To evaluate the effects of carotid endoarterectomy in the treatment of extracranial cerebrovascular disease, 26 cases with internal carotid stenosis were performed by three different kinds of surgical endoarterectomy....To evaluate the effects of carotid endoarterectomy in the treatment of extracranial cerebrovascular disease, 26 cases with internal carotid stenosis were performed by three different kinds of surgical endoarterectomy. The satisfactory results were achieved in all the patients, with no complications and mortality occurring. Endoarterectomy is the effective way to treat the extracranial cerebrovascular disease.展开更多
Background The incidence of vascular cognitive impairment(VCI)is high in patients suffering from ischaemic stroke or transient ischaemic attack(TIA)or with vascular risk factors.Effective prevention strategies for VCI...Background The incidence of vascular cognitive impairment(VCI)is high in patients suffering from ischaemic stroke or transient ischaemic attack(TIA)or with vascular risk factors.Effective prevention strategies for VCI remain limited.Anaemia or low haemoglobin was found as an independent risk factor for adverse outcomes after acute stroke.Anaemia or low haemoglobin was possibly associated with an increased risk of poststroke cognitive impairment.Whether supplement of ferrous iron to correct anaemia reduces the risk of VCI and improves adverse outcomes in patients with ischaemic cerebrovascular disease remains uncertain.Aim We aim to introduce the design and rationale of the safety and efficacy of Ferrous iron on the prevention of Vascular cOgnitive impaiRment in patients with cerebral Infarction or TIA(FAVORITE)trial.Design FAVORITE is a randomised,placebo-controlled,double-blind,multicentre trial that compares supplement of ferrous iron with placebo for recent minor stroke/TIA patients complicated with mild anaemia or iron deficiency:Ferrous succinate sustained-release tablet 0.2 g(corresponding to 70 mg of elemental iron)once daily after or during breakfast for 12 weeks or placebo with much the same colour,smell and size as ferrous iron once daily during or after breakfast for 12 weeks.All paticipants will be followed within the next year.Study outcomes The primary effective outcome is the incidence of VCI at 3 months after randomisation and the primary safety outcome includes any gastrointestinal adverse event during 3 months.Discussion The FAVORITE trial will clarify whether supplement of ferrous iron to correct low haemoglobin reduces the risk of VCI in patients with recent ischaemic stroke or TIA complicated with mild anaemia or iron deficiency compared with placebo.展开更多
Background Research data regarding the correlation between elevated oxidised low-density lipoprotein(oxLDL)cholesterol concentrations and unfavourable clinical outcomes in individuals experiencing minor acute ischaemi...Background Research data regarding the correlation between elevated oxidised low-density lipoprotein(oxLDL)cholesterol concentrations and unfavourable clinical outcomes in individuals experiencing minor acute ischaemic cerebrovascular events or transient ischaemic attack(TIA)with presumed atherosclerotic aetiology are still limited.Methods This investigation incorporated a cohort of 5814 participants derived from the Intensive Statin and Antiplatelet Therapy for Acute High-Risk Intracranial or Extracranial Atherosclerosis clinical trial.The core laboratory conducted blinded measurements of baseline plasma oxLDL concentrations.Multivariable Cox regression analyses were employed to assess the correlations between oxLDL levels and adverse clinical events.The principal endpoint for efficacy assessment was defined as the occurrence of stroke within a 90-day follow-up period.Additional secondary endpoints encompassed composite vascular events during the same observation window.The main safety endpoint assessed was the occurrence of bleeding events of moderate to severe intensity.Results The final analytical cohort comprised 5814 patients included in the final analysis.The mean age was 63.7±9.6 years,and 36.0%were female.The average concentration of circulating oxLDL was 36.62μg/dL.Elevated oxLDL concentrations demonstrated a potential correlation with heightened stroke risk(T3 vs T1:HR 1.39,95%CI 1.04 to 1.85),ischaemic stroke(T3 vs T1:HR 1.31,95%CI 0.98 to 1.76)and composite vascular events(T3 vs T1:HR 1.36,95%CI 1.02 to 1.81)within 90 days.An increased concentration of oxLDL demonstrated a significant association with elevated susceptibility to moderate and severe haemorrhagic events(T3 vs T1:HR 3.61,95%CI 1.26 to 10.34)within 90 days.Conclusion Increased concentrations of oxLDL demonstrated an independent correlation with both stroke recurrence and the occurrence of moderate-to severe haemorrhagic events in individuals presenting with acute minor ischaemic stroke or TIA at elevated risk,accompanied by intracranial or extracranial atherosclerotic lesions.展开更多
Background and purpose Symptomatic internal carotid artery stenosis(sCAS)is an essential cause of transient ischaemic attack(TIA)or minor stroke.We aimed to evaluate whether the superiority of aspirin-ticagrelor over ...Background and purpose Symptomatic internal carotid artery stenosis(sCAS)is an essential cause of transient ischaemic attack(TIA)or minor stroke.We aimed to evaluate whether the superiority of aspirin-ticagrelor over aspirin-clopidogrel varies between patients with sCAS or not.Methods This was a post-hoc analysis of the High-Risk Patients with Acute Nondisabling Cerebrovascular Events-II(CHANCE-2)trial,all of which were CYP2C19 loss-of function alleles carriers.The primary exposures of interest were the treatment group and sCAS status.The primary efficacy endpoint was the new stroke assessed within 90 days.Results A total of 5920(92.3%)from 6412 were analysed,including 197(3.3%)with sCAS and 5723(96.7%)without sCAS.Stroke recurrence occurred in 13(12.15%)and 11(12.22%)patients with sCAS who received aspirin-ticagrelor and aspirin-clopidogrel,respectively(adjusted HR,1.04;95%CI,0.46 to 2.36;p=0.930).Among patients without sCAS,there were 158 cases(5.52%)of new strokes in the aspirin-ticagrelor group and 222 cases(7.76%)in the aspirin-clopidogrel group(HR,0.70;95%CI,0.57 to 0.86;p=0.0006).The treatment-by sCAS subtype was not significant(p=0.405).Conclusions Genotype-guided dual antiplatelet treatment with aspirin-ticagrelor may be beneficial for preventing recurrent strokes in patients without sCAS;however,it appears less effective in those with sCAS.No significant interaction was found between the treatment and sCAS subtypes.展开更多
文摘To evaluate the effects of carotid endoarterectomy in the treatment of extracranial cerebrovascular disease, 26 cases with internal carotid stenosis were performed by three different kinds of surgical endoarterectomy. The satisfactory results were achieved in all the patients, with no complications and mortality occurring. Endoarterectomy is the effective way to treat the extracranial cerebrovascular disease.
基金funded by the National Key R&D Program of China(2018YFC1312300)the National Science and Technology Major Project(2017ZX09304018).
文摘Background The incidence of vascular cognitive impairment(VCI)is high in patients suffering from ischaemic stroke or transient ischaemic attack(TIA)or with vascular risk factors.Effective prevention strategies for VCI remain limited.Anaemia or low haemoglobin was found as an independent risk factor for adverse outcomes after acute stroke.Anaemia or low haemoglobin was possibly associated with an increased risk of poststroke cognitive impairment.Whether supplement of ferrous iron to correct anaemia reduces the risk of VCI and improves adverse outcomes in patients with ischaemic cerebrovascular disease remains uncertain.Aim We aim to introduce the design and rationale of the safety and efficacy of Ferrous iron on the prevention of Vascular cOgnitive impaiRment in patients with cerebral Infarction or TIA(FAVORITE)trial.Design FAVORITE is a randomised,placebo-controlled,double-blind,multicentre trial that compares supplement of ferrous iron with placebo for recent minor stroke/TIA patients complicated with mild anaemia or iron deficiency:Ferrous succinate sustained-release tablet 0.2 g(corresponding to 70 mg of elemental iron)once daily after or during breakfast for 12 weeks or placebo with much the same colour,smell and size as ferrous iron once daily during or after breakfast for 12 weeks.All paticipants will be followed within the next year.Study outcomes The primary effective outcome is the incidence of VCI at 3 months after randomisation and the primary safety outcome includes any gastrointestinal adverse event during 3 months.Discussion The FAVORITE trial will clarify whether supplement of ferrous iron to correct low haemoglobin reduces the risk of VCI in patients with recent ischaemic stroke or TIA complicated with mild anaemia or iron deficiency compared with placebo.
基金supported by the Capital’s Funds for Health Improvement and Research(2024-1-2043)National Natural Science Foundation of China(No.82425101,No.82101358)+3 种基金Beijing Nova Program(20230484336)Capital's Funds for Health Improvement and Research(2022-2-2045)the National Key R&D Program of China(No.2022YFF1501500,2022YFF1501501,2022YFF1501502,2022YFF1501503,2022YFF1501504,2022YFF1501505,2017YFC1307900,2017YFC1307905)Beijing Laboratory of Oral Health(PXM2021_014226_000041).
文摘Background Research data regarding the correlation between elevated oxidised low-density lipoprotein(oxLDL)cholesterol concentrations and unfavourable clinical outcomes in individuals experiencing minor acute ischaemic cerebrovascular events or transient ischaemic attack(TIA)with presumed atherosclerotic aetiology are still limited.Methods This investigation incorporated a cohort of 5814 participants derived from the Intensive Statin and Antiplatelet Therapy for Acute High-Risk Intracranial or Extracranial Atherosclerosis clinical trial.The core laboratory conducted blinded measurements of baseline plasma oxLDL concentrations.Multivariable Cox regression analyses were employed to assess the correlations between oxLDL levels and adverse clinical events.The principal endpoint for efficacy assessment was defined as the occurrence of stroke within a 90-day follow-up period.Additional secondary endpoints encompassed composite vascular events during the same observation window.The main safety endpoint assessed was the occurrence of bleeding events of moderate to severe intensity.Results The final analytical cohort comprised 5814 patients included in the final analysis.The mean age was 63.7±9.6 years,and 36.0%were female.The average concentration of circulating oxLDL was 36.62μg/dL.Elevated oxLDL concentrations demonstrated a potential correlation with heightened stroke risk(T3 vs T1:HR 1.39,95%CI 1.04 to 1.85),ischaemic stroke(T3 vs T1:HR 1.31,95%CI 0.98 to 1.76)and composite vascular events(T3 vs T1:HR 1.36,95%CI 1.02 to 1.81)within 90 days.An increased concentration of oxLDL demonstrated a significant association with elevated susceptibility to moderate and severe haemorrhagic events(T3 vs T1:HR 3.61,95%CI 1.26 to 10.34)within 90 days.Conclusion Increased concentrations of oxLDL demonstrated an independent correlation with both stroke recurrence and the occurrence of moderate-to severe haemorrhagic events in individuals presenting with acute minor ischaemic stroke or TIA at elevated risk,accompanied by intracranial or extracranial atherosclerotic lesions.
基金supported by grants from the National Natural Science Foundation of China(U20A20358,82471356)CAMS Innovation Fund for Medical Sciences(2019-2M 5-029).
文摘Background and purpose Symptomatic internal carotid artery stenosis(sCAS)is an essential cause of transient ischaemic attack(TIA)or minor stroke.We aimed to evaluate whether the superiority of aspirin-ticagrelor over aspirin-clopidogrel varies between patients with sCAS or not.Methods This was a post-hoc analysis of the High-Risk Patients with Acute Nondisabling Cerebrovascular Events-II(CHANCE-2)trial,all of which were CYP2C19 loss-of function alleles carriers.The primary exposures of interest were the treatment group and sCAS status.The primary efficacy endpoint was the new stroke assessed within 90 days.Results A total of 5920(92.3%)from 6412 were analysed,including 197(3.3%)with sCAS and 5723(96.7%)without sCAS.Stroke recurrence occurred in 13(12.15%)and 11(12.22%)patients with sCAS who received aspirin-ticagrelor and aspirin-clopidogrel,respectively(adjusted HR,1.04;95%CI,0.46 to 2.36;p=0.930).Among patients without sCAS,there were 158 cases(5.52%)of new strokes in the aspirin-ticagrelor group and 222 cases(7.76%)in the aspirin-clopidogrel group(HR,0.70;95%CI,0.57 to 0.86;p=0.0006).The treatment-by sCAS subtype was not significant(p=0.405).Conclusions Genotype-guided dual antiplatelet treatment with aspirin-ticagrelor may be beneficial for preventing recurrent strokes in patients without sCAS;however,it appears less effective in those with sCAS.No significant interaction was found between the treatment and sCAS subtypes.
