Base de dados : MEDLINE
Pesquisa : C10.228.140.300.150.836 [Categoria DeCS]
Referências encontradas : 18820 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 1882 ir para página                         

  1 / 18820 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Registro de Ensaios Clínicos
Texto completo
[PMID]:28455321
[Au] Autor:Derdeyn CP; Fiorella D; Lynn MJ; Turan TN; Cotsonis GA; Lane BF; Montgomery J; Janis LS; Chimowitz MI; SAMMPRIS Investigators
[Ad] Endereço:From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta,
[Ti] Título:Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis).
[So] Source:Stroke;48(6):1501-1506, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The purpose of this study was to investigate the frequency of symptomatic in-stent restenosis (ISR) and its contribution to nonprocedural symptomatic infarction in the SAMMPRIS trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis). METHODS: Patients without a periprocedural primary end point were followed up to determine the occurrence of any of the following events: ischemic stroke, cerebral infarct with temporary signs, or transient ischemic attack in the territory of the stented artery. Vascular imaging performed after these events was reviewed for ISR. Annual rates for symptomatic ISR were calculated using Kaplan-Meier estimates. RESULTS: Of 183 patients in the stenting group without a periprocedural primary end point, 27 (14.8%) had a symptomatic infarction (stroke or cerebral infarct with temporary signs) and 16 (8.7%) had transient ischemic attack alone in the territory during a median follow-up of 35.0 months. Of the 27 patients with infarctions, 17 (9.3%) had an ischemic stroke and 10 (5.5%) had a cerebral infarct with temporary signs alone. Adequate vascular imaging to evaluate ISR was available in 24 patients with infarctions (showing ISR in 16 [66.7%]) and in 10 patients with transient ischemic attack alone (showing ISR in 8 [80%]). The 1-, 2-, and 3-year rates (with 95% confidence limits) for symptomatic ISR in the SAMMPRIS stent cohort were 9.6% (6.1%-14.9%), 11.3% (7.5%-17.0%), and 14.0% (9.6%-20.2%), respectively. CONCLUSIONS: Symptomatic ISR occurred in at least 1 of 7 patients in SAMMPRIS by 3 years of follow-up and was likely responsible for the majority of nonprocedural cerebral infarctions. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00576693.
[Mh] Termos MeSH primário: Angioplastia com Balão/estatística & dados numéricos
Isquemia Encefálica/epidemiologia
Constrição Patológica/epidemiologia
Doenças Arteriais Intracranianas/epidemiologia
Doenças Arteriais Intracranianas/terapia
Complicações Pós-Operatórias/epidemiologia
Stents/estatística & dados numéricos
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Assistência ao Convalescente
Idoso
Angioplastia com Balão/efeitos adversos
Isquemia Encefálica/diagnóstico
Angiografia Cerebral
Infarto Cerebral/diagnóstico por imagem
Infarto Cerebral/epidemiologia
Constrição Patológica/diagnóstico por imagem
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Ataque Isquêmico Transitório/diagnóstico por imagem
Ataque Isquêmico Transitório/epidemiologia
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Complicações Pós-Operatórias/diagnóstico por imagem
Recidiva
Risco
Stents/efeitos adversos
Acidente Vascular Cerebral/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014537


  2 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29384950
[Au] Autor:Lee S; Byun JS; Jung MS; Kim JM; Nam TK
[Ad] Endereço:Departments of Radiology.
[Ti] Título:Usefulness of multiphase computed tomography angiography in a patient with transient ischemic attack in the hyperacute phase: A case report.
[So] Source:Medicine (Baltimore);96(52):e9502, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Patients with transient ischemic attack (TIA) have the possibility of developing stroke in the future. To prevent recurrent TIA or future stroke, identifying the cause of TIA is important. However, about two-third of patients with TIA have negative findings on diffusion-weighted imaging (DWI).We present a case of TIA, the cause of which was identified using multiphase computed tomography angiography (MCTA) in the hyperacute phase of the disease. PATIENT CONCERNS: The patient was a 57-year-old man who was admitted to the emergency department for right-side weakness persisting for 1 hour. DIAGNOSES: Occlusion of the proximal M3 segment of the left middle cerebral artery territory was found on the initial MCTA. OUTCOMES: The weakness completely resolved at 2 hours after symptom onset, and there was no acute infarction on the initial diffusion-weighted magnetic resonance imaging (MRI) on the same day. Follow-up MCTA on the next day showed recanalization of the left M3 segment. Follow-up diffusion-weighted MRI showed focal acute infarction in the left middle cerebral artery territory. LESSONS: MCTA could identify distal occlusion of the anterior circulation in patients with cardioembolic TIA in the hyperacute phase with negative DWI findings.
[Mh] Termos MeSH primário: Angiografia por Tomografia Computadorizada/métodos
Ataque Isquêmico Transitório/diagnóstico por imagem
Artéria Cerebral Média/diagnóstico por imagem
[Mh] Termos MeSH secundário: Doença Aguda
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009502


  3 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29390564
[Au] Autor:Tian Y; Jia H; Li S; Wu Y; Guo L; Tan G; Li B
[Ad] Endereço:Department of Neurology, The Second Hospital of Hebei Medical University.
[Ti] Título:The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(51):e9413, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results. OBJECTIVE: The aim of the study was to assess the associations of Lp-PLA2 levels (mass and activity) with recurrent vascular events in patients with transient ischemic attack (TIA) and/or first ischemic stroke and with stroke in the general population. METHODS: The MEDLINE, Embase, the Cochrane Library, Web of Science, Science Direct, China National Knowledge Infrastructure, China Biology Medical Disc (CBMdisc), and WanFang were searched for prospective observational studies reported until January 2017. Eligible studies reported Lp-PLA2 levels and adjusted risk estimates of recurrent vascular events and/or stroke. Risk ratio (RR) with corresponding 95% confidence intervals (CIs) were used to express the pooled data in a random-effects model. RESULTS: A total of 11 studies that comprised 20,284 participants (4,045 were TIA and/or first ischemic stroke patients and 16,239 were residents in general population) were identified, which reported either Lp-PLA2 mass levels (4 studies) or Lp-PLA2 activity levels (10 studies). The pooled RR of recurrent vascular events (467 cases) in TIA and/or first ischemic group was 2.24 (95% CI, 1.33-3.78), whereas the pooled RR of stroke (1604 cases) in the general population was 1.47 (95% CI, 1.10-1.97). The pooled RRs of Lp-PLA2 mass and activity levels with the risk of stroke in the general population were 1.69 (95% CI, 1.03-2.79) and 1.28 (95% CI, 0.88-1.85), respectively. CONCLUSIONS: In patients with TIA and first ischemic stroke, elevated Lp-PLA2 activity levels were associated with recurrent vascular events. And in the general population elevated Lp-PLA2 levels were associated with the risk of stroke, although the association between Lp-PLA2 activity levels and the risk of stroke was less profound compared with the corresponding association of stroke risk with the Lp-PLA2 mass levels.
[Mh] Termos MeSH primário: 1-Alquil-2-acetilglicerofosfocolina Esterase/sangue
Ataque Isquêmico Transitório/sangue
Acidente Vascular Cerebral/sangue
[Mh] Termos MeSH secundário: Seres Humanos
Recidiva
Acidente Vascular Cerebral/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
EC 3.1.1.47 (1-Alkyl-2-acetylglycerophosphocholine Esterase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009413


  4 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29272289
[Au] Autor:Simmatis L; Krett J; Scott SH; Jin AY
[Ad] Endereço:Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
[Ti] Título:Robotic exoskeleton assessment of transient ischemic attack.
[So] Source:PLoS One;12(12):e0188786, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We used a robotic exoskeleton to quantify specific patterns of abnormal upper limb motor behaviour in people who have had transient ischemic attack (TIA). A cohort of people with TIA was recruited within two weeks of symptom onset. All individuals completed a robotic-based assessment of 8 behavioural tasks related to upper limb motor and proprioceptive function, as well as cognitive function. Robotic task performance was compared to a large cohort of controls without neurological impairments corrected for the influence of age. Impairment in people with TIA was defined as performance below the 5th percentile of controls. Participants with TIA were also assessed with the National Institutes of Health Stroke Scale (NIHSS) score, Chedoke-McMaster Stroke Assessment (CMSA) of the arm, the Behavioural Inattention Test (BIT), the Purdue pegboard test (PPB), and the Montreal Cognitive Assessment (MoCA). Age-related white matter change (ARWMC), prior infarction and cella-media index (CMI) were assessed from baseline CT scan that was performed within 24 hours of TIA. Acute infarction was assessed from diffusion-weighted imaging in a subset of people with TIA. Twenty-two people with TIA were assessed. Robotic assessment showed impaired upper limb motor function in 7/22 people with TIA patients and upper limb sensory impairment in 4/22 individuals. Cognitive tasks involving robotic assessment of the upper limb were completed in 13 participants, of whom 8 (61.5%) showed significant impairment. Abnormal performance in the CMSA arm inventory was present in 12/22 (54.5%) participants. ARWMC was 11.8 ± 6.4 and CMI was 5.4 ± 1.5. DWI was positive in 0 participants. Quantitative robotic assessment showed that people who have had a TIA display a spectrum of upper limb motor and sensory performance deficits as well as cognitive function deficits despite resolution of symptoms and no evidence of tissue infarction.
[Mh] Termos MeSH primário: Ataque Isquêmico Transitório/diagnóstico
Robótica
[Mh] Termos MeSH secundário: Braço/fisiopatologia
Feminino
Seres Humanos
Ataque Isquêmico Transitório/fisiopatologia
Masculino
Atividade Motora
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188786


  5 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29199796
[Ti] Título:Ischemic stroke and TIA.
[So] Source:Duodecim;132(24):2367-8, 2016.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:The key steps to improve the outcome are early diagnosis of TIA and stroke symptoms, access to thrombolytic and thrombectomy therapy, urgent medical secondary prevention and acute care in a dedicated stroke unit where assessment and rehabilitation are started and carried out by a multi-professional rehabilitation team. Long-term outcome is also improved by reinforced screening of specific etiologies such as atrial fibrillation and carotid stenosis.
[Mh] Termos MeSH primário: Ataque Isquêmico Transitório/diagnóstico
Ataque Isquêmico Transitório/prevenção & controle
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/prevenção & controle
Trombectomia
Terapia Trombolítica/métodos
[Mh] Termos MeSH secundário: Anticoagulantes/uso terapêutico
Diagnóstico Precoce
Seres Humanos
Fatores de Risco
Prevenção Secundária
Reabilitação do Acidente Vascular Cerebral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


  6 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29245281
[Au] Autor:Li C; He R; Li X; Zhong Y; Ling L; Li F
[Ad] Endereço:aDepartment of Neurology, The Affiliated Guangzhou Red Cross Hospital, Jinan University, GuangzhoubDepartment of Neurology, Xiaolan Hospital of Southern Medical University, ZhongshancDepartment of Neurology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
[Ti] Título:Spontaneous spinal epidural hematoma mimicking transient ischemic attack: A case report.
[So] Source:Medicine (Baltimore);96(49):e9007, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a rare but highly disabling neurological emergency. The initial presentations are variable. Most patients of SSEH present with paraplegia or tetraplegia clinically, but recurrent hemiparesis with complete spontaneous recovery, mimicking transient ischemic attack (TIA), is a very rare initial presentation of SSEH. PATIENT CONCERNS: A 71-year-old female presented to the emergency department with 2 episodes of transient right hemiparesis in 5 hours. Two days later, above symptom reappeared and progressed to quadriplegia, dyspnea, and uroschesis quickly. The neurological examination showed tetraplegia and hypalgesia below the C2 level, but neither facial palsy nor aphasia was found. DIAGNOSIS: The patient was initially misdiagnosed as TIA and treated with antiplatelet therapy. But during the hospital day, the cervical magnetic resonance imaging showed a dorsal epidural hematoma extending from C2 to C6 level and she was diagnosed as SSEH. INTERVENTIONS: She underwent surgical decompression and hematoma removal 1 week later. OUTCOMES: One week after operation, the sensory deficit above C6 level improved, but there was no improvement in her muscle strength and dyspnea. Unfortunately, she died 1 month later. LESSONS: Our case highlights recurrent hemiparesis with complete spontaneous recovery mimicking TIA is a rare initial presentation of SSEH. It is important to perform careful clinical assessments and neuroimaging investigations for correct diagnosis. Neck pain and hemiparesis sparing cranial nerve are important signs for distinction of SSEH from acute ischemic cerebrovascular diseases.
[Mh] Termos MeSH primário: Vértebras Cervicais/patologia
Hematoma Epidural Espinal/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Vértebras Cervicais/diagnóstico por imagem
Vértebras Cervicais/cirurgia
Diagnóstico Diferencial
Erros de Diagnóstico
Feminino
Hematoma Epidural Espinal/diagnóstico por imagem
Hematoma Epidural Espinal/cirurgia
Seres Humanos
Ataque Isquêmico Transitório/diagnóstico
Imagem por Ressonância Magnética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009007


  7 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29016695
[Au] Autor:Collings SL; Lefèvre C; Johnson ME; Evans D; Hack G; Stynes G; Maguire A
[Ad] Endereço:OXON Epidemiology, London, United Kingdom.
[Ti] Título:Oral anticoagulant persistence in patients with non-valvular atrial fibrillation: A cohort study using primary care data in Germany.
[So] Source:PLoS One;12(10):e0185642, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study examined characteristics and treatment persistence among patients prescribed oral anticoagulants (OACs) for stroke prevention in non-valvular atrial fibrillation (NVAF). We identified 15,244 patients (51.8% male, 72.7% aged ≥70) with NVAF and no prior OAC therapy who were prescribed apixaban (n = 1,303), rivaroxaban (n = 5,742), dabigatran (n = 1,622) or vitamin-K antagonists (VKAs, n = 6,577) between 1-Dec-2012 and 31-Oct-2014 in German primary care (IMS® Disease Analyzer). We compared OAC persistence using Cox regression over patients' entire follow-up and using a data-driven time-partitioned approach (before/after 100 days) to handle non-proportional hazards. History of stroke risk factors (stroke/transient ischaemic attack [TIA] 15.2%; thromboembolism 14.1%; hypertension 84.3%) and high bleeding risk (HAS-BLED score≥3 68.4%) was common. Apixaban-prescribed patients had more frequent history of stroke/TIA (19.7%) and high bleeding risk (72.6%) than other OACs. 12-month persistence rates were: VKA 57.5% (95% confidence interval (CI) 56.0-59.0%), rivaroxaban 56.6% (54.9-58.2%), dabigatran 50.1% (47.2-53.1%), apixaban 62.9% (58.8-67.0%). Over entire follow-up, compared to VKA, non-persistence was similar with apixaban (adjusted hazard ratio 1.08, 95% CI 0.95-1.24) but higher with rivaroxaban (1.21, 1.14-1.29) and dabigatran (1.53, 1.40-1.68). Using post-hoc time-partitioned approach: in first 100 days, non-persistence was higher with apixaban (1.37, 1.17-1.59), rivaroxaban (1.41, 1.30-1.53) and dabigatran (1.91, 1.70-2.14) compared to VKA. Compared to apixaban, rivaroxaban non-persistence was similar (1.03, 0.89-1.20), dabigatran was higher (1.39, 1.17-1.66). After 100 days, apixaban non-persistence was lower than VKA (0.66, 0.52-0.85); rivaroxaban (0.97, 0.87-1.07) and dabigatran (1.10, 0.95-1.28) were similar to VKA. Furthermore, rivaroxaban (1.46, 1.13-1.88) and dabigatran (1.67, 1.26-2.19) non-persistence was higher than apixaban. This study describes real-world observations on OAC use, particularly early apixaban use following approval for NVAF, in Germany. We identified potential differential OAC prescribing and higher persistence with apixaban than other OACs after 100 days' treatment. Larger studies are needed with longer follow-up to establish long-term patterns.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Fibrilação Atrial/tratamento farmacológico
Dabigatrana/uso terapêutico
Pirazóis/uso terapêutico
Piridonas/uso terapêutico
Rivaroxabana/uso terapêutico
Acidente Vascular Cerebral/prevenção & controle
[Mh] Termos MeSH secundário: Administração Oral
Idoso
Fibrilação Atrial/fisiopatologia
Estudos de Coortes
Feminino
Alemanha
Hemorragia/fisiopatologia
Seres Humanos
Hipertensão/fisiopatologia
Ataque Isquêmico Transitório/fisiopatologia
Masculino
Atenção Primária à Saúde
Fatores de Risco
Tromboembolia/fisiopatologia
Vitamina K/antagonistas & inibidores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Pyrazoles); 0 (Pyridones); 12001-79-5 (Vitamin K); 3Z9Y7UWC1J (apixaban); 9NDF7JZ4M3 (Rivaroxaban); I0VM4M70GC (Dabigatran)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185642


  8 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28887378
[Au] Autor:Epstein KA; Viscoli CM; Spence JD; Young LH; Inzucchi SE; Gorman M; Gerstenhaber B; Guarino PD; Dixit A; Furie KL; Kernan WN; IRIS Trial Investigators
[Ad] Endereço:From the Yale School of Medicine (K.A.E., C.M.V., L.H.Y., S.E.I., B.G., W.N.K.), New Haven, CT; University of Western Ontario (J.D.S.), London, Canada; Maine Medical Center (M.G.), Portland; Fred Hutchinson Cancer Research Center (P.D.G.), Seattle, WA; University of Newcastle Upon Tyne (A.D.), Newca
[Ti] Título:Smoking cessation and outcome after ischemic stroke or TIA.
[So] Source:Neurology;89(16):1723-1729, 2017 Oct 17.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess whether smoking cessation after an ischemic stroke or TIA improves outcomes compared to continued smoking. METHODS: We conducted a prospective observational cohort study of 3,876 nondiabetic men and women enrolled in the Insulin Resistance Intervention After Stroke (IRIS) trial who were randomized to pioglitazone or placebo within 180 days of a qualifying stroke or TIA and followed up for a median of 4.8 years. A tobacco use history was obtained at baseline and updated during annual interviews. The primary outcome, which was not prespecified in the IRIS protocol, was recurrent stroke, myocardial infarction (MI), or death. Cox regression models were used to assess the differences in stroke, MI, and death after 4.8 years, with correction for adjustment variables prespecified in the IRIS trial: age, sex, stroke (vs TIA) as index event, history of stroke, history of hypertension, history of coronary artery disease, and systolic and diastolic blood pressures. RESULTS: At the time of their index event, 1,072 (28%) patients were current smokers. By the time of randomization, 450 (42%) patients had quit smoking. Among quitters, the 5-year risk of stroke, MI, or death was 15.7% compared to 22.6% for patients who continued to smoke (adjusted hazard ratio 0.66, 95% confidence interval 0.48-0.90). CONCLUSION: Cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years in the IRIS trial cohort.
[Mh] Termos MeSH primário: Ataque Isquêmico Transitório/epidemiologia
Abandono do Hábito de Fumar/métodos
Fumar/epidemiologia
Fumar/terapia
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio/epidemiologia
Infarto do Miocárdio/etiologia
Modelos de Riscos Proporcionais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170910
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004524


  9 / 18820 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28882227
[Au] Autor:King JB; Azadani PN; Suksaranjit P; Bress AP; Witt DM; Han FT; Chelu MG; Silver MA; Biskupiak J; Wilson BD; Morris AK; Kholmovski EG; Marrouche N
[Ad] Endereço:Pharmacy Department, Kaiser Permanente Colorado, Aurora, Colorado; CARMA Center, Division of Cardiovascular Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.
[Ti] Título:Left Atrial Fibrosis and Risk of Cerebrovascular and Cardiovascular Events in Patients With Atrial Fibrillation.
[So] Source:J Am Coll Cardiol;70(11):1311-1321, 2017 Sep 12.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF. OBJECTIVES: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF. METHODS: This was a retrospective cohort study of 1,228 patients with AF who underwent late gadolinium enhancement (LGE)-cardiac magnetic resonance imaging to quantify LA fibrosis severity between January 2007 and June 2015. Patients were stratified according to Utah stage of LA LGE criteria, and observed for the occurrence of MACCE, which included a composite of stroke or transient ischemic attack (TIA), myocardial infarction, acute decompensated HF, or cardiovascular death. Disease risk score (DRS) stratification was used to control for between-group differences in baseline characteristics and risk. RESULTS: During follow-up, 62 strokes or TIAs, 42 myocardial infarctions, 156 HF events, and 38 cardiovascular deaths occurred. In DRS stratified analysis, the hazard ratio comparing patients with stage IV versus stage I LA LGE was 1.67 (95% confidence interval: 1.01 to 2.76) for the composite MACCE outcome. The only individual component of the MACCE outcome to remain significantly associated with advanced LGE following DRS stratification was stroke or TIA (hazard ratio: 3.94; 95% confidence interval: 1.72 to 8.98). CONCLUSIONS: This retrospective analysis demonstrated that more severe LA LGE is associated with increased MACCE risk, driven primarily by increased risk of stroke or TIA.
[Mh] Termos MeSH primário: Fibrilação Atrial/complicações
Átrios do Coração/patologia
Ataque Isquêmico Transitório/etiologia
Imagem Cinética por Ressonância Magnética/métodos
Infarto do Miocárdio/etiologia
[Mh] Termos MeSH secundário: Idoso
Fibrilação Atrial/diagnóstico
Causas de Morte/tendências
Feminino
Fibrose/complicações
Fibrose/diagnóstico
Seguimentos
Seres Humanos
Incidência
Ataque Isquêmico Transitório/diagnóstico
Ataque Isquêmico Transitório/epidemiologia
Masculino
Meia-Idade
Infarto do Miocárdio/diagnóstico
Infarto do Miocárdio/epidemiologia
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Taxa de Sobrevida/tendências
Utah/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE


  10 / 18820 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28835400
[Au] Autor:Markus HS; Larsson SC; Kuker W; Schulz UG; Ford I; Rothwell PM; Clifton A; VIST Investigators
[Ad] Endereço:From the Stroke Research Group (H.S.M., S.C.L.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; Nuffield Department of Clinical Neurosciences (W.K., U.G.S., P.M.R.), John Radcliffe Hospital, University of Oxford; Robertson Centre for Biostatistics (I.F.),
[Ti] Título:Stenting for symptomatic vertebral artery stenosis: The Vertebral Artery Ischaemia Stenting Trial.
[So] Source:Neurology;89(12):1229-1236, 2017 Sep 19.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare in the Vertebral Artery Ischaemia Stenting Trial (VIST) the risks and benefits of vertebral angioplasty and stenting with best medical treatment (BMT) alone for symptomatic vertebral artery stenosis. METHODS: VIST was a prospective, randomized, open-blinded endpoint clinical trial performed in 14 hospitals in the United Kingdom. Participants with symptomatic vertebral stenosis ≥50% were randomly assigned (1:1) to vertebral angioplasty/stenting plus BMT or to BMT alone with randomization stratified by site of stenosis (extracranial vs intracranial). Because of slow recruitment and cessation of funding, recruitment was stopped after 182 participants. Follow-up was a minimum of ≥1 year for each participant. RESULTS: Three patients did not contribute any follow-up data and were excluded, leaving 91 patients in the stent group and 88 in the medical group. Mean follow-up was 3.5 (interquartile range 2.1-4.7) years. Of 61 patients who were stented, stenosis was extracranial in 48 (78.7%) and intracranial in 13 (21.3%). No periprocedural complications occurred with extracranial stenting; 2 strokes occurred during intracranial stenting. The primary endpoint of fatal or nonfatal stroke occurred in 5 patients in the stent group vs 12 in the medical group (hazard ratio 0.40, 95% confidence interval 0.14-1.13, = 0.08), with an absolute risk reduction of 25 strokes per 1,000 person-years. The hazard ratio for stroke or TIA was 0.50 ( = 0.05). CONCLUSIONS: Stenting in extracranial stenosis appears safe with low complication rates. Large phase 3 trials are required to determine whether stenting reduces stroke risk. ISRCTNCOM IDENTIFIER: ISRCTN95212240. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with symptomatic vertebral stenosis, angioplasty with stenting does not reduce the risk of stroke. However, the study lacked the precision to exclude a benefit from stenting.
[Mh] Termos MeSH primário: Angioplastia/métodos
Fármacos Hematológicos/uso terapêutico
Avaliação de Resultados (Cuidados de Saúde)
Intervenção Coronária Percutânea/métodos
Stents
Insuficiência Vertebrobasilar/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Angioplastia/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Ataque Isquêmico Transitório/etiologia
Masculino
Meia-Idade
Intervenção Coronária Percutânea/efeitos adversos
Método Simples-Cego
Acidente Vascular Cerebral/etiologia
Insuficiência Vertebrobasilar/complicações
Insuficiência Vertebrobasilar/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Hematologic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004385



página 1 de 1882 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde