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Article ; Online: Association between the controlling nutritional status score and outcomes in ischemic stroke patients with active cancer.

Sakurai, Rei / Gon, Yasufumi / Shimada, Yuki / Okazaki, Shuhei / Todo, Kenichi / Sasaki, Tsutomu / Mochizuki, Hideki

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2024 Volume 120, Page(s) 170–174

Abstract: Background: The effect of nutritional status on survival in ischemic stroke patients with active cancer remains unclear.: Methods: This study retrospectively evaluated ischemic stroke patients with active cancer admitted to a university hospital in ... ...

Abstract	Background: The effect of nutritional status on survival in ischemic stroke patients with active cancer remains unclear. Methods: This study retrospectively evaluated ischemic stroke patients with active cancer admitted to a university hospital in Japan between 2006 and 2016. Patients were followed for 2 years after stroke. The controlling nutritional status (CONUT) score was used to classify undernutrition degree into 4 groups: normal, light, moderate, and severe. Survival rates were compared using the Kaplan-Meier method. Hazard ratio (HR) and 95 % confidence intervals (CIs) for mortality were calculated using Cox regression models. Results: A total of 158 patients (31 % women; median age: 71 years) were analyzed. Of these, 47 % had distant metastasis. The median (interquartile range) National Institute of Health Stroke Scale and CONUT scores were 4 (1-10) and 5 (3-7), respectively. Kaplan-Meier curve indicated that patients with poorer nutritional status had worse outcomes (overall log-rank test, p < 0.001). The univariable Cox regression analysis showed that the HR (95 % CI) for the light, moderate, and severe groups were 1.14 (0.45-2.86), 3.01 (1.27-7.12), and 2.94 (1.10-7.84), respectively. This statistical significance did not persist after adjustment for potential confounders (HR [95 % CI] for the light, moderate, and severe groups were 0.95 [0.36-2.49], 1.56 [0.57-4.28], and 1.34 [0.37-4.92], respectively). Past stroke, distant metastasis, and plasma D-dimer levels on admission were independent predictors of prognosis. Conclusions: This single-center, retrospective study suggests that nutritional status serves as a prognostic indicator for ischemic stroke patients with active cancer. However, the effect is not statistically independent.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Nutritional Status ; Retrospective Studies ; Ischemic Stroke ; Malnutrition ; Prognosis ; Neoplasms ; Stroke
Language	English
Publishing date	2024-01-20
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2024.01.011
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Article ; Online: Real-time cerebral blood flow velocity during limb-shaking transient ischemic attacks.

Kitano, Takaya / Sakaguchi, Manabu / Okazaki, Shuhei / Todo, Kenichi / Mochizuki, Hideki

Acta neurologica Belgica

2022 Volume 123, Issue 2, Page(s) 635–636

MeSH term(s)	Humans ; Ischemic Attack, Transient/diagnostic imaging ; Extremities ; Tremor ; Cerebrovascular Circulation ; Blood Flow Velocity
Language	English
Publishing date	2022-03-14
Publishing country	Italy
Document type	Letter
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-022-01914-3
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Article ; Online: Impact of stroke on survival in patients with cancer.

Gon, Yasufumi / Sasaki, Tsutomu / Kawano, Tomohiro / Okazaki, Shuhei / Todo, Kenichi / Takeda, Toshihiro / Matsumura, Yasushi / Mochizuki, Hideki

Thrombosis research

2023 Volume 222, Page(s) 109–112

MeSH term(s)	Humans ; Neoplasms/complications ; Stroke/complications ; Survival Rate
Language	English
Publishing date	2023-01-06
Publishing country	United States
Document type	Letter
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2023.01.002
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Article ; Online: One-year morbidity and mortality in patients treated with standard-dose and low-dose apixaban after acute large vessel occlusion stroke.

Murakami, Yasutaka / Todo, Kenichi / Uchida, Kazutaka / Yamagami, Hiroshi / Sakai, Nobuyuki / Gon, Yasufumi / Okazaki, Shuhei / Sasaki, Tsutomu / Yoshimura, Shinichi / Morimoto, Takeshi / Mochizuki, Hideki

Journal of thrombosis and thrombolysis

2024 Volume 57, Issue 4, Page(s) 622–629

Abstract: Although low-dose direct oral anticoagulants (DOACs) are recommended for patients at high risk of bleeding complications, it remains unclear whether the dose reduction in real-world setting is also appropriate in patients after large-vessel occlusion ( ... ...

Abstract	Although low-dose direct oral anticoagulants (DOACs) are recommended for patients at high risk of bleeding complications, it remains unclear whether the dose reduction in real-world setting is also appropriate in patients after large-vessel occlusion (LVO) stroke. This study hypothesized that patients with atrial fibrillation (AF) and LVO receiving low-dose DOACs have an increased risk of ischemic and hemorrhagic events. The study aimed to assess 1 year morbidity and mortality in patients treated with standard-dose and low-dose apixaban after LVO stroke. A post hoc analysis was performed using the acute LVO registry data, which enrolled patients with AF and LVO who received apixaban within 14 days of stroke onset. The incidences of ischemic events (ischemic stroke, acute coronary syndrome, acute myocardial infarction, and systemic embolism), major bleeding events, and death from any cause were compared between patients receiving standard- and low-dose apixaban. Of 643 patients diagnosed with LVO, 307 (47.7%) received low-dose apixaban. After adjustment for clinically relevant variables, no significant differences were observed in the incidence of ischemic events (adjusted hazard ratio [aHR]: 2.12, 95% confidence interval [CI] 0.75-6.02), major bleeding events (aHR: 1.17, 95% CI 0.50-2.73), and death from any cause (aHR: 1.95, 95% CI 0.78-4.89) between patients receiving standard- and low-dose apixaban. No significant differences were observed in the incidence of ischemic events, major bleeding events, or death from any cause between patients with AF and LVO receiving standard- and low-dose apixaban.
MeSH term(s)	Humans ; Anticoagulants/therapeutic use ; Stroke/etiology ; Hemorrhage/chemically induced ; Pyridones/therapeutic use ; Atrial Fibrillation/drug therapy ; Ischemic Stroke/complications ; Morbidity ; Pyrazoles
Chemical Substances	apixaban (3Z9Y7UWC1J) ; Anticoagulants ; Pyridones ; Pyrazoles
Language	English
Publishing date	2024-03-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1230645-9
ISSN	1573-742X ; 0929-5305
ISSN (online)	1573-742X
ISSN	0929-5305
DOI	10.1007/s11239-024-02954-7
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Zs.A 4352: Show issues

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Article ; Online: Von Willebrand Factor Antigen Levels Predict Poor Outcomes in Patients With Stroke and Cancer: Findings From the Multicenter, Prospective, Observational SCAN Study.

Kawano, Tomohiro / Gon, Yasufumi / Sakaguchi, Manabu / Yamagami, Hiroshi / Abe, Soichiro / Hashimoto, Hiroyuki / Ohara, Nobuyuki / Takahashi, Daisuke / Abe, Yuko / Takahashi, Tsutomu / Okazaki, Shuhei / Todo, Kenichi / Mochizuki, Hideki / Sasaki, Tsutomu

Journal of the American Heart Association

2024 Volume 13, Issue 3, Page(s) e032284

Abstract: Background: Patients with acute ischemic stroke and active cancer have more severe neurological symptoms, elevated risks of stroke recurrence, and death compared with the general population. We examined whether von Willebrand factor (vWF) antigen levels ...

Abstract	Background: Patients with acute ischemic stroke and active cancer have more severe neurological symptoms, elevated risks of stroke recurrence, and death compared with the general population. We examined whether von Willebrand factor (vWF) antigen levels at stroke onset were associated with the poor outcomes of patients with stroke and cancer. Methods and results: Using data from 90 patients with acute ischemic stroke and active cancer who were registered in the SCAN (Ischemic Stroke in Patients With Cancer and Neoplasia) study, a prospective multicenter, observational study in Japan, we divided patients into 2 groups according to their median vWF antigen levels (high, n=46; or low, n=44). The high-vWF group had a significantly higher initial National Institutes of Health Stroke Scale score (median, 7 [interquartile range, 3-11.25] versus 3 [interquartile range, 1-8.5]; Conclusions: Elevated vWF antigen levels were associated with adverse outcomes in patients with cancer-associated stroke and may represent a useful biomarker to guide future therapeutic interventions.
MeSH term(s)	Humans ; Ischemic Stroke/complications ; Neoplasms/complications ; Neoplasms/epidemiology ; Prospective Studies ; Risk Factors ; Stroke/diagnosis ; von Willebrand Factor ; Multicenter Studies as Topic ; Observational Studies as Topic
Chemical Substances	von Willebrand Factor
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.032284
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Article ; Online: Higher Frequency of Premature Atrial Contractions Correlates With Atrial Fibrillation Detection after Cryptogenic Stroke.

Stroke

2024 Volume 55, Issue 4, Page(s) 946–953

Abstract: Background: Covert atrial fibrillation (AF) is a major cause of cryptogenic stroke. This study investigated whether a dose-dependent relationship exists between the frequency of premature atrial contractions (PACs) and AF detection in patients with ... ...

Abstract	Background: Covert atrial fibrillation (AF) is a major cause of cryptogenic stroke. This study investigated whether a dose-dependent relationship exists between the frequency of premature atrial contractions (PACs) and AF detection in patients with cryptogenic stroke using an insertable cardiac monitor (ICM). Methods: We enrolled consecutive patients with cryptogenic stroke who underwent ICM implantation between October 2016 and September 2020 at 8 stroke centers in Japan. Patients were divided into 3 groups according to the PAC count on 24-hour Holter ECG: ≤200 (group L), >200 to ≤500 (group M), and >500 (group H). We defined a high AF burden as above the median of the cumulative duration of AF episodes during the entire monitoring period. We evaluated the association of the frequency of PACs with AF detection using log-rank trend test and Cox proportional hazard model and with high AF burden using logistic regression model, adjusting for age, sex, CHADS Results: Of 417 patients, we analyzed 381 patients with Holter ECG and ICM data. The median age was 70 (interquartile range, 59.5-76.5), 246 patients (65%) were males, and the median duration of ICM recording was 605 days (interquartile range, 397-827 days). The rate of new AF detected by ICM was higher in groups with more frequent PAC (15.5%/y in group L [n=277] versus 44.0%/y in group M [n=42] versus 71.4%/y in group H [n=62]; log-rank trend Conclusions: The frequency of PACs was dose-dependently associated with AF detection in patients with cryptogenic stroke.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/complications ; Atrial Premature Complexes/diagnosis ; Atrial Premature Complexes/epidemiology ; Atrial Premature Complexes/complications ; Stroke/diagnosis ; Ischemic Stroke/complications ; Electrocardiography, Ambulatory
Language	English
Publishing date	2024-03-04
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.123.044813
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Zs.A 448: Show issues

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Article ; Online: Atrial Fibrillation Detection and Ischemic Stroke Recurrence in Cryptogenic Stroke: A Retrospective, Multicenter, Observational Study.

Todo, Kenichi / Okazaki, Shuhei / Doijiri, Ryosuke / Yamazaki, Hidekazu / Sonoda, Kazutaka / Koge, Junpei / Iwata, Tomonori / Ueno, Yuji / Yamagami, Hiroshi / Kimura, Naoto / Morimoto, Masafumi / Kondo, Daisuke / Koga, Masatoshi / Nagata, Eiichiro / Miyamoto, Nobukazu / Kimura, Yoko / Gon, Yasufumi / Sasaki, Tsutomu / Mochizuki, Hideki

Journal of the American Heart Association

2024 Volume 13, Issue 3, Page(s) e031508

Abstract: Background: Atrial fibrillation (AF) is known to be a strong risk factor for stroke. However, the risk of stroke recurrence in patients with cryptogenic stroke with AF detected after stroke by an insertable cardiac monitor (ICM) is not well known. We ... ...

Abstract	Background: Atrial fibrillation (AF) is known to be a strong risk factor for stroke. However, the risk of stroke recurrence in patients with cryptogenic stroke with AF detected after stroke by an insertable cardiac monitor (ICM) is not well known. We sought to evaluate the risk of ischemic stroke recurrence in patients with cryptogenic stroke with and without ICM-detected AF. Methods and results: We retrospectively reviewed patients with cryptogenic stroke who underwent ICM implantation at 8 stroke centers in Japan. Cox regression models were developed using landmark analysis and time-dependent analysis. We set the target sample size at 300 patients based on our estimate of the annualized incidence of ischemic stroke recurrence to be 3% in patients without AF detection and 9% in patients with AF detection. Of the 370 patients, 121 were found to have AF, and 110 received anticoagulation therapy after AF detection. The incidence of ischemic stroke recurrence was 4.0% in 249 patients without AF detection and 5.8% in 121 patients with AF detection ( Conclusions: The risk of ischemic stroke recurrence in patients with cryptogenic stroke with ICM-detected AF, 90% of whom were subsequently anticoagulated, was not higher than in those without ICM-detected AF.
MeSH term(s)	Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Ischemic Stroke/complications ; Retrospective Studies ; Electrocardiography, Ambulatory/methods ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.031508
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Article ; Online: The role of national guidelines while staying abroad with an acute stroke.

Okazaki, Shuhei / Fatar, Marc

Cerebrovascular diseases (Basel, Switzerland)

2014 Volume 38, Issue 3, Page(s) 161–162

MeSH term(s)	Asian Continental Ancestry Group ; Europe ; Fibrinolytic Agents/administration & dosage ; Humans ; Japan ; Practice Guidelines as Topic/standards ; Stroke/drug therapy ; Tissue Plasminogen Activator/administration & dosage ; Travel ; United States
Chemical Substances	Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2014
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	1069462-6
ISSN	1421-9786 ; 1015-9770
ISSN (online)	1421-9786
ISSN	1015-9770
DOI	10.1159/000367647
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Article ; Online: Humoral and cellular responses to SARS-CoV-2 vaccination in patients with autoantibody-mediated neuroimmunology.

Kihara, Keigo / Kinoshita, Makoto / Sugimoto, Tomoyuki / Okazaki, Shuhei / Murata, Hisashi / Beppu, Shohei / Shiraishi, Naoyuki / Sugiyama, Yasuko / Koda, Toru / Okuno, Tatsusada / Mochizuki, Hideki

Journal of neurology, neurosurgery, and psychiatry

2023 Volume 94, Issue 6, Page(s) 495–497

MeSH term(s)	Humans ; COVID-19 Vaccines ; SARS-CoV-2 ; COVID-19/prevention & control ; Vaccination ; Antibodies, Viral
Chemical Substances	COVID-19 Vaccines ; Antibodies, Viral
Language	English
Publishing date	2023-01-03
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	3087-9
ISSN	1468-330X ; 0022-3050
ISSN (online)	1468-330X
ISSN	0022-3050
DOI	10.1136/jnnp-2022-330478
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Article ; Online: The tight junction protein occludin modulates blood-brain barrier integrity and neurological function after ischemic stroke in mice.

Sugiyama, Shintaro / Sasaki, Tsutomu / Tanaka, Hiroo / Yan, Haomin / Ikegami, Takeshi / Kanki, Hideaki / Nishiyama, Kumiko / Beck, Goichi / Gon, Yasufumi / Okazaki, Shuhei / Todo, Kenichi / Tamura, Atsushi / Tsukita, Sachiko / Mochizuki, Hideki

Scientific reports

2023 Volume 13, Issue 1, Page(s) 2892

Abstract: Blood-brain barrier (BBB) disruption contributes to brain injury and neurological impairment. Tight junctions (TJs) and cell-cell adhesion complexes develop between endothelial cells in the brain to establish and maintain the BBB. Occludin, the first ... ...

Abstract	Blood-brain barrier (BBB) disruption contributes to brain injury and neurological impairment. Tight junctions (TJs) and cell-cell adhesion complexes develop between endothelial cells in the brain to establish and maintain the BBB. Occludin, the first transmembrane protein identified in TJs, has received intense research interest because numerous in vitro studies have suggested its importance in maintaining BBB integrity. However, its role in maintaining BBB integrity after ischemic stroke is less clear owing to the lack of in vivo evidence. This study aimed to investigate the dynamics and function of occludin across the acute and chronic phases after stroke using occludin-deficient mice. By photochemically induced thrombosis model, the expression of occludin was decreased in brain endothelial cells from ischemic lesions. The neurological function of occludin-deficient mice was continuously impaired compared to that of wild-type mice. BBB integrity evaluated by Evans blue and 0.5-kDa fluorescein in the acute phase and by 10-kDa fluorescein isothiocyanate-labeled dextran in the chronic phase was decreased to a greater extent after stroke in occludin-deficient mice. Furthermore, occludin-deficient mice showed decreased claudin-5 and neovascularization after stroke. Our study reveals that occludin plays an important role from the acute to the chronic phase after ischemic stroke in vivo.
MeSH term(s)	Animals ; Mice ; Occludin/genetics ; Tight Junction Proteins ; Ischemic Stroke ; Blood-Brain Barrier ; Endothelial Cells ; Stroke ; Fluorescein
Chemical Substances	Occludin ; Tight Junction Proteins ; fluorescein isothiocyanate dextran ; Fluorescein (TPY09G7XIR)
Language	English
Publishing date	2023-02-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-29894-1
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