Risultati per: Stroke

Circulation, Volume 151, Issue 5, Page 331-333, February 4, 2025.

Introduction
Stroke is a major cause of acquired disability globally, yet the neural mechanisms driving motor recovery post-stroke remain elusive. Recent research has underscored the growing significance of subcortical pathways in neural plasticity and motor control. Among these, the cortico-reticulospinal tract (CRST) has gained attention in rehabilitation due to its unique ascending and descending structural features as well as its cellular properties which position it as an excellent candidate to compensate for inadequate motor control post-stroke. However, the optimal strategies to harness the CRST for motor recovery remain unknown. Non-invasive modulation of the CRST presents a promising though challenging, therapeutic opportunity. Acoustic startle priming (ASP) training and intermittent theta burst stimulation (iTBS) are emerging as potential methods to regulate CRST function. This study aims to investigate the feasibility of segmentally modulating the cortico-reticular and reticulospinal tracts through ASP and iTBS while evaluating the resulting therapeutic effects.

Methods and analysis
This is a randomised, blinded interventional trial with three parallel groups. A total of 36 eligible participants will be randomly assigned to one of three groups: (1) iTBS+ASP group, (2) iTBS+non-ASP group, (3) sham iTBS+ASP group. The trial comprises four phases: baseline assessment, post-first intervention assessment, assessment after 3 weeks of intervention and a 4-week follow-up. The primary outcomes are the changes in the Fugl-Meyer Assessment-Upper Extremity and Modified Ashworth Scale after the 3-week intervention. Secondary outcomes include neurophysiological metrics and neuroimaging results from diffusion tensor imaging and resting-state functional MRI.

Ethics and dissemination
The trial is registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR2400085220) and Medical Ethics Committee of Tongji Hospital, affiliated with Tongji Medical College, Huazhong University of Science and Technology (Registration No.TJ-IRB20231109). It will be conducted in the Departments of Rehabilitation Medicine and Radiology at Tongji Hospital in Wuhan, China. The findings will be disseminated through peer-reviewed journal publications and presentations at scientific conferences.

Trial registration number
ChiCTR2400085220.

Stroke, Volume 56, Issue Suppl_1, Page ATMP33-ATMP33, February 1, 2025. Introduction:Acute ischemic stroke (AIS) with large vessel occlusion (LVO) benefits from mechanical thrombectomy (MT), but the majority of Americans require interhospital transfer for MT. Thrombolysis at the spoke hospital with the patient transferred to the hub for MT is a model known as “drip-and-ship.” In contrast, “mothership” patients present directly to MT capable centers and have immediate access to MT. We sought to evaluate the effects of thrombolysis dwell time (time for the drug to work) and drip-and-ship versus mothership status on recanalization rates.Methods:Among 385 patients who received thrombolysis for AIS at our academic comprehensive stroke center from January 1, 2023 to June 30 2024, 76 patients had LVO and repeat vessel imaging available to evaluate for recanalization status. Thrombolysis dwell time was defined as the timefrom administration of thrombolysis to repeat vascular imaging. Recanalization was defined as complete resolution of the occlusion. Partial recanalization was defined as some recanalization (i.e. M1 transformed into M2). Patients without vascular imaging or without repeat vessel imaging were excluded. Data was collected on demographics, last known normal time (LKN), National Institutes of Health Stroke Scale (NIHSS), thrombolysis administration time, and repeat vascular imaging results.Results:Among 76 AIS LVO patients, the mean age was 68.8 years (range, 25.1 to 96.8), and 40 (52.6%) were women. The mean initial NIHSS was 14.7 (range, 0 to 34). Twenty-three (30%) were mothership and 53 (69.7%) were drip-and-ship. The mean time from LKN to thrombolysis was 2.2 hours (range, 0 to 4.9). The site of LVO occlusion was as follows: 56 (76.7%) M1, 8 (10.5%) M2s occlusions, 5 (6.6%) carotid terminus, 5 (6.6%) basilar, and 2 (2.6%) PCA occlusions. In 69 (90.8%), repeat vascular imaging was cerebral angiogram. There were 7 (9.2%) complete recanalization, and 20 (26.2%) partial recanalization. Mothership status was associated with lower rates of partial recanalization (8.7% vs 34%, p 0.016) and shorter mean thrombolysis dwell time (0.9 hours vs 2.7 hours, p < 0.0001) compared to drip-and-ship status.Conclusions:In LVO AIS patients who receive thrombolysis, drip-and ship status is associated with higher partial recanalization rates and longer thrombolysis drug dwell time compared to mothership status. This may impact strategy for recruitment of sites in clinical trials.

Stroke, Volume 56, Issue Suppl_1, Page ATP313-ATP313, February 1, 2025. Background:Lipoprotein(a) (lp(a)) concentrations is an independent risk factor of atherosclerotic cardiovascular disease (ASCVD). The association between lp(a) and prognosis of ischemic stroke patients is uncertain.Hypothesis:The study is aimed to investigate the shape and the association of the risk of short-term and long-term stroke recurrence across the distribution of lp(a) concentrations, and explore whether combining ASCVD risk has an influence on the association.Method:Patients with acute ischemic stroke within 7 days in the Third China National Stroke Registry (CNSR-III) having lp(a) measurements were included in the study. The outcomes were stroke recurrence within one year and two years. ASCVD risk included diabetes mellitus, stroke history and early onset. Based on ASCVD risk and lp(a) concentrations, there were four groups: lp(a)70 mg/dL without ASCVD risk. To display the shape of the relationship between lp(a) and stroke recurrence within two years, lp(a) concentrations were modeled using natural cubic splines with median concentration serving as the reference adjusted by confounders. And the association was assessed using Cox proportional hazards models and Kaplan-Meier curves.Result:Among 9952 included patients with the mean age of 63 years and 69% of male, the median lp(a) concentrations was 18.06 (inter-quartile range, 8.85-35.66) mg/dL. The relationship between lipoprotein(a) and stroke recurrence appeared linear across the distribution. Compared to patients with lp(a)=50 mg/dL was associated with a higher risk of stroke recurrence (adjusted HR for one-year outcome:1.19, 95%CI: 1.01-1.41, p =0.04; adjusted HR for two-year outcome:1.21, 95%CI: 1.04-1.40, p =0.01). Compared to patients with lp(a)70 mg/dL without ASCVD risk (HR:0.90, 95%CI: 0.65-1.26, p =0.55).Conclusion:Lipoprotein(a) concentrations was associated with short-term and long-term prognosis of ischemic stroke, with a linear risk gradient across the distribution. Baseline ASCVD risk may influence the association between lp(a) and stroke recurrence.

Stroke, Volume 56, Issue Suppl_1, Page ATP315-ATP315, February 1, 2025. Introduction:While Asian populations appear healthier than non-Hispanic Whites overall, recent studies have highlighted significant health disparities within Asian subgroups in the US. However, most US health databases aggregate Asians into broader categories, limiting understanding of subgroup-specific risks. This study aims to investigate the disparity in stroke risk among Asian subgroups in California – a state where nearly 30% of U.S. Asians live.Methods:We analyzed 2013-2019 Behavioral Risk Factor Surveillance System (BRFSS) data from California. Stroke prevalence was determined by self-reported diagnosis. Asian subgroups were categorized as East Asian (Chinese, Japanese, Korean), South Asian (Indian, Pakistani), Southeast Asian (Filipino, Vietnamese, Cambodian), and Other Asian. Logistic regression models examined odds of stroke prevalence by Asian broadly and detailed categorized subgroups using non-Hispanic Whites as the reference and adjusting for age and sex.Results:Among 1,768 Asian participants, females comprised 47% overall, ranging from 37% (South Asians) to 52% (Southeast Asians). The mean age for all Asians is about 42 years, and the subgroups show similar results. Detailed subgroups showed Filipinos had the highest female proportion (54%) and Indians the lowest (36%). Age distribution showed Japanese were oldest (52 years) and Cambodians youngest (37 years). After adjusting for age and sex, East Asians demonstrated significantly lower odds of stroke prevalence (OR=0.43; 95% CI: 0.24-0.77) compared to non-Hispanic Whites. Southeast Asians had increased stroke risk (OR=1.17), although non-significant. In detailed subgroup analysis, Chinese showed lower stroke prevalence (OR=0.39; 95% CI: 0.17-0.87), while Cambodians had significantly higher prevalence (OR=4.43; 95% CI: 1.02-19.23).Conclusions:Our findings reveal significant heterogeneity in stroke prevalence among Asian American subgroups in California. The fluctuation in results underscores the importance of disaggregated analyses in stroke research, and future research should expand upon these findings to uncover the underlying causes in the variance. This study is the beginning of an important roadmap to mitigating stroke disparities in Asian populations by tailoring stroke prevention and treatment methods to specific Asian subgroups, rather than integrating all subgroups into a singular broad category.

Stroke, Volume 56, Issue Suppl_1, Page AWMP120-AWMP120, February 1, 2025. Introduction:We previously demonstrated that Mucosal-associated Invariant T (MAIT) cells were involved in acute ischemic stroke by regulating neuroinflammation (JAHA 2021). This study aimed to clarify the dynamics and role of circulating peripheral MAIT cells in acute ischemic stroke patients.Methods:We enrolled patients with acute ischemic stroke who admitted to Jichi Medical University Hospital, classifying them into severe (NIHSS ≥10) and mild (NIHSS

Stroke, Volume 56, Issue Suppl_1, Page ATMP29-ATMP29, February 1, 2025. Introduction:Mobile Stroke Treatment Units (MSTU) are improving clinical outcomes by significantly shortening the time-to-treatment. On scene, the specialized staff, including a registered nurse and critical care paramedic, are able to rapidly assess the patient for acute stroke symptoms. This rapid treatment algorithm can potentially lead to missed strokes as compared to those patients transported via standard Emergency Medical Services (EMS). Therefore, we evaluated the rate of missed stroke diagnosis through MSTU assessment in the field as compared to the standard EMS-to-Emergency Department (ED) pathway.Methods:A retrospective analysis of patients with potential stroke evaluated by the MSTU crew between 7/25/23 and 5/31/24 was performed. Admission criteria includes age 18 years or older, last known well within 24 hours, one or more cardinal signs of stroke, and exclusions of any other suspected diagnosis outside of stroke or neurological disorders. Our study evaluated patients who were excluded from MSTU admission based on failure to meet said admission criteria. These patients were transported to the hospital by standard EMS. Patient demographics, symptoms, and final hospital diagnoses were extracted to complete univariate and multivariable regression analyses.Results:Our final analysis included 235 patients (mean age 66.3, 56.0% women) evaluated by the MSTU crew, but not admitted due to lower concern for stroke. In our study cohort, 11 had a final diagnosis of stroke that were missed upon initial MSTU evaluation. Patients with missed stroke were significantly older (OR 1.04 (95%CI 1.01 – 1.08), p=0.04) and had a nonsignificant trend towards female sex (OR 0.44 (95%CI 0.14 – 1.45), p=0.17). We did not see any differences among specific MSTU staff performing the evaluation or time of day and day of week. Of the 11 patients with a final stroke diagnosis, none received any acute interventions on arrival to the hospital.Conclusion:Our MSTU admission criteria resulted in an overall low rate of true stroke misses with none of the “missed strokes” receiving an acute intervention at the hospital. Rapid patient evaluation on scene by an expert stroke crew adhering to a standardized admission criterion does not lead to acute stroke interventions being performed upon arrival to the ED. Older patients with stroke-like symptoms evaluated by a Mobile Stroke Treatment Unit are more likely to be misdiagnosed, which deserves further investigation.

Stroke, Volume 56, Issue Suppl_1, Page ATMP37-ATMP37, February 1, 2025. Introduction:Limited studies have examined racial disparities in long-term survival after acute ischemic stroke (AIS) with inconsistent findings. We examined these disparities among Medicare fee-for-service (FFS) beneficiaries in U.S.Methods:We analyzed data on 1,997,487 Medicare FFS beneficiaries aged ≥65 years hospitalized with incident AIS (ICD-10 code I63) and survived >30 days from January 1, 2000 to December 31, 2017, and were followed-up until December 31, 2022. Cox proportional hazard models estimated the adjusted hazard ratio (aHR, 95% CI) and adjusted survival curves by race/ethnicity (non-Hispanic White (White), non-Hispanic Black (Black), Hispanic and Other). Models were adjusted for age, sex, and comorbidities.Results:The median age at AIS hospitalization was 78 years (IQR 72.0-84.0); 57.0% were women; 81.8%, 10.8%, 4.8% and 2.6% were White, Black, Hispanic and Other, respectively. Over a median follow-up of 4.9-years (IQR 1.7-8.8), there were 1,738,452 all-cause deaths. Adjusted 5-year survival after AIS improved from 2000-2004 to 2015-2017 for White (46.5% (95% CI 46.4-46.6) to 50.9% (50.7-51.1)), and Black (46.0% (45.8-46.3) to 48.9% (48.3-49.2)). For Hispanic and Other, survival remained largely unchanged: 54.4% (54.1-54.8) to 54.2% (53.6-54.8)) for Hispanic and 55.9% (55.4-56.4) to 54.7% (54.0-55.5) for Other. A clear pattern of long-term survival after AIS emerged by race/ethnicity showing similar survival between Hispanic and Other and between White and Black people (Figure). Stroke mortality risk was ~25% higher for White and Black compared to Hispanic and Other (aHR 1.25 (1.24-1.26)). This pattern was consistent across age groups and sex.Conclusions:Long-term survival after AIS has improved for White and Black Medicare FFS beneficiaries over time, while it remained largely unchanged for Hispanic and Other groups. This indicates persistent racial disparities in stroke outcomes.

Stroke, Volume 56, Issue Suppl_1, Page ATMP30-ATMP30, February 1, 2025. Background:The prehospital scales have been developed to identify stroke patients with large vessel occlusion (LVO) to facilitate rapid transport to appropriate stroke centres. In practice, these stroke scales have moderate accuracy. There is a pressing need for adjunct easy-to-use and interpret diagnostic devices to improve prehospital stroke diagnosis and LVO detection. We aim to determine whether a machine learning algorithm using adjunct electroencephalography (EEG) Spectra can improve the accuracy of LVO detectionMethods:Adult patients with suspected acute stroke were prospectively enrolled as soon as possible on arrival at the emergency department. A wearable MuseTMheadband (InteraXon Inc, Canada) with an embedded 4-channel EEG was used for a resting 3-minute recording. EEG Spectra including relative alpha, beta, theta and delta spectral powers, delta-alpha ratio (DAR) and pairwise-derived brain symmetry indices (pdBSI) were calculated. These indices were compared between patients with LVO and non-LVO groups. The accuracy of LVO detection was tested with the aid of supervised machine learning(ML) algorithms including EEG Spectra, Los Angeles Motor Stroke Scale (LAMS), sex and side of stroke.Results:A total of 142 patients were included in the analysis with a mean age of 69.6±13.7 years, 60(42.2%) females, (Stroke Subtype:113[79.6%] were ischemic stroke, 22[15.5%] stroke mimics, 7[4.9%] intracerebral hemorrhage) and median NIHSS 5(2-11). Thirty-seven(26.1%) patients had LVO and EEG was acquired at a median of 6h 45m (3h 29m – 14h 15m) after symptom onset. Relative alpha spectral power was lower in both affected (p

Stroke, Volume 56, Issue Suppl_1, Page ATMP41-ATMP41, February 1, 2025. Background:Stroke remains a leading cause of mortality and morbidity, with treatment and outcomes differing across ethnic groups. Tele-stroke networks have expanded access to stroke care, particularly in underserved areas, but the impact of ethnicity on these outcomes is still being explored. This study aims to compare stroke treatment outcomes among White/Caucasian, African-American, and Other ethnic groups within a tele-stroke network.Methods:We conducted a retrospective analysis of 4,256 stroke patients treated within a tele-stroke network spanning 38 hospitals. Patients were categorized into three ethnic groups: White/Caucasian (n = 2,925), African-American (n = 1,122), and other (n = 209). Data on baseline characteristics, treatment interventions, and discharge outcomes were analyzed using chi-square tests for categorical variables and Kruskal-Wallis tests for continuous variables.Results:The median age was highest in White/Caucasian patients (70 years, IQR 57-81) and lowest in the other group (61 years, IQR 49-72) (p < 0.001). True strokes occurred in 82.3% of White/Caucasian patients, 79.3% of African-American patients, and 89.9% of the other group (p = 0.001). tPA was administered to 19.4% of White/Caucasian patients, 16.7% of African-American patients, and 15.2% of the other group (p = 0.12). Mechanical thrombectomy rates were similar across all groups (p = 0.07). Discharge to home was most common in the other group (58.4%), followed by African-American (50.3%) and White/Caucasian patients (44.9%) (p = 0.01).Conclusion:This study identified important ethnic differences in stroke treatment and outcomes within a tele-stroke network. While there were no significant disparities in the administration of key treatments such as tPA and mechanical thrombectomy, differences in age, gender distribution, stroke severity, and true stroke rates highlight the need for tailored approaches in stroke management to address the unique needs of different racial/ethnic groups.

Stroke, Volume 56, Issue Suppl_1, Page ATMP32-ATMP32, February 1, 2025. Introduction:Facilitating evidence-based uptake of new medication regimens for disease prevention is a well-recognized public health challenge. Using data from GWTG-Stroke, researchers previously reported that, after minor ischemic stroke (NIHSS 0-3), the use of aspirin-clopidogrel for stroke prevention is highly variable despite guideline recommendations. We sought to explore potential changes in dual antiplatelet therapy (DAPT) use in patients with moderate ischemic stroke (NIHSS 4-5) after the publication of the THALES (The Acute Stroke or Transient Ischemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death) trial in 2020.Methods:We used the GWTG-Stroke registry to describe patterns of DAPT use in the U.S. from 2019 to 2023. All patients with a final diagnosis of ischemic stroke, NIHSS 4-5, hospital arrival within 24 hours, who lacked an indication for anticoagulation (e.g., atrial fibrillation) and were not treated with thrombolysis/thrombectomy were included in our study. Patients with NIHSS 4-5 (moderate stroke) were not included in prior randomized controlled trials of aspirin-clopidogrel for short-term stroke prevention but were included in THALES. We reported basic demographic features of our cohort and used the Cochran-Armitage trend test to report changes in aspirin-ticagrelor use by year.Results:We identified a total of 40,624 acute ischemic stroke patients with NIHSS 4-5 during the study period. The mean age was 68 years and 47% of patients were women. We found that a total of 20,293 (50%) patients were discharged on aspirin-clopidogrel whereas 1,335 (3.5%) were discharged on aspirin-ticagrelor. The use of both DAPT regimens significantly increased over time (Figure 1, p

Stroke, Volume 56, Issue Suppl_1, Page ATMP35-ATMP35, February 1, 2025. Introduction:Studies have suggested efficacy of glycoprotein IIb/IIIa antagonists such as tirofiban for patients with acute ischemic stroke (AIS). However, neurological deterioration is still common in many of the recommended antiplatelet regimens. We aimed to evaluate the efficacy and safety of tirofiban versus dual antiplatelet therapy (DAPT) or aspirin in patients with AIS.Methods:Following PRISMA guidelines, we searched Pubmed, Embase, Scopus and Cochrane databases for studies comparing effects of tirofiban versus DAPT or aspirin alone in patients with AIS. Main outcomes were increase in NIHSS score, Modified Rankin Scale (mRS) scores at 90 days (0 to 2), intracranial hemorrhage (ICH) and mortality. Statistics analysis was performed using Review Manager 5.4.1 software. Heterogeneity was assessed with I2statistics.Results:We included 5 RCT and 5 non-RCT studies covering 1,857 patients, of whom 926 were treated with Tirofiban. Neurological deterioration, assessed by changes in NIHSS scores from baseline across four studies, was less pronounced in the Tirofiban group (MD -0.32; 9% CI -0.83-0.19; p

Stroke, Volume 56, Issue Suppl_1, Page AWP186-AWP186, February 1, 2025. Background and Purpose:Primary aldosteronism (PA) is characterized by the autonomous overproduction of aldosterone leading to the risk of occurrence of acute ischemic stroke (AIS), but the exact prevalence of PA is unknown in patients with AIS. PA induces oxidative stress and inflammation through vascular endothelial cells, which may damage small vessel disease (SVD). We conducted a prospective study to investigate the prevalence of screening and definite diagnosis of PA in patients with AIS. Next, we aimed to reveal whether SVD markers could be associated with PA.Methods:We screened consecutive patients with AIS who participated in our prospective study to investigate the prevalence of PA and followed up for PA evaluation from October 2020 to December 2022. Inclusion criteria were patients with AIS hospitalized and diagnosed with hypertension. Exclusion criteria were patients taking medications affecting renin, aldosterone, and catecholamines. The screening criteria for PA was defined as the aldosterone-to-renin ratio > 200. Final diagnosis of PA was judged by endocrinologist if one of the captopril challenge test, saline infusion test, and furosemide-upright test was positive following discharge. We evaluated total SVD score based on white matter hyperintensities (separately scored by periventricular hyperintensity [PVH] and deep and subcortical white matter hyperintensity), cerebral microbleeds (CMBs; categorized into deep, lobar, and infratentorial lesions), enlarged perivascular spaces (separately scored in basal ganglia and centrum semiovale), and old lacunes on MRI.Results:We included 120 patients with AIS (93 [78%] male, median age 62 years, Figure 1). The screening for PA was positive in 33 (28%) patients and 8 (7%) patients were finally diagnosed with definite PA. In Poisson regression analysis with a robust variance estimator, total SVD score was related to positive PA screening (prevalence ratio [PR] 1.261, 95% CI 1.021-1.556,p= 0.031) and definite PA diagnosis (PR 1.946, 95% CI 1.229-3.082,p= 0.005, Figure 2). In terms of each SVD marker, severe PVH, and deep and lobar CMBs were associated with positive PA screening and definite PA diagnosis (Figure 3).Conclusions:Twenty-eight percent of patients with AIS were positive for PA screening, and then about a quarter of them were confirmed as definite PA. SVD burden, especially PVH, and deep and lobar CMBs, might be associated with positive screening and definite diagnosis of PA.

Stroke, Volume 56, Issue Suppl_1, Page ATP324-ATP324, February 1, 2025. Background and Purpose:Antiphospholipid antibody syndrome (APS) is a rare cause of cerebral infarction, but the effect of antiphospholipid antibodies (aPL) on the acute phase of ischemic stroke in each stroke subtypes is still unclear, especially in the elderly patients. To clarify this, we compared antiphospholipid antibody levels in patients with acute cerebral infarction with or without recurrence, expansion, or hemorrhagic transformation of infarct in each stroke subtype.Methods:Consecutive ischemic stroke patients in a comprehensive stroke center were screened between April 2013 and April 2024. Inclusion criteria were: 1) admitted 24 hours from the onset, 2) more than 60 years-old on the admission, 3) who had follow-up MRI/CT around one week from the onset, and 4) whose aPL (anti-cardiolipin-beta2-glycoprotein I complex antibody [β2-GPI], anti-cardiolipin antibody [aCL] and lupus anticoagulant [LAC]) measured during the admission for suspected APS. Then, we dichotomized the patients with and without recurrence (R), expansion (E), or hemorrhagic transformation (HT) of infarct upon follow-up MRI/CT findings. We compared clinical features including aPL between the groups by each stroke subtypes based on TOAST classification. Sensitivity and specificity were calculated from receiver operating characteristic (ROC) curve of aPL for predicting R, E, and HT.Results:We screened 2,528 consecutive ischemic stroke patients and 271 patients met the inclusion criteria (60 [22%] cardioembolism (CE), 43 [16%] large-artery atherosclerosis, 29 [11%] small-vessel occlusion and 139 [51%] others). In enrolled patients, 30 (11%) patients showed R, 43 (16%) patients for E and 65 (24%) patients for HT. In CE, CL aCL and LAC were higher in patients with R compared without R (aCL 9.5 vs. 8.0 U/mL,p=0.047; LAC 1.15 vs. 1.01,p=0.006) while aPL were not significantly different in other stroke subtypes. Also, aPL were not significantly different between the patients with and without E or HT. In CE, R increased as LAC became higher (1st tertile vs. 2nd tertile vs. 3rd tertile of LAC: 0 (0%) vs. 1 (6%) vs. 6 (33%),p=0.004). In ROC analysis, the optimal cutoff of LAC for predicting R in CE was 1.12 (area under curve 0.83 [95% confidence interval 0.71-0.94],p=0.006; sensitivity 0.86, specificity 0.82).Conclusions:In CE, LAC was associated with acute recurrence of infarct. LAC should be measured in cardioembolic stroke with recurrence in acute phase.

Stroke, Volume 56, Issue Suppl_1, Page ATMP31-ATMP31, February 1, 2025. Background:A prehospital, paramedic-administered scale to distinguish intracerebral hemorrhage (ICH) from acute cerebral ischemia (ACI) could improve routing to appropriate centers, enrich field randomized trials with targeted subtype patients, and potentially guide prehospital clinical treatment such as hyperacute blood pressure (BP) lowering. We aimed to create a quickly administered prehospital scale from prospectively performed field assessments.Methods:Two scales were created from NIH Field Administration of Stroke Therapy Magnesium (FAST-MAG) trial data, using logistic regression model with backward stepwise variable selection and retention criterion of p

Stroke, Volume 56, Issue Suppl_1, Page ATP316-ATP316, February 1, 2025. Background:Despite improvements in the safety of transcatheter aortic valve replacement (TAVR), ~4% of patients experience a procedure-related stroke. TAVR seems to be preferred in patients with cancer; however, related research on the clinical efficacy and stroke outcomes of TAVR in patients with cancer is limited. This study aimed to evaluate the association of TAVR-related stroke in patients with cancer and without cancer.Methods:This retrospective cohort study identified 14,046 patients with aortic valve stenosis that underwent TAVR. Patients were stratified into two groups: cancer patients 13583 (96.7%) and non-cancer patients 463 (3.3%). We assessed if there was a difference in stroke events between cancer and non-cancer patients. Binary logistic regression models were used to measure the stroke association.Results:Among 14,046 TAVR patients, 214 (1.5%) had a procedure-related stroke. These patients were more likely to be female (p=0.0007, 95% CI: 1.219-2.102), older (p