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  • Ovid Technologies (Wolters Kluwer Health)  (51)
  • 2015-2019  (51)
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  • Ovid Technologies (Wolters Kluwer Health)  (51)
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  • 2015-2019  (51)
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  • 1
    Online Resource
    Online Resource
    Effects of Alteplase for Acute Stroke on the Distribution of Functional Outcomes : A Pooled Analysis of 9 Trials
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Stroke Vol. 47, No. 9 ( 2016-09), p. 2373-2379
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 9 ( 2016-09), p. 2373-2379
    Abstract: Thrombolytic therapy with intravenous alteplase within 4.5 hours of ischemic stroke onset increases the overall likelihood of an excellent outcome (no, or nondisabling, symptoms). Any improvement in functional outcome distribution has value, and herein we provide an assessment of the effect of alteplase on the distribution of the functional level by treatment delay, age, and stroke severity. Methods— Prespecified pooled analysis of 6756 patients from 9 randomized trials comparing alteplase versus placebo/open control. Ordinal logistic regression models assessed treatment differences after adjustment for treatment delay, age, stroke severity, and relevant interaction term(s). Results— Treatment with alteplase was beneficial for a delay in treatment extending to 4.5 hours after stroke onset, with a greater benefit with earlier treatment. Neither age nor stroke severity significantly influenced the slope of the relationship between benefit and time to treatment initiation. For the observed case mix of patients treated within 4.5 hours of stroke onset (mean 3 hours and 20 minutes), the net absolute benefit from alteplase (ie, the difference between those who would do better if given alteplase and those who would do worse) was 55 patients per 1000 treated (95% confidence interval, 13–91; P =0.004). Conclusions— Treatment with intravenous alteplase initiated within 4.5 hours of stroke onset increases the chance of achieving an improved level of function for all patients across the age spectrum, including the over 80s and across all severities of stroke studied (top versus bottom fifth means: 22 versus 4); the earlier that treatment is initiated, the greater the benefit.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.116.013644
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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  • 2
    Online Resource
    Online Resource
    Relative systolic blood pressure reduction and clinical outcomes in hyperacute intracerebral hemorrhage : the SAMURAI-ICH observational study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Journal of Hypertension Vol. 33, No. 5 ( 2015-05), p. 1069-1073
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 5 ( 2015-05), p. 1069-1073
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/HJH.0000000000000512
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 605532-1
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  • 3
    Online Resource
    Online Resource
    Abstract 7: Outcome Prediction in Acute Stroke Patients by Continuous Glucose Monitoring: COntinuous glucose Monitoring for acute stroke Patients receiving Latest treatment (COMPLEAT) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. Suppl_1 ( 2018-01-22)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
    Abstract: Background and purpose: Association of dynamic variation of blood glucose during initial days after stroke onset with stroke outcomes has not been yet clarified. The purpose of this study was to examine the relationship between glucose barometers obtained by continuous glucose monitoring (CGM) and clinical outcomes in acute stroke patients. Methods: Continuous patients with acute ischemic stroke (AIS) or intracerebral hemorrhage (ICH) within 24 hours after onset were included. CGM device (iPro2) was attached for the initial 72 hours after emergent admission. Seven glucose barometers were obtained from CGM: maximum, minimum, mean, and standard deviation of blood glucose levels, as well as area under the curve more than 8 mmol/L blood glucose (8AUC), distribution time more than 8 mmol/L blood glucose (8time-ratio), and presence of time less than 3.9 mmol/L during 72 hours. Primary outcome measure was unfavorable clinical outcome at 3 months (mRS ≥3). Secondary outcome measure was early neurological deterioration after stroke (an increase of ≥4 NIHSS scores from the baseline or death) within 7 days. Results: One hundred patients with AIS (n=58) or ICH (n=42) were included. Blood glucose level varied between 5.2±1.4 mmol/L and 11.4±3.3 mmol/L during 72 hours with 8AUC of 0.7±1.4 minхmmol/L, 8time-ratio of 31.7±32.7%, and presence of hypoglycemia in 15% of the overall patients. Mean glucose level (adjusted OR 1.59, 95% CI 1.13-2.25 /1 mmol/L), 8AUC (2.06, 1.14-3.72 /1 minхmmol/L) and 8time-ratio (1.25, 1.05-1.49 /10%)were related to unfavorable outcome for overall patients, as well as for AIS patients (2.11, 1.26-3.53; 2.43, 1.24-4.78; 1.72, 1.23-2.39, respectively). Only 8time-ratio was related to neurological deterioration for overall patients (adjusted OR 1.49, 95% CI 1.08-2.05 /10%). Conclusion: High mean glucose levels, 8time-ratio and 8 AUC levels were associated with unfavorable outcome at 3 months. High 8time-ratio levels were related to early neurological deterioration within 7 days.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.49.suppl_1.7
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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  • 4
    Online Resource
    Online Resource
    Abstract WP50: Histopathologic Analysis of Retrieved Thrombi in Acute Ischemic Stroke Patients With Cancer
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Introduction: The procoagulant state in cancer increases the thrombotic risk and underlying cancer could affect treatment strategies and outcomes in stroke patients. Therefore, it is important to detect cancer as a cause of stroke. However, the histopathologic characteristics of retrieved thrombi in cancer patients remain understudied. Aims: The aims of this study were to assess the histopathological difference between the thrombi in cancer patients and in non-cancer patients. Methods: We studied consecutive patients with acute large-vessel occlusion treated with endovascular therapy between October 2010 and December 2016 from our single-center registry. We histopathologically investigated retrieved thrombi using staining with hematoxylin and eosin and Masson’s trichrome. We observed the existence of organization and the ratios of erythrocyte and fibrin/platelet components, using a lattice composed of 10х10 squares. Results: Of 180 patients studied, 17 cases (8 women, 76.5±11.5 years old) had cancer and 163 cases (69 women, 74.1±11.2 years old) did not. There were no significant differences in basic clinical characteristics and cardiovascular risk factors including atrial fibrillation between the two groups. Cancer-related cases had higher proportions of fibrin/platelets (56.6±27.4% vs. 40.1±23.9%, p 〈 0.01), less proportions of erythrocytes (42.1±28.3% vs. 57.5±25.1%, p=0.02) and higher serum D-dimer levels (5.9 ± 8.2 vs. 2.4 ± 4.3, p 〈 0.01) than non-cancer cases. The ROC analysis showed the cut-off ratio of fibrin/platelet components related to cancer was 55.7% with a sensitivity of 74.8%, specificity 58.8%, and AUC value 0.67(95% CI: 0.533–0.813), the cut-off ratio of erythrocyte components was 44.7% with a sensitivity of 71.2%, specificity 58.9%, and AUC value 0.66(95% CI: 0.514–0.797). Conclusion: Cancer-associated acute large artery occlusion was relatively due to emboli with the fibrin/platelet rich component.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.WP50
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Detrimental Effect of Chronic Hypertension on Leptomeningeal Collateral Flow in Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. 7 ( 2019-07), p. 1751-1757
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 7 ( 2019-07), p. 1751-1757
    Abstract: We aimed to evaluate the effect of chronic hypertension on acute leptomeningeal collateral flow in patients with large-vessel ischemic stroke using digital subtraction angiography, which is the gold standard for the assessment of collateral circulation. Methods— Of the consecutive ischemic stroke patients from October 2011 to December 2017 seen in our institution, patients with acute occlusion of the M1 segment of the middle cerebral artery confirmed on initial digital subtraction angiography were enrolled. Chronic hypertension was defined as its documentation before the index stroke or as the administration of antihypertensive medications before onset. Angiographic leptomeningeal collateral flow was evaluated according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Flow Grading System and dichotomized the findings into excellent (grade 3–4) or poor (grade 0–2) collateral status for analysis. Results— Of the 3759 consecutive ischemic stroke patients, 100 patients were analyzed. Thirty-nine patients (39%) had poor collateral status. Patients with poor collateral status were older, more frequently male, and had chronic hypertension more frequently, shorter time from onset to angiography, and higher admission systolic blood pressure than those with excellent collateral status. Multivariable logistic analysis with prespecified covariates showed a significantly positive association between chronic hypertension and poor collateral status (odds ratio, 2.80; 95% CI, 1.08–7.70; P =0.034). This association was independent of admission systolic blood pressure. The proportion of patients with poor collateral status increased in a stepwise manner in patients without chronic hypertension, hypertensive patients with premorbid antihypertensive medications, and hypertensive patients without antihypertensive medications ( P for trend 〈 0.001). Conclusions— Our data suggest that chronic hypertension has a detrimental effect on acute leptomeningeal collateral flow in patients with cerebral large-vessel occlusion. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT02251665.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.119.025142
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
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  • 6
    Online Resource
    Online Resource
    Abstract TP67: Cerebral Microbleeds Are Associated With Hemorrhagic Infarction Among Acute Ischemic Stroke Patients With NVAF: The SAMURAI-NVAF Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Stroke Vol. 47, No. suppl_1 ( 2016-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. suppl_1 ( 2016-02)
    Abstract: Background and purpose: Cerebral microbleeds (CMBs) are prevalent among stroke patients, and have shown to be the risk factor for the future ischemic or hemorrhagic stroke in several reports. However, the significance of CMBs among acute ischemic stroke patients, especially those with non-valvular arterial fibrillation (NVAF), remains unknown. Methods: Of 1,192 patients who participated in the SAMURAI-NVAF study (an ongoing prospective, multicenter, observational study), 1,099 patients (77.6±10.0 y.o, 620 men) underwent a T2* weighted image (T2*WI). Association of CMBs detected on T2*WI with the incidence of any hemorrhagic infarction (any HI and PH) and PH2 seven days after the index stroke and symptomatic hemorrhagic events and modified Rankin Scale (mRS) at discharge were assessed. Results: CMBs were detected in 256 patients (23.2%); single CMB in 96, 2-4 CMBs in 109, and ≥5 CMBs in 51. Hemorrhagic infarction was more frequent as the number of CMBs increased (21.5%, 21.9%, 26.6%, and 33.3% in patients with 0, 1, 2-4, and ≥5 CMBs, respectively: p=0.024, analyzed by Cochran-Armitage test for trend). PH2 was identified in 2.5%, 0%, 2.8% and 3.9%, respectively (p=0.824), symptomatic hemorrhagic event in 1.2%, 1.0%, 0%, and 0%, respectively (p=0.5910), and mRS 3-6 in 51.5%, 54.2%, 54.1%, and 62.7%, respectively (p=0.4370). Presence of CMBs was independently associated with any hemorrhagic infarction [odds ratio (OR) 1.72; 95% confidence interval (CI) 1.18-2.51; p=0.005] after adjustment for age, sex, premorbid mRS, infarct size, infarct number, and intravenous thrombolysis, but not with PH2 (p=0.639), symptomatic hemorrhagic events (p=0.633), or mRS 3-6 (p=0.212). Among 253 patients receiving intravenous thrombolysis or endvascular therapy, CMBs were also independently associated with hemorrhagic infarction (OR 2.75; 95%CI 1.27-6.04; p=0.010), but not with the other outcomes. Conclusions: CMBs were associated with any hemorrhagic infarction in acute ischemic stroke patients with NVAF regardless of receiving thrombolysis or not. However, they were not associated with PH2, symptomatic hemorrhagic events, or unfavorable vital or functional outcomes.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.47.suppl_1.tp67
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 80381-9
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  • 7
    Online Resource
    Online Resource
    Abstract T P158: Albuminuria Is Associated With Neurological Deterioration and Poor Outcome in Acute Stroke Patients With Non-valvular Atrial Fibrillation: The SAMURAI-NVAF Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. suppl_1 ( 2015-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. suppl_1 ( 2015-02)
    Abstract: Background and purpose: The impact of albuminuria on clinical outcomes in acute cardioembolic stroke is not fully investigated. We assessed whether high spot urine albumin/creatinine ratio (ACR) was associated with clinical outcomes in acute stroke with non-valvular atrial fibrillation (NVAF). Methods: From 2011 to 2014, we enrolled acute ischemic stroke/TIA patients with NVAF in the SAMURAI-NVAF study, which is a multicenter, observational study. Patients with complete ACR values were included in the analysis. They were divided into the N (normal, ACR 〈 30mg/g) and the H (high, ACR ≥ 30mg/g) groups. Clinical outcomes were neurological deterioration (an increase of NIHSS ≥1 point during the initial 7 days) and poor outcome (mRS of 4-6 at 3 months). Results: Of 558 patients (328 men, 77±10 y) who were included, 271 and 287 were assigned to the H group and the N group, respectively. As compared with patients in the N group, those in the H group were more frequently female (52 vs 31%, p 〈 0.001) and older (80±10 vs 75±10 y, p 〈 0.001). On admission, patients in the H group more frequently had diabetes (28 vs 17%, p = 0.003), less frequently had paroxysmal AF (68 vs 57%, p = 0.009), had higher levels of SBP (157±28 vs 151±24 mmHg, p = 0.003), NIHSS score (11 vs 5, p 〈 0.001), CHA2DS2-VASc score (6 vs 5, p 〈 0.001), plasma glucose (141±62 vs 132±41 mg/dL, p = 0.04), and brain natriuretic peptide (348±331 vs 259±309 pg/mL, p = 0.002), and had lower levels of hemoglobin (13±2 vs 14±2 g/dL, p = 0.02), and estimated glomerular filtration ratio (eGFR) (60±24 vs 66±20 mL/min/1.73m2 p = 0.002). On imaging studies, patients in the H group more frequently had large infarct (29 vs 20 %, p = 0.02) and culprit artery occlusion (64 vs 48%, p 〈 0.001). Neurological deterioration (14 vs 4%, p 〈 0.001) and poor outcome (49 vs 24%, p 〈 0.001) were more frequently observed in the H group. On multivariate regression analysis adjusted for significant confounders and reperfusion therapy, the H group was associated with neurological deterioration (OR 2.43; 95% CI 1.14-5.5; p = 0.02) and poor outcome (OR 2.75; 95% CI 1.45-5.2; p = 0.002), although eGFR was not significantly related to either. Conclusion: High ACR, a marker of albuminuria, was independently associated with unfavorable outcomes in acute stroke patients with NVAF.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.46.suppl_1.tp158
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 80381-9
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  • 8
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    Online Resource
    Abstract WMP67: Arterial Velocity on Carotid Ultrasonography Can Predict the Stenosis Progression in Patients With Vertebro-basillar Dissection
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. Suppl_1 ( 2018-01-22)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
    Abstract: Purpose: Morphological changes of affected arteries in intracranial artery dissection often occur in the acute phase. The usefulness of carotid ultrasonography (CU) to evaluate the changes is not well investigated. The purpose of this study was to assess the value of CU indexes to detect artery stenosis progression on magnetic resonance angiography (MRA). Methods: This is a retrospective, single-center, observational study. We enrolled patients with intracranial vertebro-basilar artery dissection diagnosed based on criteria by the expert group (Debette S, et al: Lancet Neurol 2015) who were admitted within 30 days after onset from 2011 January to 2017 June. Carotid ultrasonography was performed on admission (median 0 days after onset) and follow-up (median, 40 days after onset; interquartile range, 11-106) to examined the flow velocity of both vertebral arteries. MRA was done on admission and follow-up just before or after the follow-up CU. Two stroke neurologists who were blinded to patients’ information assessed the change of vessel forms on MRA; stenosis progression was defined as an follow-up arterial diameter of 〈 50% as compared to that at baseline on MRA. Patients were divided into two groups: those with stenosis progression (P group ) and the others (non-P group). Peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV) and pulsatility index (PI) were measured by CU and each baseline to follow-up ratio (follow-up/baseline) was compared between the two groups. Result: Of 26 patients (11 women, 53±8 years old) who were enrolled, 10 (28%) showed stenosis progression (P group). The P group had lower EDV ratio (0.34±0.63 vs 1.05±0.39, P 〈 0.01) and higher PI ratio (1.95±0.76 vs 0.85±0.30, P 〈 0.01) than the non-P group. Using Receiver Operating Characteristic (ROC) curve analysis, the area under the curve (AUC) of EDV ratio to predict stenosis progression was 0.87 (P 〈 0.01) with the cut-off value of 0.54, sensitivity of 87.5% and specificity of 93.3% and that of PI ratio was 0.93 (P 〈 0.01) with 1.17, 88.9% and 82.3%, respectively. Conclusion: Carotid ultrasonography is useful to predict the chrocnic stenosis progression of vertebra-basilar artery dissection.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.49.suppl_1.WMP67
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Abstract TMP101: Relationship Between RNF213 p.R4810K (c.14429G〉A) Variant and Anatomical Variations of the Circle of Willis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. Suppl_1 ( 2019-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. Suppl_1 ( 2019-02)
    Abstract: Background and purpose: RING finger protein 213 ( RNF213 ) gene is strongly associated with intracranial arterial stenosis as well as Moyamoya disease and its dysregulation is known to impair cerebral perfusion in rodents. We thus investigated the relationship between RNF213 p.R4810K (c.14429G 〉 A) variant and the anatomical variations of the circle of Willis in cerebrovascular disease. Methods: We consecutively enrolled non-cardioembolic stroke or transient ischemic attack patients with (n = 20) or without (n = 80) RNF213 p.R4810K (c.14429G 〉 A) variation from those who participated in the biobank of our Institute over the past 2 years. Moyamoya disease cases were excluded. We evaluated anatomical variations of the vessels constituting the circle of the Willis, namely, intracranial internal carotid artery, anterior communicating artery (AcomA), anterior cerebral artery A1 segment, posterior communicating artery (PcomA), posterior cerebral artery P1 segment, and middle cerebral artery M1 segment, using maximum intensity projection of a time-of-flight magnetic resonance angiography collected at 3 Tesla. Results: The RNF213 p.R4810K (c.14429G 〉 A) variant carrier had higher frequency of focal narrowing of the M1 segment compared to the non-carrier (50% vs 10%, p 〈 0.01) and an absence of AcomA (15% vs 3.7%, p=0.09). By contrast, unexpectedly, unilateral or bilateral absence of PcomA was significantly less frequent (25% vs 61%, p 〈 0.01). Multivariate analysis adjusted for age and sex showed that the variant carrier state was independently associated with unilateral or bilateral presence of PcomA (odds ratio (OR) 4.44, 95% confidence interval (CI) 1.01 - 20.6, p 〈 0.05) and focal M1 narrowing (OR 3.30, 95% CI 0.82 - 12.6, p=0.09). Conclusions: The RNF 213 p.R4810K (c.14429G 〉 A) variant carrier showed higher frequency of arteriopathy in the anterior circulation accompanied by higher patency rate of PcomA. In the variant carrier, dysplasia of the anterior circulation arteries may lead to compensatory collateral flow from posterior to anterior circulation through PcomA.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.50.suppl_1.TMP101
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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  • 10
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    Online Resource
    Prevalence of RNF213 p.R4810K Variant in Early-Onset Stroke With Intracranial Arterial Stenosis
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. 6 ( 2019-06), p. 1561-1563
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 6 ( 2019-06), p. 1561-1563
    Abstract: The ring finger protein 213 gene ( RNF213 ) is a susceptibility gene for moyamoya disease and large-artery ischemic stroke in East Asia. We examined the prevalence and correlates of the RNF213 p.R4810K variant in patients with early-onset ischemic stroke in a Japanese single-center cohort. Methods— We analyzed 70 early-onset stroke patients with intracranial arterial stenosis who developed a noncardioembolic stroke or transient ischemic attack from 20 to 60 years of age. Patients with moyamoya disease were excluded. Results— The RNF213 p.R4810K variant was found in 17 patients (24%), and more often in women than men (38% versus 16%, odds ratio 3.3; 95% CI, 1.1–10.2, P =0.04). The variant was identified in 35% of patients with stenosis in the M1 segment of the middle cerebral artery or the A1 segment of the anterior cerebral artery (odds ratio, 25.0; 95% CI, 1.4–438; P 〈 0.01) but in only one patient (9%) with intracranial posterior circulation stenosis. Conventional atherosclerotic risk factors did not differ between variant carriers and noncarriers. Conclusions— The RNF213 p.R4810K variant is common in early-onset ischemic stroke with anterior circulation stenosis in Japan. Further investigation of the RNF213 gene will provide new insights into pathogenetic mechanisms of early-onset stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.118.024712
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 80381-9
    detail.hit.zdb_id: 1467823-8
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