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  • 1
    Online Resource
    Online Resource
    Lower Incidence of M2/ANXA5 Carriage in Recurrent Pregnancy Loss Patients With Elevated Lipoprotein(a) Levels
    SAGE Publications ; 2014
    In:  Clinical and Applied Thrombosis/Hemostasis Vol. 20, No. 7 ( 2014-10), p. 706-709
    Details
    In: Clinical and Applied Thrombosis/Hemostasis, SAGE Publications, Vol. 20, No. 7 ( 2014-10), p. 706-709
    Abstract: This study compared the incidence of M2/ANXA5 haplotype carriage, a documented repeated miscarriage risk factor, in patient groups with normal and elevated lipoprotein(a) (Lp(a)) levels. A total of 138 women with ≥2 consecutive, idiopathic recurrent miscarriages, categorized in patients with elevated (≥30 mg/dL, n = 44) and normal Lp(a) level ( 〈 30 mg/dL, n = 94) were recruited at the recurrent pregnancy loss (RPL) clinic of Munich Großhadern University Hospital. A total of 500 fertile women served as controls. All patients were genotyped for ANXA5 promoter haplotypes, genetic frequencies were compared, and odds ratios (ORs) and relative risks of M2 carriers were calculated. Women with M2 haplotype had an almost 2 times higher relative risk of RPL (OR 2.6, 95% confidence interval 1.5-4.6, P = .001) than fertile controls. Furthermore, risk rises to 2.47 in patients having normal Lp(a) levels (OR 3.2, 95% confidence interval 1.7-5.9, P = .001), whereas women with high Lp(a) levels exhibit notably lower apparent RPL risk of 1.39 (OR 1.4, 95% confidence interval 0.5-4.1, P = .659).
    Type of Medium: Online Resource
    ISSN: 1076-0296 , 1938-2723
    URL: Article
    DOI: 10.1177/1076029613516189
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
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    detail.hit.zdb_id: 1237357-6
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  • 2
    Online Resource
    Online Resource
    Lessons From the EThIGII Trial : Proper Putative Benefit Assessment of Low-Molecular-Weight Heparin Treatment in M2/ANXA5 Haplotype Carriers
    SAGE Publications ; 2017
    In:  Clinical and Applied Thrombosis/Hemostasis Vol. 23, No. 1 ( 2017-01), p. 27-33
    Details
    In: Clinical and Applied Thrombosis/Hemostasis, SAGE Publications, Vol. 23, No. 1 ( 2017-01), p. 27-33
    Abstract: This study presents sample size considerations derived from the Efficacy of Thromboprophylaxis as an Intervention during Gravidity (EThIGII) trial (ClinicalTrials.gov: NCT00400387) to address the question of low-molecular-weight heparin (LMWH) treatment in women with recurrent pregnancy loss (RPL) depending on the M2/ANXA5 haplotype. To evaluate the possible influence of such treatment on miscarriage rates of trial participants, a post hoc analysis of ANXA5 promoter genotypes in the light of M2/ANXA5 ( RPRGL3) distribution was performed using logistic models. DNA for genotyping was available from 129 LMWH and 95 control patients, 44 (19.6%) of whom were M2/ANXA5 carriers. Miscarriages occurred in 1 (4.0%) of 25 M2/ANXA5 carriers from the LMWH group compared to 4 (21.1%) of 19 in the control group, resulting in an odds ratio (95% confidence interval) for miscarriage of 0.16 (0.016-1.5) for women treated with LMWH. In noncarriers, miscarriage rates were 6 (5.8%) of 104 versus 7 (9.2%) of 76 for the LMWH and the control groups, respectively, corresponding to an odds ratio for miscarriage of 0.60 (0.19-1.9). The apparent beneficial effects of miscarriage rate reduction in M2/ANXA5 carriers with RPL concur with biological considerations about improvement in reduced ANXA5 function through LMWH treatment in an adequate murine model. The data obtained were instrumental to design proper assessment of the existence and magnitude of this effect.
    Type of Medium: Online Resource
    ISSN: 1076-0296 , 1938-2723
    URL: Article
    DOI: 10.1177/1076029616658117
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2230591-9
    detail.hit.zdb_id: 1237357-6
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  • 3
    Online Resource
    Online Resource
    Predictors of Futile Recanalization in Ischemic Stroke Patients with low baseline NIHSS
    SAGE Publications ; 2024
    In:  International Journal of Stroke
    Details
    In: International Journal of Stroke, SAGE Publications
    Abstract: There is yet no randomized controlled evidence that mechanical thrombectomy (MT) is superior to best medical treatment in patients with large vessel occlusion but minor stroke symptoms (National Institutes of Health Stroke Scale [NIHSS] 〈 6). Prior studies of patients with admission NIHSS scores 〉 6 observed unfavorable functional outcomes despite successful recanalization, commonly termed as futile recanalization (FR), in up to 50% of cases. Aim The aim of this study is to determine the prevalence of FR in patients with minor stroke and identify associated patient-specific risk factors. Methods Our multicenter cohort study screened all patients prospectively enrolled in the German Stroke Registry Endovascular Treatment from 2015 to 2021 (n=13082). Included were patients who underwent MT for anterior circulation vessel occlusion with a baseline NIHSS score of 〈 6 and successful recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] score of 2b–3). FR was defined by a modified Rankin Scale (mRS) score of 2–6 at 90 days. Multivariable logistic regression analysis was conducted to explore factors associated with FR. Results A total of 674 patients met the inclusion criteria. FR occurred in 268 (40%) patients. Multivariable logistic regression analysis indicates that higher age (adjusted odds ratio: 1.04 [95% confidence interval: 1.02-1.06]), pre-stroke mRS 1 (aOR: 2.70 [1.51-4.84] ), transfer from admission hospital to comprehensive stroke center (aOR: 1.67 [1.08-2.56]), longer time from symptom onset/last seen well to admission (aOR: 1.02 [1.00-1.04] ), MT under general anesthesia (aOR: 1.78 [1.13-2.82]), higher NIHSS after 24 hours (aOR: 1.09 [1.05-1.14] ), and symptomatic intracranial hemorrhage (aOR: 16.88 [2.03-140.14]) increased the odds of FR. There was no significant difference in primary outcome between achieving mTICI 2b or 3. Conclusions Unfavorable functional outcomes despite successful vessel recanalization were frequent in acute ischemic stroke patients with low NIHSS scores on admission. We provide patient-specific risk factors that indicate an increased risk of FR and should be considered when treating patients with minor stroke. Data access statement The data that support the findings of our study are available on reasonable request after approval of the GSR steering committee.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930241264737
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2024
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    detail.hit.zdb_id: 2211666-7
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  • 4
    Online Resource
    Online Resource
    The negative effect of aging on cerebral venous outflow in acute ischemic stroke
    SAGE Publications ; 2023
    In:  Journal of Cerebral Blood Flow & Metabolism Vol. 43, No. 10 ( 2023-10), p. 1648-1655
    Details
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 43, No. 10 ( 2023-10), p. 1648-1655
    Abstract: Cortical venous outflow (VO) represents an imaging biomarker of increasing interest in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO). We conducted a retrospective multicenter cohort study to investigate the effect of aging on VO. A total of 784 patients met the inclusion criteria. Cortical Vein Opacification Score (COVES) was used to assess VO profiles on admission CT angiography. Cerebral microperfusion was determined using the hypoperfusion intensity ratio (HIR) derived from perfusion imaging. Arterial collaterals were assessed using the Tan scale. Multivariable regression analysis was performed to identify independent determinants of VO, HIR and arterial collaterals. In multivariable regression, higher age correlated with worse VO (adjusted odds ratio [95% CI]; 0.83 [0.73–0.95] ; P = 0.006) and poorer HIR (β coefficient [95% CI], 0.014 [0.005–0.024] ; P = 0.002). The negative effect of higher age on VO was mediated by the extent of HIR (17.3%). We conclude that higher age was associated with worse VO in AIS-LVO, partially explained by the extent of HIR reflecting cerebral microperfusion. Our study underlines the need to assess collateral blood flow beyond the arterial system and provides valuable insights into deteriorated cerebral blood supply in elderly AIS-LVO patients.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    URL: Article
    DOI: 10.1177/0271678X231179558
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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    detail.hit.zdb_id: 604628-9
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