Vitamin K Antagonists and Risk of Subdural Hematoma

STROKEAHA: May 13, 2014 Background and Purpose—Subdural hematomas are an important bleeding complication of anticoagulation. We quantify the risk of subdural hematoma associated with anticoagulation with vitamin K antagonists (VKAs) compared with other oral antithrombotic therapies. Methods—Randomized trials were identified from the Cochrane Central Register of Controlled Trials and were included if published since 1980 and […]

Drivers of Costs Associated With Reperfusion Therapy in Acute Stroke

STROKEAHA: May 13, 2014 Background and Purpose—The Interventional Management of Stroke (IMS) III study tested the effect of intravenous tissue-type plasminogen activator (tPA) alone when compared with intravenous tPA followed by endovascular therapy and collected cost data to assess the economic implications of the 2 therapies. This report describes the factors affecting the costs of the […]

Extra-Virgin Olive Oil Consumption Reduces Risk of Atrial Fibrillation: The PREDIMED Trial

CIRCULATIONAHA: April 30, 2014 Background—The PREvención con DIeta MEDiterránea (PREDIMED) randomized primary prevention trial showed that a Mediterranean diet enriched with either extra-virgin olive oil or mixed nuts reduces incidence of stroke, myocardial infarction or cardiovascular mortality. We assessed the effect of these diets on the incidence of atrial fibrillation in the PREDIMED trial. Methods and Results—Participants were […]

Virtual Reality Exercise Improves Mobility After Stroke

STROKEAHA: April 24, 2014 Background and Purpose—Exercise using virtual reality (VR) has improved balance in adults with traumatic brain injury and community-dwelling older adults. Rigorous randomized studies regarding its efficacy, safety, and applicability with individuals after stroke are lacking. The purpose of this study was to determine whether an adjunct VR therapy improves balance, mobility, and […]

Relationship Between Time in Therapeutic Range and Comparative Treatment Effect of Rivaroxaban and Warfarin: Results From the ROCKET AF Trial

J Am Heart Assoc. 4/22/2014 Background Time in therapeutic range (TTR) is a standard quality measure of the use of warfarin. We assessed the relative effects of rivaroxaban versus warfarin at the level of trial center TTR (cTTR) since such analysis preserves randomized comparisons. Methods and Results TTR was calculated using the Rosendaal method, without exclusion of international […]

Effect of backward walking treadmill training on walking capacity after stroke: a randomized clinical trial

Wiley: 4/15/14 Rationale Residual walking deficits are common in people after stroke. Treadmill training can increase walking speed and walking distance. A new way to increase the challenge of walking is to walk backwards. Backward treadmill walking may provide advantages by promoting improvement in balance, walking spatiotemporal parameters and quality that may reflect in improving walking distance. Aim […]

Safety and efficacy of uric acid in patients with acute stroke (URICO-ICTUS): a randomised, double-blind phase 2b/3 trial

The Lancet Neurology: April 2, 2014 Introduction Uric acid is an antioxidant with neuroprotective effects in experimental models of stroke. We assessed whether uric acid therapy would improve functional outcomes at 90 days in patients with acute ischaemic stroke. Methods URICO-ICTUS was a randomised, double-blind, placebo-controlled, phase 2b/3 trial that recruited patients with acute ischaemic stroke […]

Did a quality improvement collaborative make stroke care better? A cluster randomized trial

Implementation Science: April 1, 2014 Background Stroke can result in death and long-term disability. Fast and high-quality care can reduce the impact of stroke, but UK national audit data has demonstrated variability in compliance with recommended processes of care. Though quality improvement collaboratives (QICs) are widely used, whether a QIC could improve reliability of stroke care […]

Outcome markers for clinical trials in cerebral amyloid angiopathy

The Lancet Neurology: February 27, 2014 Efforts are underway for early-phase trials of candidate treatments for cerebral amyloid angiopathy, an untreatable cause of haemorrhagic stroke and vascular cognitive impairment. A major barrier to these trials is the absence of consensus on measurement of treatment effectiveness. A range of potential outcome markers for cerebral amyloid angiopathy can […]

Challenges of Decision Making Regarding Futility in a Randomized Trial

STROKEAHA: April 3, 2014 Background and Purpose—Interventional Management of Stroke (IMS) III is a randomized, parallel arm trial comparing the approach of intravenous tissue plasminogen activator followed by endovascular treatment with intravenous tissue plasminogen activator alone in patients with acute ischemic stroke presenting <3 hours of symptom onset. The trial intended to enroll 900 subjects to […]

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