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1. Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack. (Abstract)

Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack. An increasing body of evidence suggests that inflammation plays a key role in stroke, in particular stroke of atherosclerotic origin. Anti-inflammatory medications are a widely heterogeneous group of drugs that are used to suppress the innate inflammatory pathway and thus prevent persistent or recurrent inflammation. Anti-inflammatory agents have the potential (...) history of ischaemic stroke or transient ischaemic attack (TIA).We searched the Cochrane Central Register of Controlled Trials (CENTRAL; last searched 29 May 2019); MEDLINE (1948 to 29 May 2019); Embase (1980 to 29 May 2019); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 29 May 2019); and Scopus (1995 to 29 May 2019). In an effort to identify additional published, unpublished, and ongoing trials, we searched several grey literature sources (last searched 30 May 2019

2020 Cochrane

2. Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack. (Abstract)

Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack. Stroke is a leading cause of morbidity and mortality worldwide. Antiplatelet agents are considered to be the cornerstone for secondary prevention of stroke, but the role of using multiple antiplatelet agents early after stroke or transient ischaemic attack (TIA) to improve outcomes has not been established.To determine the effectiveness and safety of initiating, within (...) ; composite outcome of stroke, myocardial infarction, and vascular death; intracranial haemorrhage; extracranial haemorrhage; ischaemic stroke; death from all causes; and haemorrhagic stroke. We computed an estimate of treatment effect and performed a test for heterogeneity between trials. We analysed data on an intention-to-treat basis and assessed bias for all studies. We rated the certainty of the evidence using the GRADE approach.We included 15 RCTs with a total of 17,091 participants. Compared

2020 Cochrane

3. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

occlusion of the proximal posterior circulation (that is, basilar or posterior cerebral artery) demonstrated by CTA or MRA and and Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 9 of 38if there is the potential to salvage brain tissue, as shown by imaging such as CT perfusion or diffusion-weighted MRI sequences showing limited (...) ) for people with acute stroke who meet all of the following criteria: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 17 of 38clinical deficits that suggest infarction in the territory of the middle cerebral artery, with a score above 15 on the NIHSS decreased level of consciousness, with a score of 1 or more on item 1a

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

4. Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack. Full Text available with Trip Pro

first published in January 2014 and subsequently updated in December 2017.To assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events for people with stroke or transient ischaemic attack (TIA).We searched the Cochrane Stroke Group Trials Register (30 July 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 7), MEDLINE (1949 to 30 July 2019), Embase (1980 to 30 July 2019), CINAHL (1982 to 30 July 2019), AMED (1985 (...) Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack. Peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists are insulin-sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review

2019 Cochrane

5. Emergency care: Single or dual antiplatelet therapy after a transient ischaemic attack or minor ischaemic stroke?

Emergency care: Single or dual antiplatelet therapy after a transient ischaemic attack or minor ischaemic stroke? Single or dual antiplatelet therapy after a transient ischaemic attack or minor ischaemic stroke? | BMJ Evidence-Based Medicine Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password (...) For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Single or dual antiplatelet therapy after a transient ischaemic attack or minor ischaemic stroke? Article Text EBM Verdict Emergency care Single or dual antiplatelet therapy after a transient ischaemic attack or minor ischaemic stroke? Kamal R Mahtani , Carl Heneghan , Jeffrey Aronson Statistics from Altmetric.com A recent systematic review provides evidence on the antiplatelet

2019 Evidence-Based Medicine

6. Interventions for preventing silent cerebral infarcts in people with sickle cell disease. Full Text available with Trip Pro

silent cerebral infarcts or stroke; three trials were for primary stroke prevention and one trial dealt with secondary stroke prevention. Three trials compared the use of regular long-term red blood cell transfusions to standard care. Two of these trials included children with no previous long-term transfusions: one in children with normal transcranial doppler (TCD) velocities; and one in children with abnormal TCD velocities. The third trial included children and adolescents on long-term transfusion (...) -term red blood cell transfusions versus standard care Children with no previous long-term transfusions and higher risk of stroke (abnormal TCD velocities or previous history of silent cerebral infarcts) Long-term red blood cell transfusions may reduce the incidence of silent cerebral infarcts in children with abnormal TCD velocities, risk ratio (RR) 0.11 (95% confidence interval (CI) 0.02 to 0.86) (one trial, 124 participants, low-quality evidence); but make little or no difference to the incidence

2020 Cochrane

7. Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD2 score combined with the position of intracranial vascular stenosis. Full Text available with Trip Pro

Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD2 score combined with the position of intracranial vascular stenosis. This study aims to investigate the value of the ABCD score combined with the position of the offending vessel stenosis in predicting the risk of transient ischemic attack (TIA) to develop into cerebral infarction.The ABCD score and head magnetic resonance imaging + magnetic resonance angiography (MRA) results of 192 patients with TIA were (...) with short-term prognosis was analyzed.Based on the ABCD score, the incidence of cerebral infarction after 1 week was significantly higher in the high-risk group (85.7%) than in the moderate-risk group (16.7%) and low-risk group (1.9%), and the differences were statistically significant (P < .05). When the ABCD score was ≥4 points, the incidence of cerebral infarction after 1 week was significantly higher in the proximal vascular stenosis group (59.1%) than in the nonproximal vascular stenosis group

2019 Medicine

8. Cohort study: Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin

Cohort study: Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin | BMJ Evidence (...) OR managers of institutional accounts Username * Password * your user name or password? You are here Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin Article Text Aetiology/Harm Cohort study Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin

2015 Evidence-Based Medicine

9. Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack: A Pooled Analysis of Clopidogrel in High-Risk Patients With Acute Non-Disabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and Full Text available with Trip Pro

Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack: A Pooled Analysis of Clopidogrel in High-Risk Patients With Acute Non-Disabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and Dual antiplatelet therapy with clopidogrel and aspirin is effective for secondary prevention after minor ischemic stroke or transient ischemic attack (TIA). Uncertainties remained about the optimal duration of dual antiplatelet therapy (...) for minor stroke or TIA.To obtain precise estimates of efficacy and risk of dual antiplatelet therapy after minor ischemic stroke or TIA.This analysis pooled individual patient-level data from 2 large-scale randomized clinical trials that evaluated clopidogrel-aspirin as a treatment to prevent stroke after a minor stroke or high-risk TIA. The Clopidogrel in High-Risk Patients With Acute Non-Disabling Cerebrovascular Events (CHANCE) trial enrolled patients at 114 sites in China from October 1, 2009

2019 JAMA neurology

10. Study on the risk prediction for cerebral infarction after transient ischemic attack: A STROBE compliant study. Full Text available with Trip Pro

Study on the risk prediction for cerebral infarction after transient ischemic attack: A STROBE compliant study. Transient ischemic attack (TIA) is often recurrent, and about one-third of patients will progress to cerebral infarction. Rapidly identifying high-risk patients is pivotal to prevent the development of cerebral infarction. Therefore, this study aimed to evaluate the value of ABCD score, ABCD score combined with magnetic resonance diffusion weighted imaging (DWI) and intracranial (...) arterial magnetic resonance angiography (MRA) in predicting cerebral infarction after 2 to 30 days of transient ischemic attack (TIA).182 patients with TIA from August 2011 to August 2014 were enrolled as study subjects, and their clinical data, test results of DWI and MRA were collected. The incidence of cerebral infarction was observed at 2 days, 7 days and 30 days after TIA in patients with TIA, through scoring according to the 7-point ABCD score method proposed by Johnston. The relationship between

2020 Medicine

11. Transient ischaemic attack

dysfunction caused by focal brain, spinal cord, or retinal ischaemia, without acute infarction. Easton JD, Saver JL, Albers GW, et al. Definition and evaluation of transient ischemic attack. Stroke. 2009;40:2276-2293. http://stroke.ahajournals.org/content/40/6/2276.full http://www.ncbi.nlm.nih.gov/pubmed/19423857?tool=bestpractice.com This replaced the former definition of focal neurological impairment lasting less than 24 hours. The majority of TIAs resolve within the first hour, and diagnostic imaging (...) of therapy. Transient ischaemic attacks (TIAs) have considerable risk of early recurrent cerebral ischaemic events. Evaluation and initiation of secondary prevention should occur rapidly. In addition to a complete neurological examination and evaluation for diseases that mimic TIA, diagnostic imaging such as MRI with diffusion-weighted images may be helpful to detect evidence of sub-clinical cerebral infarction. Definition A transient ischaemic attack (TIA) is a transient episode of neurological

2018 BMJ Best Practice

12. A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial (Abstract)

A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial Patients with recent stroke or transient ischaemic attack are at high risk for a further vascular event, possibly leading to permanent disability or death. Although evidence-based treatments for secondary prevention are available, many patients do not achieve recommended behavioural modifications and pharmaceutical prevention targets (...) in the long-term. We aimed to investigate whether a support programme for enhanced secondary prevention can reduce the frequency of recurrent vascular events.INSPiRE-TMS was an open-label, multicentre, international randomised controlled trial done at seven German hospitals with acute stroke units and a Danish stroke centre. Patients with non-disabling stroke or transient ischaemic attack within 2 weeks from study enrolment and at least one modifiable risk factor (ie, arterial hypertension, diabetes

2019 EvidenceUpdates

13. Ticagrelor plus aspirin versus clopidogrel plus aspirin for platelet reactivity in patients with minor stroke or transient ischaemic attack: open label, blinded endpoint, randomised controlled phase II trial. Full Text available with Trip Pro

Ticagrelor plus aspirin versus clopidogrel plus aspirin for platelet reactivity in patients with minor stroke or transient ischaemic attack: open label, blinded endpoint, randomised controlled phase II trial. To test the hypothesis that ticagrelor plus aspirin is safe and superior to clopidogrel plus aspirin for reducing high platelet reactivity at 90 days and stroke recurrence in patients with minor stroke or transient ischaemic attack, particularly in carriers of the CYP2C19 loss-of-function (...) atherosclerosis in the ticagrelor/aspirin group had a lower stroke recurrence at 90 days than those in the clopidogrel/aspirin group (6.0% v 13.1%; hazard ratio 0.45, 95% confidence interval 0.20 to 0.98; P=0.04). No difference was seen in the rates of major or minor haemorrhagic events between the ticagrelor/aspirin and clopidogrel/aspirin groups (4.8% v 3.5%; P=0.42).Patients with minor stroke or transient ischaemic attack who are treated with ticagrelor plus aspirin have a lower proportion of high platelet

2019 BMJ Controlled trial quality: predicted high

14. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies. Full Text available with Trip Pro

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies. Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic (...) drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke.We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult

2019 Lancet Neurology

15. Dual antiplatelet therapy versus aspirin alone for stroke prevention after transient ischaemic attack or minor acute ischaemic stroke: an updated systematic review and meta-analysis

Dual antiplatelet therapy versus aspirin alone for stroke prevention after transient ischaemic attack or minor acute ischaemic stroke: an updated systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility (...) design Example: Species, sex, weight, age, co‐morbidity, anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s

2021 PROSPERO

16. Observational study: Risk of vascular events is lower than expected in patients with transient ischaemic attack or minor stroke treated promptly by stroke specialists

, Labreuche J , et al ., TIAregistry.org Investigators. One-year risk of stroke after transient ischemic attack or minor stroke . Context Previous studies estimated the risk of subsequent vascular events in patients with transient ischaemic attack (TIA) or minor stroke at 10–20% within 3 months. 1 , 2 Prevention strategies have been adjusted since. Up-to-date numbers would help to detect a possible temporal trend in risk and to prospectively evaluate risk-scoring tools and specific risk factors in current (...) Observational study: Risk of vascular events is lower than expected in patients with transient ischaemic attack or minor stroke treated promptly by stroke specialists Risk of vascular events is lower than expected in patients with transient ischaemic attack or minor stroke treated promptly by stroke specialists | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time

2016 Evidence-Based Medicine

17. Ticagrelor (Brilique) for preventing thombotic events in patients with acute ischaemic stroke or high risk transient ischaemic attack

belongs to a class of drugs called cyclopentyltriazolopyrimidine inhibitors, which bind directly to the P2Y₁₂ receptor without conversion to an active metabolite. This allows a rapid onset of action. Ticagrelor is intended to prevent thrombotic events in patients with acute ischaemic stroke or high risk transient ischaemic attack (TIA). Ticagrelor is administered at a dose of 90mg twice daily, following a single 180mg loading dose. It is currently licensed in combination with aspirin (...) Ticagrelor (Brilique) for preventing thombotic events in patients with acute ischaemic stroke or high risk transient ischaemic attack Ticagrelor (Brilique) for preventing thombotic events in patients with acute ischaemic stroke or high risk transient ischaemic attack Ticagrelor (Brilique) for preventing thombotic events in patients with acute ischaemic stroke or high risk transient ischaemic attack NIHR HSRIC Record Status This is a bibliographic record of a published health technology

2015 Health Technology Assessment (HTA) Database.

18. Risk Factors and Mortality Associated with Multimorbidity in People with Stroke or Transient Ischaemic Attack: A Study of 8,751 UK Biobank Participants Full Text available with Trip Pro

Risk Factors and Mortality Associated with Multimorbidity in People with Stroke or Transient Ischaemic Attack: A Study of 8,751 UK Biobank Participants Multimorbidity is common in stroke, but the risk factors and effects on mortality remain poorly understood.To examine multimorbidity and its associations with sociodemographic/lifestyle risk factors and all-cause mortality in UK Biobank participants with stroke or transient ischaemic attack (TIA).Data were obtained from an anonymized community (...) cohort aged 40-72 years. Overall, 42 comorbidities were self-reported by those with stroke or TIA. Relative risk ratios demonstrated associations between participant characteristics and number of comorbidities. Hazard ratios demonstrated associations between the number and type of comorbidities and all-cause mortality. Results were adjusted for age, sex, socioeconomic status, smoking, and alcohol intake. Data were linked to national mortality data. Median follow-up was 7 years.Of 8,751 participants

2018 Journal of comorbidity

19. Personalised antiplatelet therapy based on pharmacogenomics in acute ischaemic minor stroke and transient ischaemic attack: study protocol for a randomised controlled trial. Full Text available with Trip Pro

Personalised antiplatelet therapy based on pharmacogenomics in acute ischaemic minor stroke and transient ischaemic attack: study protocol for a randomised controlled trial. Antiplatelet therapy combining aspirin and clopidogrel is considered to be a key intervention for acute ischaemic minor stroke (AIMS) and transient ischaemic attack (TIA). However, the interindividual variability in response to clopidogrel resulting from the polymorphisms in clopidogrel metabolism-related genes has greatly (...) on days 2-21. The primary efficacy endpoint is a new stroke event (ischaemic or haemorrhagic) that happens within 1 year. The secondary efficacy endpoint is analysed as the individual or composite outcomes of the new clinical vascular event (ischaemic stroke, haemorrhagic stroke, myocardial infarction or vascular death). Baseline characteristics and outcomes after treatment will be evaluated.This protocol has been approved by the ethics committee of Yangpu Hospital, Tongji University School

2019 BMJ open Controlled trial quality: predicted high

20. Acute Cerebral Stroke with Multiple Infarctions and COVID-19, France, 2020. Full Text available with Trip Pro

Acute Cerebral Stroke with Multiple Infarctions and COVID-19, France, 2020. We describe 2 cases in coronavirus disease patients in France involving presumed thrombotic stroke that occurred during ongoing anticoagulation treatment for atrial fibrillation stroke prophylaxis; 1 patient had positive antiphospholipid antibodies. These cases highlight the severe and unique consequences of coronavirus disease-associated stroke.

2020 Emerging Infectious Diseases

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