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Article ; Online: Optimal Medical Management of Atherosclerotic Intracranial Stenosis.

Wabnitz, Ashley M / Turan, Tanya N

2024 Volume 55, Issue 2, Page(s) 335–343

Abstract: Reducing the high risk of recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) has proven to be challenging, but aggressive medical management, with intensive risk factor control and antithrombotic therapy, has been ...

Abstract	Reducing the high risk of recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) has proven to be challenging, but aggressive medical management, with intensive risk factor control and antithrombotic therapy, has been shown to be beneficial. High-intensity statins are recommended for patients with atherosclerotic stroke, including sICAS. Ezetimibe and PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors are beneficial for those who fail to reach low-density lipoprotein targets or those with statin intolerance. The treatment target for sICAS is low-density lipoprotein <70 mg/dL. In neurologically stable patients, blood pressure should be treated to goal <140/90 mm Hg with the use of thiazide diuretics, angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers preferentially. For those with diabetes, treat to goal hemoglobin A1C ≤7% for most patients through combination of diet, insulin, and hypoglycemic drugs. Some degree of physical activity (eg, walking, stationary biking with arms or legs, etc) should be encouraged in all patients with sICAS who are not severely disabled. A minimum of 10 minutes of moderate-intensity aerobic activity 4 times a week is recommended for patients who are capable of exercise. For all patients with severe sICAS (70%-99% stenosis), dual antiplatelet therapy for up to 90 days followed by single antiplatelet agent is recommended.
MeSH term(s)	Humans ; Constriction, Pathologic ; Proprotein Convertase 9 ; Stroke/drug therapy ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Lipoproteins, LDL
Chemical Substances	PCSK9 protein, human (EC 3.4.21.-) ; Proprotein Convertase 9 (EC 3.4.21.-) ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins, LDL
Language	English
Publishing date	2024-01-22
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.123.043633
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Zs.A 448: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Antihypertensive Pharmacotherapy for Patients Undergoing Carotid Revascularization.

Turan, Tanya N / Lal, Brajesh K / Meschia, James F

Annals of vascular surgery

2024 Volume 101, Page(s) 193–194

MeSH term(s)	Humans ; Antihypertensive Agents/adverse effects ; Treatment Outcome ; Carotid Arteries ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/drug therapy ; Endarterectomy, Carotid/adverse effects ; Stents ; Stroke/etiology ; Retrospective Studies ; Risk Factors
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2024-01-01
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2023.11.020
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Zs.A 2882: Show issues

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Article ; Online: Past, Present, and Future of Intracranial Atherosclerosis Treatment.

de Havenon, Adam / Turan, Tanya N

Stroke

2023 Volume 55, Issue 2, Page(s) 471–473

MeSH term(s)	Humans ; Stroke ; Brain Ischemia ; Intracranial Arteriosclerosis/diagnostic imaging ; Intracranial Arteriosclerosis/therapy ; Angioplasty ; Stents ; Treatment Outcome
Language	English
Publishing date	2023-12-28
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.123.044270
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Zs.A 448: Show issues

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Article ; Online: The CASSISS Randomized Clinical Trial.

Turan, Tanya N / Psychogios, Marios-Nikos

Stroke

2022 Volume 54, Issue 1, Page(s) 286–289

Abstract: The CASSISS trial (China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis), recently published ... ...

Abstract	The CASSISS trial (China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis), recently published in
MeSH term(s)	Humans ; Constriction, Pathologic ; Stroke/prevention & control ; Angioplasty ; Stents ; Intracranial Arteriosclerosis/surgery ; Treatment Outcome ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-11-11
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.122.041096
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Zs.A 448: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Asymptomatic Intracranial Atherosclerotic Stenosis: The Risk Above the Carotids.

Turan, Tanya N / Kicielinski, Kimberly P

Journal of the American College of Cardiology

2021 Volume 78, Issue 6, Page(s) 572–574

MeSH term(s)	Atherosclerosis/epidemiology ; Constriction, Pathologic ; Humans ; Intracranial Arteriosclerosis/diagnosis ; Intracranial Arteriosclerosis/diagnostic imaging
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2021.05.042
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Zs.A 1846: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 196: Show issues

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Article: The Association of Hypertensive Disorders of Pregnancy with Infant Mortality, Preterm Delivery, and Small for Gestational Age.

Wilson, Dulaney A / Mateus, Julio / Ash, Emily / Turan, Tanya N / Hunt, Kelly J / Malek, Angela M

Healthcare (Basel, Switzerland)

2024 Volume 12, Issue 5

Abstract: Gestational hypertension, preeclampsia, eclampsia, and chronic hypertension (CHTN) are associated with adverse infant outcomes and disproportionately affect minoritized race/ethnicity groups. We evaluated the relationships between hypertensive disorders ... ...

Abstract	Gestational hypertension, preeclampsia, eclampsia, and chronic hypertension (CHTN) are associated with adverse infant outcomes and disproportionately affect minoritized race/ethnicity groups. We evaluated the relationships between hypertensive disorders of pregnancy (HDP) and/or CHTN with infant mortality, preterm delivery (PTD), and small for gestational age (SGA) in a statewide cohort with a diverse racial/ethnic population. All live, singleton deliveries in South Carolina (2004-2016) to mothers aged 12-49 were evaluated for adverse outcomes: infant mortality, PTD (20 to less than <37 weeks) and SGA (<10th birthweight-for-gestational-age percentile). Logistic regression models adjusted for sociodemographic, behavioral, and clinical characteristics. In 666,905 deliveries, mothers had superimposed preeclampsia (HDP + CHTN; 1.0%), HDP alone (8.0%), CHTN alone (1.8%), or no hypertension (89.1%). Infant mortality risk was significantly higher in deliveries to women with superimposed preeclampsia, HDP, and CHTN compared with no hypertension (relative risk [RR] = 1.79, 1.39, and 1.48, respectively). After accounting for differing risk by race/ethnicity, deliveries to women with HDP and/or CHTN were more likely to result in PTD (RRs ranged from 3.14 to 5.25) or SGA (RRs ranged from 1.67 to 3.64). As CHTN, HDP and superimposed preeclampsia confer higher risk of adverse outcomes, prevention efforts should involve encouraging and supporting mothers in mitigating modifiable cardiovascular risk factors.
Language	English
Publishing date	2024-03-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare12050597
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Ameliorating Racial Disparities in Vascular Risk Factor Management With Aggressive Medical Management in the SAMMPRIS Trial.

Almallouhi, Eyad / Nelson, Ashley M / Cotsonis, George / Harris, William / Chimowitz, Marc I / Turan, Tanya N

Stroke

2023 Volume 54, Issue 9, Page(s) 2235–2240

Abstract: ... for exercise score) at baseline and at 1 year of follow-up were compared between Black (n=104) versus non-Black ... patients (n=347).: Results: Significant differences at baseline in Black patients (listed first) versus ...

Abstract	Background: The WASID trial (Warfarin-Aspirin Symptomatic Intracranial Disease) and the SAMMPRIS trial (Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) evaluated optimal management of symptomatic intracranial atherosclerotic stenosis. The aim of this retrospective, observational study was to determine whether aggressive medical management used in the SAMMPRIS trial ameliorated disparities in risk factor control between Black and non-Black patients. Methods: The SAMMPRIS trial was a randomized controlled trial that enrolled patients with symptomatic intracranial atherosclerotic stenosis between November 2008 and April 2011. The frequency of risk factors at study entry (baseline) and mean levels of systolic blood pressure, diastolic blood pressure, LDL (low-density lipoprotein), hemoglobin A1c, and exercise level (quantified by physician-based assessment and counseling for exercise score) at baseline and at 1 year of follow-up were compared between Black (n=104) versus non-Black patients (n=347). Results: Significant differences at baseline in Black patients (listed first) versus non-Black patients were age (57.5 versus 61.0 years; Conclusions: Significant differences in important risk factors (physical activity and diastolic blood pressure) at baseline between Black and non-Black patients resolved at 1 year, suggesting that aggressive medical management may have an important role in ameliorating disparities in risk factor control between Black and non-Black patients.
MeSH term(s)	Humans ; Middle Aged ; Stroke/etiology ; Constriction, Pathologic/complications ; Retrospective Studies ; Risk Factors ; Intracranial Arteriosclerosis/complications ; Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Randomized Controlled Trial ; Observational Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.122.042055
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Zs.A 448: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Hypertensive Disorders of Pregnancy and Pre-Pregnancy Hypertension with Subsequent Incident Venous Thromboembolic Events.

Malek, Angela M / Wilson, Dulaney A / Turan, Tanya N / Mateus, Julio / Lackland, Daniel T / Hunt, Kelly J

International journal of environmental research and public health

2024 Volume 21, Issue 1

Abstract: Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and pre-pregnancy hypertension with subsequent venous thromboembolic (VTE) events. The ... ...

Abstract	Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and pre-pregnancy hypertension with subsequent venous thromboembolic (VTE) events. The retrospective cohort study included 444,859 women with ≥1 live, singleton birth in South Carolina (2004-2016). Hospital and emergency department visit and death certificate data defined incident VTE, HDP, and pre-pregnancy hypertension. Birth certificate data also defined the exposures. Adjusted Cox proportional hazards methods modeled VTE events risk. Of the cohort, 2.6% of women had pre-pregnancy hypertension, 5.8% had HDP, 2.8% had both pre-pregnancy hypertension and HDP (both conditions), and 88.8% had neither condition. The risk of incident VTE events within one year of delivery was higher in women with HDP (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15-2.29) and both conditions (HR = 2.32, 95% CI: 1.60-3.35) compared to those with neither condition as was the risk within five years for women with HDP (HR = 1.35, 95% CI: 1.13-1.60) and for women with both conditions (HR = 1.82, 95% CI: 1.50-2.20). One- and five-year risks did not differ in women with pre-pregnancy hypertension compared to women with neither condition. Compared to non-Hispanic White (NHW) women with neither condition, the incident VTE event risk was elevated within five years of delivery for NHW (HR = 1.29, 95% CI: 1.02-1.63; HR = 1.59, 95% CI: 1.16-2.17) and non-Hispanic Black (NHB; HR = 1.51, 95% CI: 1.16-2.96; HR = 2.08, 95% CI: 1.62-2.66) women with HDP and with both conditions, respectively, and for NHB women with pre-pregnancy hypertension (HR = 1.50, 95% CI: 1.09-2.07). VTE event risk was highest in women with HDP, and the event rates were higher in NHB women than in NHW women in the same exposure group.
MeSH term(s)	Pregnancy ; Female ; Humans ; Venous Thromboembolism/epidemiology ; Hypertension, Pregnancy-Induced/epidemiology ; Retrospective Studies ; Venous Thrombosis ; Birth Certificates ; Prehypertension
Language	English
Publishing date	2024-01-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph21010089
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Article ; Online: Intracranial atherosclerotic stenosis: risk factors, diagnosis, and treatment.

Gutierrez, Jose / Turan, Tanya N / Hoh, Brian L / Chimowitz, Marc I

The Lancet. Neurology

2022 Volume 21, Issue 4, Page(s) 355–368

Abstract: Intracranial atherosclerotic stenosis (ICAS) is one of the most frequent causes of stroke worldwide and confers one of the greatest risks of recurrent stroke compared with other causes of stroke. Asymptomatic ICAS is increasingly recognised as a risk ... ...

Abstract	Intracranial atherosclerotic stenosis (ICAS) is one of the most frequent causes of stroke worldwide and confers one of the greatest risks of recurrent stroke compared with other causes of stroke. Asymptomatic ICAS is increasingly recognised as a risk factor for silent brain infarctions and dementia, magnifying the global burden of ICAS. Although ICAS is a lumen-based diagnosis, newer diagnostic imaging techniques, such as high-resolution MRI, might help to identify high-risk population subgroups to test interventions that might reduce the risk of stroke recurrence. Secondary stroke prevention in patients with ICAS currently consists of intensive management of modifiable risk factors and dual antiplatelet therapy, which is subsequently reduced to aspirin alone. Despite these therapies, the risk of recurrent stroke in patients presenting with stroke related to 70-99% ICAS exceeds 20% at 1 year; as such, better therapies are urgently needed. The optimal duration and combination of dual antiplatelet therapy in patients with ICAS is uncertain and is being investigated in addition to low-dose anticoagulation and aspirin. Other ongoing or planned studies will provide high-quality observational data on the role of transluminal angioplasty and stenting, submaximal balloon angioplasty alone, direct or indirect arterial bypass, and ischaemic conditioning for prevention of stroke in patients with ICAS.
MeSH term(s)	Aspirin/therapeutic use ; Constriction, Pathologic ; Humans ; Intracranial Arteriosclerosis/complications ; Intracranial Arteriosclerosis/diagnosis ; Intracranial Arteriosclerosis/therapy ; Platelet Aggregation Inhibitors/therapeutic use ; Risk Factors ; Stroke/diagnosis ; Stroke/etiology ; Stroke/prevention & control
Chemical Substances	Platelet Aggregation Inhibitors ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2022-02-07
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2081241-3
ISSN	1474-4465 ; 1474-4422
ISSN (online)	1474-4465
ISSN	1474-4422
DOI	10.1016/S1474-4422(21)00376-8
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Zs.A 5955: Show issues

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Article ; Online: White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment.

de Havenon, Adam / Sheth, Kevin N / Yeatts, Sharon D / Turan, Tanya N / Prabhakaran, Shyam

Stroke and vascular neurology

2022

Abstract: Background: White matter hyperintensity (WMH) on brain MRI is associated with developing dementia or mild cognitive impairment (MCI), but WMH progression over time has not been fully investigated as an independent risk factor.: Methods: We performed ... ...

Abstract	Background: White matter hyperintensity (WMH) on brain MRI is associated with developing dementia or mild cognitive impairment (MCI), but WMH progression over time has not been fully investigated as an independent risk factor. Methods: We performed a post hoc analysis of the Systolic Blood Pressure Intervention Trial - Memory and Cognition in Decreased Hypertension (SPRINT MIND) trial. The primary outcome was incident probable dementia or MCI (dementia/MCI) before the follow-up MRI at 48 months from enrolment. The primary predictor was WMH progression, defined as the Z score difference between the follow-up and baseline WMH volumes. The secondary predictor was a binary WMH progression threshold (≥1.4 mL vs <1.4 mL). Results: Among the 433 included patients, 33 (7.6%) developed dementia/MCI. There were 156 (36.0%) patients who met the WMH progression threshold of ≥1.4 mL, in whom the rate of dementia/MCI was 12.8% (20/156) vs 4.7% (13/277) of patients with <1.4 mL WMH progression (p=0.002). In multivariable logistic regression, the Z score of WMH progression was associated with dementia/MCI (OR 1.51, 95% CI 1.12 to 2.04, p=0.007) as was the WMH progression threshold of ≥1.4 mL (OR 2.89, 95% CI 1.23 to 6.81, p=0.015). Conclusions: In this post hoc analysis of SPRINT MIND, WMH progression over 48 months was associated with the development of probable dementia or MCI.
Language	English
Publishing date	2022-04-29
Publishing country	England
Document type	Journal Article
ISSN	2059-8696
ISSN (online)	2059-8696
DOI	10.1136/svn-2021-001357
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