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  1. Article ; Online: Diagnosis and Management of Cardioembolic Stroke.

    Yaghi, Shadi

    Continuum (Minneapolis, Minn.)

    2023  Volume 29, Issue 2, Page(s) 462–485

    Abstract: Objective: Cardioembolic stroke accounts for nearly 30% of ischemic strokes. Prompt diagnosis of the underlying mechanism may improve secondary prevention strategies. This article reviews recent randomized trials, observational studies, case reports, ... ...

    Abstract Objective: Cardioembolic stroke accounts for nearly 30% of ischemic strokes. Prompt diagnosis of the underlying mechanism may improve secondary prevention strategies. This article reviews recent randomized trials, observational studies, case reports, and guidelines on the diagnosis and treatment of cardioembolic stroke.
    Latest developments: Several pathologies can lead to cardioembolic stroke, including atrial fibrillation, aortic arch atheroma, patent foramen ovale, left ventricular dysfunction, and many others. Secondary stroke prevention strategies differ across these heterogeneous mechanisms. In addition to medical treatment advances such as the use of direct oral anticoagulants in patients with atrial fibrillation, surgical treatments such as closure of patent foramen ovale have been shown to reduce the risk of recurrent stroke in select patients. Furthermore, left atrial appendage occlusion is a promising strategy for patients with atrial fibrillation who are candidates for short-term oral anticoagulation therapy but not long-term oral anticoagulation therapy.
    Essential points: A thorough diagnostic evaluation is essential to determine cardioembolic causes of stroke. In addition to risk factor management and lifestyle modifications, identification and targeting of the underlying cardioembolic stroke mechanisms will lead to improved stroke prevention strategies in patients with cardioembolic stroke.
    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Embolic Stroke/chemically induced ; Embolic Stroke/complications ; Anticoagulants/therapeutic use ; Foramen Ovale, Patent/complications ; Stroke/diagnosis ; Stroke/etiology ; Stroke/prevention & control
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-04-11
    Publishing country United States
    Document type Review ; Journal Article
    ISSN 1538-6899
    ISSN (online) 1538-6899
    DOI 10.1212/CON.0000000000001217
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Toward More Personalized Management of Device-Detected Atrial Fibrillation.

    Siegler, James E / Sposato, Luciano A / Yaghi, Shadi

    JAMA neurology

    2024  

    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2024.0673
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Sex Specific Outcomes After Ischemic Stroke.

    Indraswari, Fransisca / Yaghi, Shadi / Khan, Farhan

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

    2024  , Page(s) 107754

    Abstract: N/A. ...

    Abstract N/A.
    Language English
    Publishing date 2024-05-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2024.107754
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    Zs.A 3519: Show issues Location:
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  4. Article ; Online: Emerging Management Challenges Posed by Atrial Fibrillation Detected After Stroke.

    Yaghi, Shadi / Schwamm, Lee

    Annals of neurology

    2023  Volume 94, Issue 1, Page(s) 41–42

    MeSH term(s) Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Stroke/complications ; Stroke/therapy ; Anticoagulants ; Risk Factors
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-05-02
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 80362-5
    ISSN 1531-8249 ; 0364-5134
    ISSN (online) 1531-8249
    ISSN 0364-5134
    DOI 10.1002/ana.26663
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  5. Article: Symptomatic Non-stenotic Atherosclerotic Disease in Small Subcortical Infarcts: A North American Pilot Study.

    Goldstein, Eric D / Yaghi, Shadi

    The Neurohospitalist

    2023  Volume 14, Issue 2, Page(s) 166–169

    Abstract: Recent small subcortical infarcts (SSI) are a common radiographic predecessor to lacunar stroke. SSI is comprised of several pathophysiologic processes such as branch atherosclerotic disease (BAD) and lipohyalinosis, both of which have differing outcomes ...

    Abstract Recent small subcortical infarcts (SSI) are a common radiographic predecessor to lacunar stroke. SSI is comprised of several pathophysiologic processes such as branch atherosclerotic disease (BAD) and lipohyalinosis, both of which have differing outcomes and natural history. Presently, there is not a proven method to determine whether a SSI is due to BAD or lipohyalinosis in non-stenotic vessels. However, high-resolution vessel wall imaging (HRVWI) has been reported in East Asian cohorts. We aimed to use HRVWI to identify individuals with BAD-related SSI in a North American cohort. We performed a cross-sectional study from the Rhode Island Hospital. All patients had a SSI as defined by consensus criteria. The presence of vessel wall enhancement of parent vessels were reviewed by two authors. Standard descriptive statistical techniques were used. Of 28 patients who underwent HRVWI, 7 met criteria for SSI. The median age was 68 years and 3 were female. Parent vessel wall enhancement was present in 2 patients. In our North American cohort, HRVWI was able to dichotomize individuals based on parent vessel wall enhancement suggestive of a BAD-related SSI. Further studies are needed to expand our cohort size and confirm our findings.
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2629083-2
    ISSN 1941-8752 ; 1941-8744
    ISSN (online) 1941-8752
    ISSN 1941-8744
    DOI 10.1177/19418744231212999
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  6. Article ; Online: Bilateral Medial Medullary Infarction: The Airpod Sign.

    Agarwal, Shashank / Raz, Eytan / Yaghi, Shadi

    Stroke

    2023  Volume 54, Issue 4, Page(s) e157–e158

    MeSH term(s) Humans ; Medulla Oblongata/diagnostic imaging ; Magnetic Resonance Imaging ; Infarction
    Language English
    Publishing date 2023-02-09
    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.122.042054
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  7. Article ; Online: Impaired Venous Outflow and Lacunar Stroke Outcomes: A Pilot Study.

    Oh, Hyunju / Shu, Liqi / Agrawal, Kritisha / Yaghi, Shadi / Goldstein, Eric D

    Stroke

    2024  

    Language English
    Publishing date 2024-04-17
    Publishing country United States
    Document type Letter
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.124.046654
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  8. Article ; Online: The impact of pre-stroke aspirin exposure on radiographic appearance and disability outcomes: A post-hoc analysis of the SPS3 trial: Aspirin Use and Small Subcortical Stroke.

    Goldstein, Eric D / Liew, Sabrina Q R / Shu, Liqi / Yaghi, Shadi

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

    2024  Volume 33, Issue 3, Page(s) 107566

    Abstract: Objectives: The effect of pre-stroke use of aspirin on small subcortical infarct dimensions or outcomes is not well described. We aimed to bridge this knowledge gap amongst a well-described and heterogeneous patient population.: Materials and methods!# ...

    Abstract Objectives: The effect of pre-stroke use of aspirin on small subcortical infarct dimensions or outcomes is not well described. We aimed to bridge this knowledge gap amongst a well-described and heterogeneous patient population.
    Materials and methods: We performed a post-hoc analysis of the Secondary Prevention of Small Subcortical Stroke (SPS3) trial. The primary exposure was aspirin use ≤7 days of index stroke. The primary outcomes were infarct dimensions. Functional outcomes by modified Rankin Scale (mRS) was a secondary outcome. Age restricted (≥55 years) subgroup analyses were performed as a sensitivity analysis. Descriptive statistical and regression modeling were performed for data analysis.
    Results: We included 1423 participants of which 453(31.8 %) used aspirin. Aspirin use was associated with more cardiovascular risk diagnoses. Maximal infarct diameter did not differ with pre-stroke aspirin use (11.3±4.2 mm versus 11.8±4.1 mm, p=0.057) however infarct area was smaller with exposure (126.4±90.0 mm
    Conclusions: In this post-hoc analysis of the SPS3 trial, pre-stroke aspirin use was associated with a smaller infarct area regardless of aspirin strength and without impact on functional outcomes. These findings were more pronounced in participants ≥55 years.
    Registration: https://clinicaltrials.gov/study/NCT00059306?term= %22sps3 %22&rank=1.
    MeSH term(s) Humans ; Middle Aged ; Aspirin/adverse effects ; Platelet Aggregation Inhibitors/adverse effects ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Cerebral Infarction ; Treatment Outcome
    Chemical Substances Aspirin (R16CO5Y76E) ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2024.107566
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    Zs.A 3519: Show issues Location:
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  9. Article: Stroke in Young Adults.

    Bukhari, Syed / Yaghi, Shadi / Bashir, Zubair

    Journal of clinical medicine

    2023  Volume 12, Issue 15

    Abstract: Stroke in young adults is associated with significant morbidity, and its prevalence is rising in the United States. This is partly attributed to a rise in the prevalence of traditional risk factors including hypertension, hypercholesterolemia, obesity, ... ...

    Abstract Stroke in young adults is associated with significant morbidity, and its prevalence is rising in the United States. This is partly attributed to a rise in the prevalence of traditional risk factors including hypertension, hypercholesterolemia, obesity, diabetes mellitus, smoking and heart disease. In addition, there are non-modifiable risk factors comprising migraine, pregnancy and postpartum state, illicit drug use, oral contraceptives and hypercoagulable state. The mechanisms causing stroke in young adults are unique and include cervical dissection, cardioembolic phenomenon, vasculitis and vasculopathy, connective tissue disease, patent foramen ovale and cerebral venous thrombosis. The diagnosis of stroke in the young population can be challenging given its myriad clinical presentations. In this document, we provide an overview of the epidemiology of stroke in young adults, explore mechanisms that may explain increasing rates of stroke in this population, and provide a critical updated overview of the existing literature on the management and prevention of stroke in young adults.
    Language English
    Publishing date 2023-07-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12154999
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  10. Article ; Online: Roundtable of Academia and Industry for Stroke Prevention: Prevention and Treatment of Large-Vessel Disease.

    Yaghi, Shadi / Albin, Catherine / Chaturvedi, Seemant / Savitz, Sean I

    Stroke

    2023  Volume 55, Issue 1, Page(s) 226–235

    MeSH term(s) Humans ; Stroke/prevention & control ; Organizations
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type 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.123.043910
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