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Article ; Online: The Concept of Transient Ischemic Attack-Reply.

Easton, J Donald / Johnston, S Claiborne

2022 Volume 327, Issue 24, Page(s) 2457

MeSH term(s)	Humans ; Ischemic Attack, Transient
Language	English
Publishing date	2022-06-28
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.7630
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Article ; Online: Time to Retire the Concept of Transient Ischemic Attack.

Easton, J Donald / Johnston, S Claiborne

JAMA

2022 Volume 327, Issue 9, Page(s) 813–814

MeSH term(s)	Humans ; Ischemic Attack, Transient ; Terminology as Topic
Language	English
Publishing date	2022-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.0300
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Article ; Online: Baseline Stroke Risk and Efficacy of Dual-Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.

Daghlas, Iyas / Johnston, S Claiborne / Easton, J Donald / Kim, Anthony S

Stroke

2024 Volume 55, Issue 2, Page(s) 385–391

Abstract: Background: High-risk transient ischemic attacks and minor ischemic strokes are followed by a variable risk of ischemic stroke. We aimed to determine how baseline stroke risk modified the efficacy of clopidogrel-aspirin (referred to here as dual- ... ...

Abstract	Background: High-risk transient ischemic attacks and minor ischemic strokes are followed by a variable risk of ischemic stroke. We aimed to determine how baseline stroke risk modified the efficacy of clopidogrel-aspirin (referred to here as dual-antiplatelet therapy [DAPT]) for transient ischemic attack and minor ischemic stroke. Methods: We performed an unplanned secondary analysis of the POINT trial (Platelet-Oriented Inhibition in New Transient Ischemic Attack and Minor Ischemic Stroke). We first evaluated the associations of the CHA Results: A total of 4841 trial participants were included in this analysis, with 2400 participants assigned to treatment with short-term DAPT and 2430 participants to treatment with aspirin and placebo. The dichotomized SPI-II score, but not the CHA Conclusions: Stratification by baseline stroke risk identifies a patient subgroup that derives greater absolute benefit from treatment with DAPT. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00991029.
MeSH term(s)	Humans ; Aspirin/adverse effects ; Drug Therapy, Combination ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Hemorrhage/complications ; Ischemic Attack, Transient/drug therapy ; Ischemic Attack, Transient/epidemiology ; Ischemic Attack, Transient/complications ; Ischemic Stroke/drug therapy ; Platelet Aggregation Inhibitors/adverse effects ; Risk Factors ; Stroke/epidemiology ; Stroke/prevention & control ; Stroke/complications ; Treatment Outcome ; Clinical Trials as Topic
Chemical Substances	Aspirin (R16CO5Y76E) ; Platelet Aggregation Inhibitors
Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.123.044927
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Article ; Online: Henry J.M. Barnett, MD, FRCP (C).

Easton, J Donald

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2016 Volume 25, Issue 12, Page(s) 2791

MeSH term(s)	Biomedical Research/history ; History, 20th Century ; History, 21st Century ; Humans ; Neurology/history ; Stroke/history ; Stroke/prevention & control
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Biography ; Historical Article ; Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2016.10.036
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Article ; Online: New opportunities to optimize antithrombotic therapy for secondary stroke prevention.

Kim, Anthony S / Easton, J Donald

International journal of stroke : official journal of the International Stroke Society

2019 Volume 14, Issue 3, Page(s) 220–222

Abstract: Stroke symptoms can be unsettling, even when symptoms resolve, but focusing on stroke prevention can be empowering provided that effective interventions for appropriate patient populations are available. Current options include interventions for ... ...

Abstract	Stroke symptoms can be unsettling, even when symptoms resolve, but focusing on stroke prevention can be empowering provided that effective interventions for appropriate patient populations are available. Current options include interventions for symptomatic carotid artery stenosis, anticoagulation for atrial fibrillation, high-dose statins, new oral anticoagulants, new developments in atrial fibrillation detection, and new therapeutics are in development. For antiplatelet therapy, aspirin monotherapy is effective but dual antiplatelet therapy with the combination of aspirin and clopidogrel increases hemorrhage risks over the long term that outweigh potential benefits. In the short term though, both the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trials have shown a benefit of short-term dual-antiplatelet therapy, though the increased major hemorrhage risk seen in POINT could justify applying dual-antiplatelet therapy to just the first 21 days. Furthermore, since clopidogrel is a prodrug that must be metabolized to have antiplatelet activity, it is not surprising that the treatment effect in CHANCE was limited to patients who were not carriers of loss-of-function alleles for clopidogrel metabolism. Ticagrelor, an antiplatelet agent which failed to meet its primary endpoint as monotherapy compared to aspirin in the Acute Stroke or Transient Ischaemic Attack Treated with Aspirin or Ticagrelor and Patient Outcomes (SOCRATES) trial, is currently being tested as combination therapy with aspirin compared to aspirin alone in Acute Stroke or Transient Ischaemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death (THALES). These developments along with improvements to the infrastructure to perform rapid evaluations and to apply intensive secondary stroke prevention interventions hold continued promise for the future.
MeSH term(s)	Aspirin/therapeutic use ; Clopidogrel/therapeutic use ; Drug Therapy, Combination ; Fibrinolytic Agents/therapeutic use ; Humans ; Ischemic Attack, Transient/drug therapy ; Platelet Aggregation Inhibitors/therapeutic use ; Secondary Prevention ; Stroke/drug therapy ; Ticagrelor/therapeutic use ; Ticlopidine/therapeutic use ; Treatment Outcome
Chemical Substances	Fibrinolytic Agents ; Platelet Aggregation Inhibitors ; Clopidogrel (A74586SNO7) ; Ticagrelor (GLH0314RVC) ; Ticlopidine (OM90ZUW7M1) ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2019-02-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2303728-3
ISSN	1747-4949 ; 1747-4930
ISSN (online)	1747-4949
ISSN	1747-4930
DOI	10.1177/1747493019828548
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Article ; Online: History of carotid endarterectomy then and now: personal perspective.

Easton, J Donald

Stroke

2014 Volume 45, Issue 6, Page(s) e101–3

MeSH term(s)	Carotid Arteries/surgery ; Endarterectomy, Carotid/history ; Endarterectomy, Carotid/methods ; History, 20th Century ; History, 21st Century ; Humans
Language	English
Publishing date	2014-06
Publishing country	United States
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.113.003501
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Article ; Online: Review and update of the concept of embolic stroke of undetermined source.

Diener, Hans-Christoph / Easton, J Donald / Hart, Robert G / Kasner, Scott / Kamel, Hooman / Ntaios, George

Nature reviews. Neurology

2022 Volume 18, Issue 8, Page(s) 455–465

Abstract: Ischaemic strokes have traditionally been classified according to the TOAST criteria, in which strokes with unclear aetiology are classified as cryptogenic strokes. However, the definition of cryptogenic stroke did not meet the operational criteria ... ...

Abstract	Ischaemic strokes have traditionally been classified according to the TOAST criteria, in which strokes with unclear aetiology are classified as cryptogenic strokes. However, the definition of cryptogenic stroke did not meet the operational criteria necessary to define patient populations for randomized treatment trials. To address this problem, the concept of embolic stroke of undetermined source (ESUS) was developed and published in 2014. A hypothesis that underpinned this concept was that most strokes in patients with ESUS are caused by embolic events, perhaps many cardioembolic, and that anticoagulation would prevent secondary ischaemic events. On this basis, two large randomized trials were conducted to compare the non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran and rivaroxaban with aspirin. Neither NOAC was superior to aspirin in these trials, although subgroups of patients with ESUS seemed to benefit specifically from anticoagulation or antiplatelet therapy. The neutral results of the trials of anticoagulation and insights into ESUS from research conducted since the concept was introduced warrant reassessment of the ESUS construct as a research concept and a treatment target. In this Review, we discuss the evidence produced since the concept of ESUS was introduced, and propose updates to the criteria and diagnostic algorithm in light of the latest knowledge.
MeSH term(s)	Administration, Oral ; Anticoagulants/therapeutic use ; Aspirin ; Embolic Stroke ; Humans ; Intracranial Embolism/complications ; Ischemic Stroke ; Platelet Aggregation Inhibitors/therapeutic use ; Stroke/diagnosis ; Stroke/drug therapy ; Stroke/etiology
Chemical Substances	Anticoagulants ; Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2022-05-10
Publishing country	England
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2491514-2
ISSN	1759-4766 ; 1759-4758
ISSN (online)	1759-4766
ISSN	1759-4758
DOI	10.1038/s41582-022-00663-4
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Article ; Online: Antithrombotic management for transient ischemic attack and ischemic stroke (other than atrial fibrillation).

Easton, J Donald

Current atherosclerosis reports

2011 Volume 13, Issue 4, Page(s) 314–320

Abstract: The new definition and risk stratification for transient ischemic attack (TIA) have clear implications for the urgency of evaluation and treatment. The optimal antithrombotic treatment for TIA is being intensively studied. New guidelines for prevention ... ...

Abstract	The new definition and risk stratification for transient ischemic attack (TIA) have clear implications for the urgency of evaluation and treatment. The optimal antithrombotic treatment for TIA is being intensively studied. New guidelines for prevention of non-cardioembolic stroke in patients with stroke or TIA recommend the use of antiplatelet agents rather than oral anticoagulation. New antiplatelet drugs are being used in cardiovascular patients, and their role in cerebrovascular patients is being studied. The impact of genetic CYP2C19 polymorphisms is becoming clarified in cardiovascular patients and it is likely these polymorphisms will affect the management of cerebrovascular patients. The results of trials of clopidogrel plus aspirin in patients with lacunar strokes and acute TIAs are forthcoming. The results of CLOSURE I, a study of a patent foramen ovale device closure trial for cryptogenic stroke or TIA, showed no differences in stroke or TIA at 2 years.
MeSH term(s)	Adenosine/analogs & derivatives ; Adenosine/therapeutic use ; Aryl Hydrocarbon Hydroxylases/genetics ; Brain Ischemia/drug therapy ; Cilostazol ; Clinical Trials as Topic ; Clopidogrel ; Cytochrome P-450 CYP2C19 ; Cytochrome P-450 Enzyme System/genetics ; Fibrinolytic Agents/therapeutic use ; Foramen Ovale, Patent/therapy ; Genotype ; Humans ; Ischemic Attack, Transient/drug therapy ; Piperazines/therapeutic use ; Platelet Aggregation Inhibitors/therapeutic use ; Polymorphism, Genetic ; Prasugrel Hydrochloride ; Risk Assessment ; Risk Factors ; Stroke/drug therapy ; Tetrazoles/therapeutic use ; Thiophenes/therapeutic use ; Ticagrelor ; Ticlopidine/analogs & derivatives ; Ticlopidine/therapeutic use
Chemical Substances	Fibrinolytic Agents ; Piperazines ; Platelet Aggregation Inhibitors ; Tetrazoles ; Thiophenes ; Cytochrome P-450 Enzyme System (9035-51-2) ; Clopidogrel (A74586SNO7) ; Aryl Hydrocarbon Hydroxylases (EC 1.14.14.1) ; CYP2C19 protein, human (EC 1.14.14.1) ; Cytochrome P-450 CYP2C19 (EC 1.14.14.1) ; Prasugrel Hydrochloride (G89JQ59I13) ; Ticagrelor (GLH0314RVC) ; Adenosine (K72T3FS567) ; Cilostazol (N7Z035406B) ; Ticlopidine (OM90ZUW7M1)
Language	English
Publishing date	2011-05-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057369-8
ISSN	1534-6242 ; 1523-3804
ISSN (online)	1534-6242
ISSN	1523-3804
DOI	10.1007/s11883-011-0185-0
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Article ; Online: Risk of Stroke after Transient Ischemic Attack or Minor Stroke.

Kim, Anthony S / Easton, J Donald / Johnston, S Claiborne

The New England journal of medicine

2016 Volume 375, Issue 4, Page(s) 386–387

MeSH term(s)	Female ; Humans ; Ischemic Attack, Transient/complications ; Male ; Stroke/etiology
Language	English
Publishing date	2016-07-28
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc1606657#SA1
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Article ; Online: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3): Rationale and design of a multicenter randomized placebo-controlled trial.

Wang, Yongjun / Li, Jiejie / Johnston, S Claiborne / Hankey, Graeme J / Easton, J Donald / Meng, Xia / Shi, Fu-Dong / Wang, Yilong / Zhao, Xingquan / Li, Zixiao / Liu, Liping / Gu, Hongqiu / Jiang, Yong / Wang, Anxin / Pan, Yuesong / Jing, Jing / Niu, Siying / Li, Hao

International journal of stroke : official journal of the International Stroke Society

2023 Volume 18, Issue 7, Page(s) 873–878

Abstract: Background: Anti-inflammatory therapy using colchicine has reduced recurrent vascular events in patients with coronary heart disease.: Design: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack ( ...

Abstract	Background: Anti-inflammatory therapy using colchicine has reduced recurrent vascular events in patients with coronary heart disease. Design: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3) is a randomized, double-blind, placebo-controlled multicenter trial, in which 8,238 patients with acute minor-to-moderate ischemic stroke (NIHSS ⩽ 5) or high-risk transient ischemic attack (TIA) (ABCD Trial registry name: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3);
MeSH term(s)	Humans ; Ischemic Attack, Transient/drug therapy ; Stroke/drug therapy ; Stroke/chemically induced ; Platelet Aggregation Inhibitors/therapeutic use ; Aspirin/therapeutic use ; Ischemic Stroke/drug therapy ; Clopidogrel/therapeutic use ; Colchicine/therapeutic use
Chemical Substances	Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E) ; Clopidogrel (A74586SNO7) ; Colchicine (SML2Y3J35T)
Language	English
Publishing date	2023-05-11
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2303728-3
ISSN	1747-4949 ; 1747-4930
ISSN (online)	1747-4949
ISSN	1747-4930
DOI	10.1177/17474930231172312
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