Optimal combination secondary prevention drug treatment and stroke outcomes.

Abstract:

OBJECTIVE:To investigate the effect of optimal combination of evidence-based drug therapies including antihypertensive agents, lipid modifiers, and antithrombotic agents on risk of recurrent vascular events after stroke. METHODS:We analyzed the database of a multicenter trial involving 3,680 recent noncardioembolic stroke patients aged 35 years or older and followed for 2 years. Patients were categorized by appropriateness level 0 to III depending on the number of drugs prescribed divided by the number of drugs potentially indicated for each patient (0 = none of the indicated medications prescribed and III = all indicated medications prescribed). Independent associations of medication appropriateness level with recurrent stroke (primary outcome), stroke/coronary heart disease/vascular death as major vascular events (secondary outcome), and death (tertiary outcome) were assessed. RESULTS:The unadjusted rate of stroke declined with increasing medication appropriateness level (15.9% for level 0, 10.3% for level I, 8.6% for level II, and 7.3% for level III). Compared with level 0: the adjusted hazard ratio of stroke for level I was 0.51 (95% confidence interval, 0.21-1.25), level II 0.50 (0.23-1.09), and level III 0.39 (0.18-0.84); of stroke/coronary heart disease/vascular death for level I 0.60 (0.32-1.14), level II 0.45 (0.25-0.80), and level III 0.39 (0.22-0.69); and of death for level I 0.89 (0.30-2.64), level II 0.71 (0.26-1.93), and level III 0.35 (0.13-0.96). CONCLUSIONS:Optimal combination of secondary prevention medication classes after a recent noncardioembolic stroke is associated with a significantly lower risk of stroke, major vascular events, and death.

journal_name

Neurology

journal_title

Neurology

authors

Park JH,Ovbiagele B

doi

10.1212/WNL.0000000000001099

subject

Has Abstract

pub_date

2015-01-06 00:00:00

pages

50-6

issue

1

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000001099

journal_volume

84

pub_type

杂志文章
  • The apolipoprotein epsilon 4 allele in Parkinson's disease with and without dementia.

    abstract::The epsilon 4 isoform of apolipoprotein E (Apo-E) may confer genetic susceptibility for familial and sporadic Alzheimer's disease (AD). Because dementia in AD and Parkinson's disease (PD) share many biologic and clinical features, we determined the Apo-E genotypes for 79 patients with PD, 22 of whom were demented, and...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.44.7.1330

    authors: Marder K,Maestre G,Cote L,Mejia H,Alfaro B,Halim A,Tang M,Tycko B,Mayeux R

    更新日期:1994-07-01 00:00:00

  • Myasthenic congenital myopathy from recessive mutations at a single residue in NaV1.4.

    abstract:OBJECTIVE:To identify the genetic and physiologic basis for recessive myasthenic congenital myopathy in 2 families, suggestive of a channelopathy involving the sodium channel gene, SCN4A. METHODS:A combination of whole exome sequencing and targeted mutation analysis, followed by voltage-clamp studies of mutant sodium ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000007185

    authors: Elia N,Palmio J,Castañeda MS,Shieh PB,Quinonez M,Suominen T,Hanna MG,Männikkö R,Udd B,Cannon SC

    更新日期:2019-03-26 00:00:00

  • Caregiver preference for rivastigmine patches versus capsules for the treatment of Alzheimer disease.

    abstract::Alzheimer disease (AD) has a significant impact on caregivers. Administering and managing medications is one of their many daily tasks. More effective modes of drug administration may benefit patient and caregiver, and may improve compliance. A prospective outcome of the IDEAL (Investigation of TransDermal Exelon in A...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1212/01.wnl.0000281848.25142.11

    authors: Blesa R,Ballard C,Orgogozo JM,Lane R,Thomas SK

    更新日期:2007-07-24 00:00:00

  • The prevalence of MS in the United States: A population-based estimate using health claims data.

    abstract:OBJECTIVE:To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets. METHODS:A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 200...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000007035

    authors: Wallin MT,Culpepper WJ,Campbell JD,Nelson LM,Langer-Gould A,Marrie RA,Cutter GR,Kaye WE,Wagner L,Tremlett H,Buka SL,Dilokthornsakul P,Topol B,Chen LH,LaRocca NG,US Multiple Sclerosis Prevalence Workgroup.

    更新日期:2019-03-05 00:00:00

  • The clinical-DWI mismatch: a new diagnostic approach to the brain tissue at risk of infarction.

    abstract:OBJECTIVE:To evaluate the usefulness of a mismatch between the severity of acute clinical manifestations and the diffusion-weighted imaging (DWI) lesion in predicting early stroke outcome and infarct volume. METHODS:One hundred sixty-six patients with a hemispheric ischemic stroke of <12 hours' duration were studied. ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000130570.41127.ea

    authors: Dávalos A,Blanco M,Pedraza S,Leira R,Castellanos M,Pumar JM,Silva Y,Serena J,Castillo J

    更新日期:2004-06-22 00:00:00

  • Antisaccade task reflects cortical involvement in mild cognitive impairment.

    abstract:OBJECTIVE:The aims of this study were to examine executive dysfunction using an antisaccade (AS) task in normal elderly (NE) and patients with mild cognitive impairment (MCI) and Alzheimer disease (AD) as well as to evaluate the relationship between AS performance and cortical thinning within AD-associated regions. ME...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182a6cbfe

    authors: Heuer HW,Mirsky JB,Kong EL,Dickerson BC,Miller BL,Kramer JH,Boxer AL

    更新日期:2013-10-01 00:00:00

  • A population study on blood-brain barrier function in 85-year-olds: relation to Alzheimer's disease and vascular dementia.

    abstract::We investigated blood-brain barrier (BBB) function in relation to Alzheimer's disease (AD) and vascular dementia (VAD) in the very elderly. Sixty-five 85-year-old persons from a population-based sample were followed for 3 years; 29 were demented at age 85 (13 with AD, 14 with VAD, and 2 with other dementias), 7 develo...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.50.4.966

    authors: Skoog I,Wallin A,Fredman P,Hesse C,Aevarsson O,Karlsson I,Gottfries CG,Blennow K

    更新日期:1998-04-01 00:00:00

  • Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports.

    abstract::With the use of the newer antidepressants beyond the traditional tricyclics and monoamine oxidase inhibitors, newer options in headache prophylaxis are provided as well as the potential for undesirable and even potentially life-threatening interactions between medications. In this article, four patient reports of a sp...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.51.1.274

    authors: Diamond S,Pepper BJ,Diamond ML,Freitag FG,Urban GJ,Erdemoglu AK

    更新日期:1998-07-01 00:00:00

  • Long-term cerebral white and gray matter changes after preeclampsia.

    abstract:OBJECTIVE:To determine whether changes in cerebral structure are present after preeclampsia that may explain increased cerebrovascular risk in these women. METHODS:We conducted a case control study in women between 5 and 15 years after either a preeclamptic or normotensive pregnancy. Brain MRI was performed. Analysis ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000003765

    authors: Siepmann T,Boardman H,Bilderbeck A,Griffanti L,Kenworthy Y,Zwager C,McKean D,Francis J,Neubauer S,Yu GZ,Lewandowski AJ,Sverrisdottir YB,Leeson P

    更新日期:2017-03-28 00:00:00

  • Effect of ApoE isoforms on mitochondria in Alzheimer disease.

    abstract:OBJECTIVE:To test the hypothesis that ApoE isoforms affect mitochondrial structure and function that are related to cognitive impairment in Alzheimer disease (AD), we systematically investigated the effects of ApoE isoforms on mitochondrial biogenesis and dynamics, oxidative stress, synapses, and cognitive performance ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000009582

    authors: Yin J,Reiman EM,Beach TG,Serrano GE,Sabbagh MN,Nielsen M,Caselli RJ,Shi J

    更新日期:2020-06-09 00:00:00

  • HLA-linked complement markers in Alzheimer's and Parkinson's disease: C4 variant (C4B2) a possible marker for senile dementia of the Alzheimer type.

    abstract::We determined the gene frequencies for the alleles of the HLA-linked complement markers C2, properdin factor B (BF), C4A (Rodgers) and C4B (Chido), and the red cell enzyme glyoxalase-I in 38 unrelated patients with senile dementia of the Alzheimer type, 42 patients with idiopathic Parkinson's disease, and 59 unaffecte...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.34.3.310

    authors: Nerl C,Mayeux R,O'Neill GJ

    更新日期:1984-03-01 00:00:00

  • 1H-MRS alterations in the cerebellum of patients with familial hemiplegic migraine type 1.

    abstract:BACKGROUND:About 20% of patients with familial hemiplegic migraine (FHM) develop progressive cerebellar signs. Genetic studies have established an association with mutations in the CACNA1A gene. However, the mechanisms underlying cerebellar involvement are largely unknown. OBJECTIVE:To use proton MR spectroscopy (1H-M...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.WNL.0000151855.98318.50

    authors: Dichgans M,Herzog J,Freilinger T,Wilke M,Auer DP

    更新日期:2005-02-22 00:00:00

  • Nonspecificity of ring enhancement in "medically cured" brain abscess.

    abstract::Since the introduction of computed tomography (CT), there have been numerous reports of brain abscess treated successfully without surgery. Because pathologic confirmation was lacking in these patients, diagnosis was based on CT abnormalities, usually ring enhancement. However, our recent clinical experience and the e...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.34.2.139

    authors: Dobkin JF,Healton EB,Dickinson PC,Brust JC

    更新日期:1984-02-01 00:00:00

  • A placebo-controlled trial of insulin-like growth factor-I in amyotrophic lateral sclerosis. European ALS/IGF-I Study Group.

    abstract::To test the safety and efficacy of recombinant human insulin-like growth factor-I (rhIGF-I) in ALS, 183 patients from eight European centers were randomized to receive double-blind placebo (n = 59) or rhIGF-I 0.1 mg/kg/day (n = 124) subcutaneously for 9 months. At study completion, the primary efficacy outcome measure...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1212/wnl.51.2.583

    authors: Borasio GD,Robberecht W,Leigh PN,Emile J,Guiloff RJ,Jerusalem F,Silani V,Vos PE,Wokke JH,Dobbins T

    更新日期:1998-08-01 00:00:00

  • Poor school and cognitive functioning with silent cerebral infarcts and sickle cell disease.

    abstract::The authors evaluated education attainment and neuropsychological deficits in children with sickle cell disease (SCD) and silent cerebral infarcts. Children with silent infarcts had twice the rate of school difficulties as children without infarcts. Eighty percent of silent infarct cases had clinically significant cog...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.56.8.1109

    authors: Schatz J,Brown RT,Pascual JM,Hsu L,DeBaun MR

    更新日期:2001-04-24 00:00:00

  • Bid signal pathway components are identified in the temporal cortex with Parkinson disease.

    abstract:OBJECTIVE:Parkinson disease (PD), a devastating neurodegenerative disorder, affects motor abilities and cognition as well. It is not clear whether the proapoptotic protein, Bid, is involved in tumor necrosis factor death receptor I (TNFRI)-mediated destructive signal transduction pathways such as cell dysfunction or ne...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182703f76

    authors: Jiang H,He P,Adler CH,Shill H,Beach TG,Li R,Shen Y

    更新日期:2012-10-23 00:00:00

  • "Undiagnosing" multiple sclerosis: the challenge of misdiagnosis in MS.

    abstract:OBJECTIVE:To describe the clinical characteristics of encounters with patients misdiagnosed with multiple sclerosis (MS). METHODS:A cross-sectional Internet-based physician survey of MS specialists was performed. RESULTS:The response rate for the survey was 50.4%. Of those who responded, the majority (95%) reported h...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e318259e1b2

    authors: Solomon AJ,Klein EP,Bourdette D

    更新日期:2012-06-12 00:00:00

  • Imitation synkinesia and sensory control of movement.

    abstract::Immitation synkinesia is usually associated with thalamic or parietal lesions. Analysis of three cases shows that the lesions may affect the posterior columns of the spinal cord or even the peripheral nervous system. In our cases, two facts stand out, a large measure of integrity of motor activity and predominant dist...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.27.7.646

    authors: Cambier J,Dehen H

    更新日期:1977-07-01 00:00:00

  • Functional hemispherectomy: EEG findings, spiking from isolated brain postoperatively, and prediction of outcome.

    abstract::We reviewed the prognostic significance of preoperative EEG findings in 25 patients who underwent functional hemispherectomy. Bilateral independent epileptogenic foci, found in five patients, generally indicate a less satisfactory outcome, with only three of the five patients becoming seizure free following hemisphere...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.11.1790

    authors: Smith SJ,Andermann F,Villemure JG,Rasmussen TB,Quesney LF

    更新日期:1991-11-01 00:00:00

  • Stroke after zoster ophthalmicus in a 12-year-old girl with protein C deficiency.

    abstract::A 12-year-old girl who had zoster ophthalmicus 10 months earlier presented with hemiparesis and corresponding basal ganglionic infarction related to middle cerebral artery branch thrombosis ipsilateral to the zoster. Hematologic evaluation disclosed protein C deficiency. This represents the first zoster-associated str...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.53.5.1128

    authors: Cadavid D,Pearl PL,Dubovsky EC,Angiolillo A,Vezina LG

    更新日期:1999-09-22 00:00:00

  • Lateralizing signs in intractable partial epilepsy: blinded multiple-observer analysis.

    abstract::We evaluated the accuracy and interobserver variability of selected ictal and postictal behavioral changes. Three observers, blinded to clinical history, EEG, and side of surgical resection, analyzed videotapes of 166 seizures in 38 patients, looking for lateralizing signs. Twenty-seven patients with temporal lobe res...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.12.2519

    authors: Chee MW,Kotagal P,Van Ness PC,Gragg L,Murphy D,Lüders HO

    更新日期:1993-12-01 00:00:00

  • The effects of 4-aminopyridine on cognitive function in patients with multiple sclerosis: a pilot study.

    abstract::4-Aminopyridine (4-AP) has a favorable effect on the disability of certain patients with MS. We investigated the effect of 4-AP on neuropsychological performance in 20 MS patients using a randomized, double-blind, placebo-controlled, crossover design. Although there was a trend for improved performance with 4-AP for t...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.44.9.1701

    authors: Smits RC,Emmen HH,Bertelsmann FW,Kulig BM,van Loenen AC,Polman CH

    更新日期:1994-09-01 00:00:00

  • Primary writing tremor and myoclonic writer's cramp.

    abstract::Four patients with primary writing tremor had a focal, task-specific tremor that responded to anticholinergic drugs. Physiologic features included EMG activity alternating in antagonist muscles, 5- to 20-microV cerebral potentials evoked by stretch of pronator teres, and no C-reflexes. Another patient had myoclonic je...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.35.9.1387

    authors: Ravits J,Hallett M,Baker M,Wilkins D

    更新日期:1985-09-01 00:00:00

  • Head trauma preceding PD: a case-control study.

    abstract:OBJECTIVE:To investigate the association of PD with preceding head trauma using a case-control study design. METHODS:The medical records-linkage system of the Rochester Epidemiology Project was used to identify 196 subjects who developed PD in Olmsted County, MN, from 1976 through 1995. Each incident case was matched ...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/01.wnl.0000068008.78394.2c

    authors: Bower JH,Maraganore DM,Peterson BJ,McDonnell SK,Ahlskog JE,Rocca WA

    更新日期:2003-05-27 00:00:00

  • Randomized controlled trial of atorvastatin in clinically isolated syndrome: the STAyCIS study.

    abstract:OBJECTIVE:To test efficacy and safety of atorvastatin in subjects with clinically isolated syndrome (CIS). METHODS:Subjects with CIS were enrolled in a phase II, double-blind, placebo-controlled, 14-center randomized trial testing 80 mg atorvastatin on clinical and brain MRI activity. Brain MRIs were performed quarter...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1212/WNL.0b013e31824f7fdd

    authors: Waubant E,Pelletier D,Mass M,Cohen JA,Kita M,Cross A,Bar-Or A,Vollmer T,Racke M,Stüve O,Schwid S,Goodman A,Kachuck N,Preiningerova J,Weinstock-Guttman B,Calabresi PA,Miller A,Mokhtarani M,Iklé D,Murphy S,Kopetskie

    更新日期:2012-04-10 00:00:00

  • Late-onset anti-NMDA receptor encephalitis.

    abstract:OBJECTIVE:To describe the clinical features and outcome of anti-NMDA receptor (NMDAR) encephalitis in patients ≥45 years old. METHOD:Observational cohort study. RESULTS:In a cohort of 661 patients with anti-NMDAR encephalitis, we identified 31 patients ≥45 years old. Compared with younger adults (18-44 years), older ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3182a4a49c

    authors: Titulaer MJ,McCracken L,Gabilondo I,Iizuka T,Kawachi I,Bataller L,Torrents A,Rosenfeld MR,Balice-Gordon R,Graus F,Dalmau J

    更新日期:2013-09-17 00:00:00

  • Treatment of Rasmussen's syndrome with ganciclovir.

    abstract::Since cytomegalovirus (CMV) has been implicated in the pathogenesis of Rasmussen's syndrome, we treated four patients with ganciclovir, a potent anti-CMV drug. A 7-year-old girl with seizures escalating to 60/day over 3 months despite triple antiepileptic drug therapy became seizure-free 5 days after initiation of tre...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.47.4.925

    authors: McLachlan RS,Levin S,Blume WT

    更新日期:1996-10-01 00:00:00

  • Biologic impact of interferon antibodies, and complexities in assessing their clinical significance.

    abstract::The relevance of neutralizing antibodies (NAb) to interferon-beta (IFNbeta) for patients with MS treated with IFNbeta injections has been controversial. Published data from several double-blind, randomized clinical trials demonstrate that disease activity in IFNbeta-treated patients with MS is similar to placebo-treat...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/01.wnl.0000092363.40248.0e

    authors: Rudick RA

    更新日期:2003-11-11 00:00:00

  • Amygdala and hippocampal volumes in children with Down syndrome: a high-resolution MRI study.

    abstract::The objective of this study was to use high-resolution MRI techniques to determine whether children with Down syndrome exhibit decreases in hippocampal and amygdala volumes similar to those demonstrated in recent studies of adults with this condition. When corrected for overall brain volumes, amygdala volumes did not ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.56.7.972

    authors: Pinter JD,Brown WE,Eliez S,Schmitt JE,Capone GT,Reiss AL

    更新日期:2001-04-10 00:00:00

  • The methylphenidate-induced stereotypy in the awake rat: local cerebral metabolism.

    abstract::The local cerebral metabolic rate for glucose (1=CMRg) was computed in rats with methylphenidate-induced stereotypy using the quantitative 14C-2-deoxyglucose (2-DG) technique. Four rats received methylphenidate 15 mg per kilogram IP. Compared to five control animals, treated rats showed statistically significant (p le...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.32.4.377

    authors: Bell RD,Alexander GM,Schwartzman RJ,Yu J

    更新日期:1982-04-01 00:00:00