Surgical Explantation of an Amplatzer Device for Patent Foramen Ovale Closure in a Patient With Nickel Allergy: A Case Report.

Patent foramen ovale (PFO) closure using percutaneous devices, such as the Amplatzer occluder, is a common treatment for patients with a history of cryptogenic stroke or transient ischemic attack (TIA). Although generally well-tolerated, some patients may develop adverse reactions to the device materials, particularly in the presence of a nickel allergy. Symptoms can include chest pain, rashes, and migraines, which may necessitate surgical removal of the device.

Headache attributed to transient ischemic attack: Assessment of its characteristics, associated factors and considerations on the diagnostic criteria.

Background: Between 10 % and 36 % of patients with transient ischemic attack present with headache. Little is known regarding the characteristics of this headache.

Objectives: To assess the frequency of headache attributed to transient ischemic attack, its characteristics, and its associated factors, and whether the third edition of the International Classification of Headache Disorders criteria are adequate for diagnosing this headache.

Field-testing the explicit diagnostic criteria for transient ischemic attack: a diagnostic accuracy study.

Background And Aim: Explicit diagnostic criteria for transient ischemic attack (TIA) (EDCT) have been recently proposed based on the assumption, that a migraine aura-like symptom is not typical for a TIA. However, migraine-like symptoms have been unexpectedly frequent in patients with confirmed ischemic stroke. This cross-sectional study aimed to field-test the EDCT to distinguish transient neurological symptoms caused by cerebral infarction from those caused by migraine aura.

Invasive vs conservative management in elderly patients with NSTEMI- insights from the SENIOR-RITA trial.

The SENIOR-RITA trial randomized 1,518 elderly Non-ST-segment elevation myocardial infarction (NSTEMI) patients to invasive or conservative strategies. The primary composite outcome of cardiovascular death or nonfatal Myocardial Infarction (MI) occurred in 25.6% of the invasive group versus 26.

The detailed transseptal puncture technique for optimal closure in patients with a patent foramen ovale.

Background: The closure of a patent foramen ovale (PFO) using transseptal puncture has particular advantages and disadvantages. Thus, transseptal puncture should be re-evaluated in detail.

Aims: We aimed to assess the effectiveness of the detailed transseptal puncture technique in patients who underwent PFO closure due to cryptogenic stroke or transient ischemic attack in terms of residual shunts and atrial fibrillation.

Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology-American Heart Association Guidelines.

Introduction/objectives: The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients.

Methods: We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables.

Post-operative bleeding in myocardial revascularization under cardiopulmonary bypass for patients treated with aspirin or dual antiplatelet therapy using reduced goal-directed anticoagulation.

Objectives: Antiplatelet therapy increases the risk of bleeding and transfusion in patients undergoing extracorporeal circulation. Reduced goal-directed anticoagulation (RGDA) is a personalized approach to reduce the anticoagulation based on a lower targeted activated clotting time (ACT). We assessed whether RGDA using optimized extracorporeal circulation (OpECC) alleviates the risk of severe bleeding in patients treated by dual antiplatelet therapy (DAPT) compared to aspirin alone during coronary artery bypass grafting (CABG).

Long-Term Statin Use Is Associated With Reduced Rates of Adverse Events in Patients With Newly Diagnosed Atrial Fibrillation.

Background: The effectiveness of statin use in preventing adverse cardiovascular events in individuals with atrial fibrillation (AF) has remained uncertain. This study aimed to assess whether statin use could lead to better outcomes among individuals with AF.

Methods And Results: We enrolled 397 787 patients with AF from January 1, 2012 to December 31, 2020.