bluuebunny/crossref_metadata_2025_split huggingface dataset:
The correlations between anti-factor Xa activity values and PT/APTT at peak and trough times in patients with venous thromboembolism using high dose of apixaban
Authors: Ono R , Fukushima K , Yamazaki T , Takahashi H , Hori Y 
Published: November 2020

Abstract

Background
The high dose (20mg/day) of apixaban is used for the initial treatment of venous thromboembolism for the first week. Although patients taking direct oral anticoagulants do not require routine coagulation monitoring, the correlations between anti-factor Xa activity (AXA) and routine coagulation markers such as prothrombin time (PT) and activated partial thromboplastin time (APTT) at peak and trough times especially when using high dose of apixaban have not been reported so far.

Purpose
The purpose is to assess the correlations between AXA values and PT/APTT at peak and trough times in patients with venous thromboembolism using high dose of Apixaban.

Methods
Twenty-six patients (10 male; 71±15 years) with proximal venous thromboembolism or pulmonary embolism using high dose (20mg/day) of apixaban were enrolled. We measured AXA, using chromogenic assay with the HemosIL Liquid Heparin kit, PT and APTT at peak and trough times. The peak time was defined as 3 hours after the intake of apixaban, and the trough time was defined as that immediately before the intake of apixaban.

Results
A significant and strong positive correlation was observed between AXA and PT at both peak and trough times (R=0.795, p&lt;0.01 and R=0.766, p&lt;0.01, respectively). A significant and moderate positive correlation was observed between AXA and APTT at trough time (R=0.527, p&lt;0.01), but no correlation was observed between AXA and APTT at peak time (R=0.366, p=0.07).

Conclusion
Our findings reveal the relationship between AXA and PT at peak and trough times has a significant strong correlation. These results suggest measuring of PT may be alternative and effective way of monitoring of AXA values when using high dose of apixaban.
Figure 1

Funding Acknowledgement
Type of funding source: None
Assessment of of twenty-five variants of polymorphic genes for lipid and carbohydrate metabolism, vascular inflammation and the neurotransmitter system in the first non-cardioembolic ischemic stroke
Authors: Shishkova V.N , Adasheva T.V , Stakhovskaya L.V , Remennic A.Y.U , Valyaeva V.V 
Published: November 2020

Abstract

The study of the relationship between various of gene polymorphism: APOA-V (rs34282181), APOA-V (rs619054), APOC-IV (rs1132899), LPL (rs199675233), LP(a) (rs41267817), APOB (rs1042031), APOB (rs676210), APOC-IV (rs1132899), APOH (rs4581), ANGPT4 (rs1044250), APOE (rs5174), APOE (rs 7412), APOE (rs 429358), APOD (rs7659), ADIPOQ (rs17366743), ADIPOQ (rs185847354), ADIROR (rs12342), TNFα (rs1800620), VEGFA (rs 62401172), IL6 (rs56383910), IL8 (rs1803205), MTHFR (rs1801131), MTHFR (rs1801133), GRM 1 (rs1047005), GRM 3 (rs2228595), BDNF (rs6265) and the development of the first non-cardioembolic ischemic stroke

Material and methods
The alleles frequencies and genotypes assessed for 25 mono-nucleotide polymorphic gene variants in 206 patients, who had first non-cardioembolic ischemic stroke, and 206 persons with no stroke, comparable with age, gender, place of living and ethnicity. Genotyping of polymorphisms was done with the prepared TaqMan probes.
Genotyping of single nucleotide polymorphisms of genes: APOA-V (rs34282181), APOA-V (rs619054), APOC-IV (rs1132899), LPL (rs199675233), LP(a) (rs41267817), APOB (rs1042031), APOB (rs676210), APOC-IV (rs1132899), APOH (rs4581), ANGPT4 (rs1044250), APOE (rs5174), APOE (rs 7412), APOE (rs 429358), APOD (rs7659), ADIPOQ (rs17366743), ADIPOQ (rs185847354), ADIROR (rs12342), TNFα (rs1800620), VEGFA (rs 62401172), IL6 (rs56383910), IL8 (rs1803205), MTHFR (rs1801131), MTHFR (rs1801133), GRM 1 (rs1047005), GRM 3 (rs2228595), BDNF (rs6265) using ready-made TaqMan probes was carried out.

Results
For polymorphisms ApoD (rs7659), ApoA5 (rs619054), ApoB (rs676210), IL8 (rs1803205) there was significant difference between groups in the variety of minor alleles and genotypes.

Conclusions
There is significant relation of mononucleotide polymorhpisms of the genes APOD (rs7659), ApoA5 (rs619054), ApoB (rs676210), IL8 (rs1803205) with the development of the first non-cardioembolic ischemic stroke In the studied groups.

Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Moscow Center for Neurorehabilitation
Blood-based biomarkers for the long-term prognosis after acute ischemic stroke – results of the Linz Stroke Unit (LISU) study
Authors: Dieplinger B , Bocksrucker C , Egger M , Bundschuh C , Mueller T 
Published: November 2020

Abstract

Background
The aim of our study was to evaluate the long-term prognostic value of blood-based biomarkers in comparison to the established National Institute of Health stroke scale (NIHSS) score in patients with acute ischemic stroke.

Methods
We measured plasma concentrations of IL-6, NT-proBNP, D-dimer, hs-cTnT, sST2, MR-proADM, MR-proANP, CT-proET-1, Copeptin, and Procalcitonin in 721 consecutive acute ischemic stroke patients within 24 h after admission to our stroke unit. Endpoint was all-cause mortality at 3 years.

Results
During follow-up, 199 patients died (28%). In univariate Cox proportional hazards regression analyses using a dichotomized approach according to median values, all blood-based biomarkers were associated with prognosis. However, in the multivariate analysis after adjustment for several clinical variables, only IL-6 &gt;7 pg/mL (risk ratio, 3.00; 95% CI, 2.03–4.44; P&lt;0.001), NT-proBNP &gt;447 ng/L (risk ratio, 2.67; 95% CI, 1.81–3.92; P&lt;0.001), NIHSS score &gt;3 (risk ratio, 2.24; 95% CI, 1.63–3.07; P&lt;0.001), Copeptin &gt;13 pmol/L (risk ratio, 1.87; 95% CI, 1.34–2.61; P&lt;0.001), and hs-cTnT &gt;14 ng/L (risk ratio, 1.74; 95% CI, 1.21–2.49; P=0.001) remained independent predictors. ROC curve analysis for mortality prediction demonstrated a higher area under the curve (AUC) for IL-6 and NT-proBNP, respectively, when compared to the NIHSS score (IL-6 AUC 0.81 vs. NIHSS AUC 0.75; P=0.016 and NT-proBNP AUC 0.80 vs. NIHSS AUC 0.75; P=0.039) and similar AUCs when comparing the NIHSS with hs-TnT (hs-TnT AUC 0.77) and Copeptin (Copeptin AUC 0.72).

Conclusions
In this large cohort of patients with acute ischemic stroke the blood-based biomarkers IL-6, NT-proBNP, hs-cTnT, and Copeptin were strong and independent prognostic markers for 3-year all-cause mortality. IL-6 and NT-proBNP even outperformed the NIHSS score for long-term mortality prediction.
ROC plots for 3-year all-cause mortality

Funding Acknowledgement
Type of funding source: None
The CRP/albumin ratio: a novel predictor of in-stent restenosis after carotid artery stenting
Authors: Calik A.N , Cinar T , Inan D , Genc D , Kuplay H , Karatas M.B , Emre A 
Published: November 2020

Abstract

Background
In-stent restenosis (ISR) remains a potential problem and raises concerns about the long-term safety and efficacy of carotid artery stenting (CAS). As inflammation has a pivotal role in the pathogenesis of ISR, a novel and more sensitive inflammatory marker, CRP/albumin ratio (CAR) may be used to predict ISR in patients undergoing CAS.

Purpose
The present study aimed to assess the predictive value of preprocedural C-reactive protein/albumin ratio (CAR) for ISR after CAS.

Method
In this retrospective study, 206 patients who underwent successful CAS procedure in a tertiary heart centre were included. For each patient, both C-reactive protein (CRP) and serum albumin were determined before the index procedure. The CAR was calculated by dividing serum CRP by serum albumin level. The main end-point of the study was ISR during long-term follow-up.

Results
ISR developed in 34 (16.5%) out of 206 patients after a mean follow-up of 24.2±1.5 months. The CAR was significantly elevated in patients with ISR compared to those who were not (0.99 [1.3] vs. 0.15 [0.2], p&lt;0.01, respectively). In a multivariate Cox regression analysis, the CAR was an independent predictor of ISR (HR: 1.85, 95% CI: 1.29–2.64, p&lt;0.01). A ROC curve analysis revealed that the optimal value of CAR in predicting ISR was &gt;0.53 with a sensitivity of 100% and a specificity of 97.1% [area under curve (AUC) 0.98, p&lt;0.001].

Conclusion
The present study demonstrated that CAR, a new inflammatory-based index, is a strong independent predictor of ISR after CAS. As a simple and easily accessible parameter, this index may be used for the assessment of ISR in patients who are treated with CAS.

Funding Acknowledgement
Type of funding source: None
Which characteristics of patent foramen ovale and associated anatomical structures determine risk of cryptogenic brain ischemia?
Authors: Dubrava J , Sidlo R 
Published: November 2020

Abstract

Background
Linking of the characteristics of persistent foramen ovale (PFO) and associated septal/atrial structures to a causal role in cryptogenic stroke is not definitely known.

Purpose
In a prospective study to assess the risk of morphological and functional features of PFO and selected septal/atrial structures for cryptogenic stroke or transient ischemic attack (TIA).

Methods
A total of 1 270 consecutive patients underwent contrast transesophageal echocardiography – 702 patients with cryptogenic brain ischemia and 568 controls without the history of stroke or TIA. We compared 224 patients with cryptogenic stroke or TIA and PFO (31.9% of all patients with brain ischemia) to 106 controls with PFO (18.7% of the control group) (p&lt;0.001). We analyzed diameter and length of the PFO, presence of the large PFO (diameter ≥4 mm), long PFO (length ≥10 mm), atrial septal aneurysm (excursion ≥15 mm), Eustachian valve or Chiari network, shunt severity (graded with a 1–3 scale) and the right-to-left shunt present under basal conditions.

Results
All parameters of PFO significantly increased relatíve risk (RR) of cryptogenic stroke/TIA vs population without PFO [RR (95% CI); p]: PFO – 2.04 (1.57; 2.66); &lt;0.001, large PFO – 4.99 (2.67; 9.39); &lt;0.001, PFO with diameter ≥ median 2.4 mm – 3.20 (2.19; 4.68); &lt;0.001, long PFO – 2.25 (1.65; 3.06); &lt;0.001, PFO with length ≥ median 12 mm – 2.26 (1.61; 3.17); &lt;0.001, moderate or large shunt – 2.25 (1.65; 3.08); &lt;0.001, shunt present under basal conditions – 2.47 (1.74; 3.52); &lt;0.001. None of the associated structures (atrial septal aneurysm, atrial septal aneurysm + PFO, Eustachian valve or Chiari network, atrial septal defect) significantly increased RR of cryptogenic stroke/TIA vs population without the respective structure. In a multivariable logistic regression model PFO diameter ≥ median 2.4 mm and long PFO emerged as significant risk factors of stroke or TIA. Patients with brain ischemia had significantly larger PFO diameter and higher prevalence of large PFO compared to controls (3.1±2.0 mm vs 2.3±1.4 mm, p&lt;0.001; 8.8% vs 2.1%, p&lt;0.001). Symptomatic patients had significantly higher prevalence of long tunnel (23.2% vs 12.3%, p&lt;0.001) and of moderate/large shunt (22.2% vs 11.8%, p&lt;0.001). There was no significant difference between patients and controls in prevalence of atrial septal aneurysm, atrial septal aneurysm + PFO, Eustachian valve or Chiari network, atrial septal defect.

Conclusions
Among the parameters of PFO large diameter was the most powerful risk factor of cryptogenic brain ischemia. Long PFO, moderate/large shunt and shunt present under basal conditions also significantly increased the risk. Associated septal/atrial structures were not found as risk factors.

Funding Acknowledgement
Type of funding source: None
Comparison of upper extremity versus lower extremity vein injections of bubble contrast in assessment of patent foramen ovale
Authors: Mutlu D , Durmaz E , Karpuz M.H , Karadag B , Ikitimur B , Koca D , Raimoglu U , Ohtaroglu Tokdil K , Tokdil H , Ongen Z 
Published: November 2020

Abstract

Background
Patent foramen ovale (PFO) is one of the causes of cardioembolism and closure of PFO is recommended by the current guidelines in patients with recurrent stroke. Transoesophageal echocardiography (TEE) using bubble-contrast study is the gold standard imaging modality for the assessment of interatrial septum. Upper-extremity veins are the most common way of injection, however, the presence of Eustachian valve and flow dynamics when bubble-contrast injection performed via upper extremity veins limits the assessment of interatrial septum in several cases. In this study, we aimed to compare the efficacy of bubble-contrast study between upper extremity injection and lower extremity injection.

Material/Methods
Patients with a suspicion of cardioembolism who were undergoing TEE study were included in this study. After routine assessment of cardiac structures, the bubble-contrast study was performed using agitated saline from both upper-extremity vein and lower-extremity vein with Valsalva manoeuvre. Right-to-left shunt and numbers of bubbles transmitted from the septum were recorded.

Results
We prospectively included 45 patients and 21 PFOs were detected. There were 9 patients with prominent Eustachian valve and in 6 patients Eustachian valve hampered the complete opacification of the right atrium. In 3 patients flow from the superior vena cava was directed towards the tricuspid valve and hampered the complete opacification. Among 21 patients with PFO, in 6 patients right-to-left shunt was not observed when agitated-saline was injected via the upper-extremity vein, however, the shunt was observed when the agitated-saline was injected via the lower-extremity vein. In 14 patients amount of bubbles passing through the interatrial septum were significantly higher when the injection was performed via the lower-extremity vein especially in patients with prominent Eustachian valve.

Conclusion
Our preliminary results indicated that compared to upper-extremity veins, injection via the lower-extremity veins provides better opacification of right atrial septum and assessment of interatrial septum. Therefore, injection through the lower-extremity veins would be the preferred choice particularly in patients with prominent Eustachian valve or downward directed flow from the superior vena cava.
Figure 1

Funding Acknowledgement
Type of funding source: None
Evaluation of left atrial mechanics and p-wave dispersion as markers of left atrial cardiopathy in patients of embolic stroke of undetermined source (ESUS)
Authors: Masood S , Azharuddin M.M , Ashraf S.M.K , Wahab S 
Published: November 2020

Abstract

Introduction
Around 25% of all ischaemic strokes have no known cause despite standard investigations. Most of these cases are suspected to have an embolic source for ischaemia, leading to the moniker of Embolic Stroke of Undetermined Source (ESUS). Recent studies suggest that abnormalities of the left atrium, in the form of atrial cardiopathy, can lead to increased risk of stroke even in the absence of atrial fibrillation (AF), which may be either as precursors to AF or as independent risk factors for the development of left atrial thrombus and subsequent stroke.

Purpose
The aim of this study was to measure LA electromechanical dissociation, LA volumes and P-wave dispersion as markers of atrial cardiopathy in patients with ESUS to determine whether atrial cardiopathy may be in the causal pathway of ESUS.

Methods
28 patients presenting with ischaemic stroke and fulfilling the criteria for ESUS were enrolled into this cross-sectional, observational study. All patients had 24-hour Holter monitoring done to rule out the presence of AF. The control group consisted of 28 age- and gender-matched apparently healthy individuals. On ECG, P-wave Dispersion (PWD) was calculated by subtracting minimum P-wave duration from maximum P-wave duration. On echocardiography, time intervals from the beginning of P-wave to beginning of A' wave from the lateral mitral annulus in tissue doppler imaging was measured as the atrial electromechanical delay. LA volumes were recorded using the Modified Biplane Simpson's method. Statistical analysis was performed using student's t-test, chi-square test, and Pearson's test.

Results
Baseline demographic and laboratory characteristics were similar between the two groups. Increased PWD (34.14±9.89 ms vs. 27.32±8.95 ms; p=0.01), atrial electromechanical delay (73.32±16.31 ms vs. 63.63±13.59 ms; p=0.02) and LA volumes were observed in patients with ESUS as compared to controls. A significant correlation was also found between these parameters (p&lt;0.01).

Discussion
According to the results of our study, PWD, atrial electromechanical delay and LA volumes may be novel predictors for ESUS. Atrial cardiopathy is a unique mechanism of thrombo-embolism in ESUS patients and our data establishes its association with ESUS. Further studies will be needed to shed more light on its role in the causality of stroke in the ESUS population.
Measurement of electromechanical delay

Funding Acknowledgement
Type of funding source: None
Speckle tracking echocardiography in patients with stroke
Authors: Trush E , Ivanova S.V , Yushchuk E.N , Savin A.A , Melehina I.V 
Published: November 2020

Abstract

Introduction
Global longitudinal strain (GLS) via speckle tracking echocardiography (STE) has emerged as a quantitative technique to estimate myocardial function and has been shown to have clinical utility in a variety of settings. The use of this technique in patients with a stroke is limited.

Purpose
Comparative analysis of myocardial deformation indicators in patients with a stroke, depending on the severity and subtype.

Results
230 patients with an acute cerebrovascular accident (132 men and 98 women) were included in our study, with the mean age of 64,9±10,8. Transient ischemic attack (TIA) was diagnosed in 39 (17%), acute ischemic stroke (AIS) in 191 (83%) patients. The type of an ischemic stroke in each patient was classified as one of the following traditional stroke subtypes: large-artery atherosclerosis (LAA) was diagnosed in 85 (44,5%), cardioembolic infarcts were diagnosed in 58 (30,4%), lacunar infarcts were diagnosed in 32 (16,8%) and in 16 (8,4%) the stroke was of another determined or undetermined etiology. There was no significant difference in left ventricular (LV) ejection fraction (EF) between the subgroups of TIA and AIS - 63.0% [60.0; 65.0] and 62.0% [58.0; 65.0], respectively. The LV GLS was within normal limits and amounted to 19.9±2.6 in the TIA group where as in the group of patients with stroke there was a significant (p&lt;0.01) decrease in GLS below standard values - 17.1±3.8. The LV EF showed no significant difference between the groups of stroke subtypes. However, a decrease in GLS was found in the series from cardioembolic infarct &gt; lacunar infarct &gt; LAA - 17.5±3.7 &gt; 16.5±6.5 &gt; 16.2±3.2 (p=0,7). A decrease in GLS was significantly more often observed in male patients.
A decrease in the level of GLS in patients with a stroke is associated with duration of type 2 diabetes, stroke severity by the National Institutes of Health Stroke Scale (NIHSS) score, ECG voltage criteria for LVH, increase in heart rate, LV mass/BSA, relative wall thickness (RWT) according to echocardiography. Significant differences in GLS from the size of the stroke focus according to CT scanning/ magnetic resonance imaging were not detected.

Conclusion
GLS via STE in patients with a stroke correlates with the severity of a stroke, the severity of LV remodeling, risk factors for cardiovascular events and requires a further study to assess the long-term prognosis

Funding Acknowledgement
Type of funding source: None
Optical coherence tomography and coronary angioscopy assessment of healed vulnerable plaque components in patients with coronary artery lesions undergoing elective percutaneous coronary intervention
Authors: Kimura S , Hara K , Ohmori M , Tateishi R , Kaneda T , Yamakami Y , Shimada H , Manno T , Iishiki A , Shimizu M , Fujii H , Suzuki M , Sasano T 
Published: November 2020

Abstract

Background
Many vulnerable plaques would progress without clinical events and might result in healed plaques (HPs). Histopathological or intracoronary image assessment of HPs has been reported. However, the morphological characteristics of HPs remain unclear yet.

Purpose
We sought to assess the healed vulnerable plaque components in patients with coronary artery lesions using optical coherence tomography (OCT) and coronary angioscopy (CAS).

Methods
We enrolled 47 patients with 50 native coronary artery lesions with angiographical severe stenosis (&gt;90% diameter-stenosis) and without severe calcification (36 lesions with stable angina pectoris (SAP) and 14 acute coronary syndrome (ACS)) undergoing pre-intervention OCT and CAS. HPs was defined as layered phenotype on OCT. Lesion morphologies and plaque characteristics in lesions with HPs were assessed using OCT and CAS images.

Results
HPs were observed in 27 lesions (54.0%) and their prevalence were similar among each clinical status (SAP 52.8%, ACS 57.1%, p=1.00). Lesions with HPs had higher prevalence of OCT-macrophage (88.0% vs. 52.0%, p=0.01), CAS-red thrombus (88.8% vs. 52.2%, p=0.004) and CAS-low grade-yellow plaque (grade 1) (55.6% vs. 21.7%, p=0.02) than those without. SAP lesions with HPs had higher prevalence of CAS-yellow plaque (35.3% vs. 5.9%, p=0.09) and OCT-thin-cap fibroatheroma (42.1% vs. 5.9%, p=0.04) than SAP without HPs. ACS lesions with HPs had less CAS-red thrombus (0.0% vs. 50.0%, p=0.03) and OCT-plaque rupture (12.5% vs. 66.7%, p=0.04) than ACS without HPs. Multivariate logistic regression analysis revealed that OCT-macrophages (odds ratio (OR): 6.65, 95%-confidence intervals: 1.07–41.5, p=0.043), CAS-red thrombus (OR 8.77, 95% CI 1.33–57.8, p=0.02), and low grade-yellow plaque (OR 13.05, 95% CI 1.97–86.5, p=0.008) were independently related with the existence of HPs lesions. Combination of these 3 factors showed a high predictive value of OCT-HPs lesions (90.9%).

Conclusions
HPs lesions showed the lower lesion vulnerability than common ACS lesions but had more intraplaque inflammatory condition compared with common SAP lesions. Combined CAS and OCT examination might be useful to clarify the plaque components of HPs lesions in vivo, leading to help us understand the clinical significance of HPs.

Funding Acknowledgement
Type of funding source: None