Presenter of 3 Presentations
Young Investigator Awards
- Zafarjon K. Abdullaev (Uzbekistan)
- Ayush Agarwal (India)
- Vivek Agarwal (India)
- Anvar Azimov (Uzbekistan)
- Ashu Bhasin (India)
- Byambasuren Luvsansuren (Mongolia)
- Surenjav Chimed (Mongolia)
- Nha Dao (Viet Nam)
- Adekunle G. Fakunle (Nigeria)
- Dmytro Filimonov (Ukraine)
- Manisha K Yalapalli (India)
- Soumya Krishnamoorthy (India)
- Pradeep Kumar (India)
- ANKITA MAHESHWARI (India)
- Trung Q. Nguyen (Viet Nam)
- Piyush Ojha (India)
- VISHNU SWARUP (India)
- Faris K. Syah (Indonesia)
- Hang T. Tran (Viet Nam)
- Shriram Varadharajan (India)
SAFETY OF RECANALIZATION THERAPY IN ACUTE ISCHEMIC STROKE PATIENTS ON ANTICOAGULANT THERAPY: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS
Abstract
Background and Aims
Limited evidence is available for the safety of recanalization therapy in acute ischemic stroke (AIS) patients with direct oral anticoagulants (DOAC) and without DOAC following endovascular therapy (EVT) or intravenous thrombolysis (IVT) treatment. We aimed to update the evidence on the safety of recanalization therapy in AIS patients with and without DOAC following EVT or IVT.
Methods
A comprehensive literature search was performed for all the published observational studies from 01st Jan 1950 to 31st Jan 2022. The primary outcome was to investigate the incidence of symptomatic intracerebral hemorrhage (sICH), while secondary outcomes include arterial recanalization, good functional recovery, and mortality at 3 months.
Results
Seventeen studies (14 for EVT and 3 for IVT) were finally included in the analysis. A significant decrease in the incidence of sICH [Risk ratio (RR)=0.85,95%CI =0.72 to 1.00, p=0.04], and a lower chance of good functional recovery at three months (RR = 0.79, 95% CI = 0.73 to 0.85, p<0.001) was observed in AIS patients with DOAC therapy as compared to AIS patients without DOAC following EVT. Additionally, a higher risk of mortality was observed in AIS patients who were without DOAC after EVT [RR=1.29, 95% CI=1.15-1.44, p=<0.001]. However, no significant differences for sICH events were observed in AIS patients with DOAC as compared to without DOAC therapy following IVT [RR=0.87, 95 % CI = 0.48 to 1.58, p=0.64].
Conclusions
Our findings suggest that Patients with AIS on DOAC therapy have a lower incidence of sICH following EVT but not after IVT.
ASSOCIATION OF MODIFIABLE RISK FACTORS WITH ISCHEMIC STROKE SUBTYPES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Abstract
Background and Aims
Ischemic Stroke (IS) is associated with various modifiable risk factors but the association of these risk factors based on TOAST classification is unknown. We aimed to summarize the published evidence for the association of modifiable risk factors with IS subtypes based on TOAST classification.
Methods
A comprehensive search for all the published articles was performed in electronic databases including PubMed, EMBASE, Cochrane Library, and Google Scholar from 01st January 1950 to 31st March 2022. Odds ratio (OR) with 95% Confidence interval (CIs) along with random effect models were used to calculate summary estimates.
Results
In our meta-analysis, 32 studies with a total of 23,404 IS, 7,121 large-artery atherosclerosis (LAA), 5,532 small-vessel occlusions (SVO), and 3,498 Cardioembolism (CE), 1,131 strokes of other determined etiology (ODE) and 4,519 stroke of undetermined etiology (UDE) were included. Our findings suggest a significant association between LAA and hypertension (OR=1.07, 95% CI=1.02-1.12), smoking (OR=1.11, 95% CI=1.04-1.17), dyslipidemia (OR=1.13, 95% CI=1.06-1.21), Diabetes Mellitus (OR=1.18, 95% CI=1.11-1.25) and Atrial Fibrillation (OR=0.55, 95% CI=0.40-0.75) in overall as well as in Asian and Caucasian studies.. A significantly strong association between hypertension, smoking, dyslipidemia, DM, and AF was also observed with SVO and CE stroke subtypes. Hypertension was only significantly associated with SVO and ODE subtypes in both Asians and Caucasians; however, only the Asian population showed a significant association of hypertension in LAA and CE subtypes.
Conclusions
A strong association between smoking, dyslipidemia, and DM with LAA and SVO subtypes of ischemic stroke was found.