Abstract:
BACKGROUND AND PURPOSE:To compare the efficacy and safety of antiplatelet agents for the secondary prevention of ischemic stroke based on cytochrome P450 2C19 (CYP2C19) polymorphisms. METHODS:This study was a prospective, multicenter, randomized, parallel-group, open-label, blind genotype trial. First time non-cardiogenic ischemic stroke patients were enrolled and screened within 30 days. Participants were randomized to receive either triflusal or clopidogrel for secondary stroke prevention. The primary outcome was the time from randomization to first recurrent ischemic stroke or hemorrhagic stroke. RESULTS:The required sample size was 1,080 but only 784 (73%) participants were recruited. In patients with a poor CYP2C19 genotype for clopidogrel metabolism (n=484), the risk of recurrent stroke among those who received triflusal treatment was 2.9% per year, which was not significantly different from those who received clopidogrel treatment (2.2% per year; hazard ratio [HR], 1.23; 95% confidence interval [CI], 0.60-2.53). In the clopidogrel treatment group (n=393), 38% had good genotypes and 62% poor genotypes for clopidogrel metabolism. The risk of recurrent stroke in patients with a good CYP2C19 genotype was 1.6% per year, which was not significantly different from those with a poor genotype (2.2% per year; HR, 0.69; 95% CI, 0.26-1.79). CONCLUSIONS:Whilst there were no significant differences between the treatment groups in the rates of stroke recurrence, major vascular events, or coronary revascularization, the efficacy of antiplatelet agents for the secondary prevention of stroke according to CYP2C19 genotype status remains unclear.
journal_name
J Strokejournal_title
Journal of strokeauthors
Han SW,Kim YJ,Ahn SH,Seo WK,Yu S,Oh SH,Nam HS,Choi HY,Yoon SS,Kim SH,Lee JY,Lee JH,Hwang YH,Lee KO,Jung YH,Lee J,Sohn SI,Kim YN,Lee KA,Bushnell CD,Lee KYdoi
10.5853/jos.2017.01249subject
Has Abstractpub_date
2017-09-01 00:00:00pages
356-364issue
3eissn
2287-6391issn
2287-6405pii
jos-2017-01249journal_volume
19pub_type
杂志文章abstract:BACKGROUND AND PURPOSE:Early neurologic deterioration (END) occurs in up to one-third of patients with ischemic stroke and is associated with poor outcomes. The purpose of the present study was to determine which stroke etiologies and vascular distributions pose a greater threat of END in stroke patients. METHODS:Usin...
journal_title:Journal of stroke
pub_type: 杂志文章
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更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:As a leading cause of disability and death in China, stroke as well as its epidemiologic features have gained increasing attention. Prior studies, however, have overgeneralized the north-to-south gradient in China. Whether the differences exist across urban and rural areas remains unexplored. Thi...
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pub_type: 杂志文章
doi:10.5853/jos.2020.02383
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abstract::Spontaneous intracerebral hemorrhage (ICH) is a catastrophic illness causing significant morbidity and mortality. Despite advances in surgical technique addressing primary brain injury caused by ICH, little progress has been made treating the subsequent inflammatory cascade. Pre-clinical studies have made advancements...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2019.02236
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abstract::Trimethylamine N-oxide (TMAO) is produced when trimethylamine, a waste product of gut microbes, is converted via hepatic flavin monooxygenases. As TMAO is a potential causative factor in various cardiovascular diseases (CVDs) considerable research interest has arisen on its use as a biomarker. Higher TMAO levels are a...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2019.00472
更新日期:2019-05-01 00:00:00
abstract::Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the "Stroke Statistics in Korea" project, aimed at writing a contemporary, comprehensive, and representative report on ...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2018.03125
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To test whether alcohol intake, both observational and estimated by genetic instruments, is associated with risk of ischemic and haemorrhagic stroke. METHODS:We used data from the Copenhagen City Heart Study 1991 to 1994 and 2001 to 2003, and the Copenhagen General Population Study 2003 to 2012 ...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2017.01466
更新日期:2018-05-01 00:00:00
abstract:: ...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2019.00850
更新日期:2019-09-01 00:00:00
abstract:: ...
journal_title:Journal of stroke
pub_type: 社论
doi:10.5853/jos.2019.02474
更新日期:2019-09-01 00:00:00
abstract::Heart failure (HF) is one of the major causes of death worldwide. Despite the high incidence of stroke in patients with HF, there has been a controversy as to whether HF itself is a risk factor for stroke. Recently, there is a great deal of evidence that HF itself increases the risk of stroke. In previous studies, the...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2017.02810
更新日期:2018-01-01 00:00:00
abstract::CT perfusion (CTP) has been applied increasingly in research of ischemic stroke. However, in clinical practice, it is still a relatively new technology. For neurologists and radiologists, the challenge is to interpret CTP results properly in the context of the clinical presentation. In this article, we will illustrate...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2013.15.3.164
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The benefit of statins in acute stroke remains uncertain. Statins may prevent stroke recurrence during the acute stage of stroke via pleiotropic effects. However, statins may increase the risk of intracerebral hemorrhage. We investigated the effect and safety of rosuvastatin in acute stroke patie...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2015.01578
更新日期:2016-01-01 00:00:00
abstract::Hypertension is the most important potentially reversible risk factor for stroke in all age groups; high blood pressure (BP) is also associated with increased risk of recurrent stroke in patients who have already had an ischemic or hemorrhagic event. Twenty-four hour ambulatory BP monitoring (ABPM) has become an impor...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2015.01102
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Organized inpatient stroke care is one of the most effective therapies for improving patient outcomes. Many stroke centers have been established to meet this need, however, there are limited data on the effectiveness of these organized comprehensive stroke center (CSC) in the real-world setting. ...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2013.15.1.57
更新日期:2013-01-01 00:00:00
abstract::Intravenous thrombolysis is an effective treatment for acute ischaemic stroke. However, vascular recanalization rates remain poor especially in the setting of large artery occlusion. On the other hand, endovascular intra-arterial therapy addresses this issue with superior recanalization rates compared with intravenous...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2015.17.2.127
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cerebral small vessel disease (SVDs) are related with large artery atherosclerosis. However, the association between aortic atheroma (AA) and cerebral small vessel disease has rarely been reported. This study evaluated the relationship between presence and burden of AAs and those of SVDs in patie...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2016.00171
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Thrombolysis >4.5 hours after ischemic stroke onset is unproven. We assessed the feasibility of tenecteplase (TNK) treatment in patients with evidence of an ischemic penumbra 4.5 to 24 hours after onset. METHODS:Acute ischemic stroke patients underwent perfusion computed tomography (CT)/magnetic...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2017.00178
更新日期:2018-01-01 00:00:00
abstract::Stroke genetics includes several topics of clinical interest, including (1) molecular genetic variations affecting risk of monogenic stroke syndromes; (2) molecular genetic variations affecting risk of common stroke syndromes, sometimes with specific effects on risk of specific main types of stroke or subtypes of isch...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2014.16.3.114
更新日期:2014-09-01 00:00:00
abstract::Patent foramen ovale (PFO) is growing in clinical interest because of a renewed focus on embolic stroke of undetermined source (ESUS), the PFO attributable fraction (the 10-point Risk of Paradoxical Embolism score), technical advances in PFO diagnosis, and the emergence of endovascular device closure as a treatment op...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2015.17.3.229
更新日期:2015-09-01 00:00:00
abstract::The optimal treatment strategy for secondary prevention in patients with cryptogenic stroke and patent foramen ovale (PFO) has been a matter of controversy for decades. After three randomized trials failed to show a benefit of closure with an excess of complications in the interventional arm, two large recent trials s...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2018.03097
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Rapid recanalization might improve clinical outcomes after intraarterial thrombolysis (IAT) for acute ischemic stroke patients with collateral circulation. We determined whether rapid recanalization and collateral circulation affect clinical outcomes after IAT. METHODS:We retrospectively evaluat...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2015.17.1.76
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Compression of the anterior optic pathway results in visual deficits that can lead to the detection of unruptured aneurysms in the internal carotid artery (ICA). The general types of treatment modalities for aneurysms and visual deficits include surgery and endosaccular coiling. This study retros...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2015.17.3.344
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The pathogenesis of moyamoya disease (MMD) remains poorly understood, and no reliable molecular biomarkers for MMD have been identified to date. The present study aimed to identify epigenetic biomarkers for use in the diagnosis of MMD. METHODS:We performed integrated analyses of gene expression ...
journal_title:Journal of stroke
pub_type: 杂志文章
doi:10.5853/jos.2018.00962
更新日期:2018-09-01 00:00:00
abstract::Endovascular recanalization therapy (ERT) has been a standard of care for patients with acute ischemic stroke due to large artery occlusion (LAO) within 6 hours after onset, since five landmark ERT trials conducted by 2015 demonstrated its clinical benefit. Recently, two randomized clinical trials demonstrated that ER...
journal_title:Journal of stroke
pub_type: 指南
doi:10.5853/jos.2019.00024
更新日期:2019-05-01 00:00:00
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journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2014.16.2.59
更新日期:2014-05-01 00:00:00
abstract::Proper classification of the causative mechanism of stroke is important for optimizing stroke treatment and assessing prognosis. The primary etiology of stroke differs according to race and ethnicity: emboli originating from the heart or extracranial large arteries are common in Western populations, whereas small-vess...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2014.16.1.8
更新日期:2014-01-01 00:00:00
abstract::To date, reperfusion with tissue plasminogen activator (tPA) remains the gold standard treatment for ischemic stroke. However, when tPA is given beyond 4.5 hours of stroke onset, deleterious effects of the drug ensue, especially, hemorrhagic transformation (HT), which causes the most significant morbidity and mortalit...
journal_title:Journal of stroke
pub_type: 杂志文章,评审
doi:10.5853/jos.2016.01515
更新日期:2017-01-01 00:00:00