Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases

Liu, Liping; Chen, Weiqi; Zhou, Hongyu; Duan, Wanying; Li, Shujuan; Huo, Xiaochuan; Xu, Wei-Hai; Huang, Lian; Zheng, Huaguang; Liu, Jingyi; Liu, Hui; Wei, Yufei; Xu, Jin; Wang, Yongjun

doi:10.1136/svn-2020-000378

Cited by 232 publications

(208 citation statements)

References 29 publications

Supporting

Mentioning

179

Contrasting

Unclassified

Order By: Relevance

“…According to the relevant guidelines, if the patients in the cohort met the criteria of thrombolysis, they would be treated by intravenous alteplase (the dosage = 0. 9 mg/kg × patient’s body weight (kg); 10% of the dosage was injected intravenously as a bolus within the first minute and the remaining 90% injected intravenously within 1 h) or neuro-intervention [ 12 ]. The inclusion/exclusion criteria of thrombolysis followed the Chinese guideline [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…9 mg/kg × patient's body weight (kg); 10% of the dosage was injected intravenously as a bolus within the first minute and the remaining 90% injected intravenously within 1 h) or neuro-intervention [12]. The inclusion/exclusion criteria of thrombolysis followed the Chinese guideline [12]. Figure 1 showed the flow diagram of selecting patients.…”

Section: Participants Enrollmentmentioning

confidence: 99%

See 1 more Smart Citation

Persistent inflammation worsens short-term outcomes in massive stroke patients

Hou

Wang

et al. 2021

BMC Neurol

View full text Add to dashboard Cite

Background Persistent inflammation is an important driver of disease progression and affects prognosis. Some indicators of inflammation predict short-term outcomes. The relationship between prognosis, especially mortality, and persistent inflammation in massive stroke has not been studied, and this has been the subject of our research. Methods From April 1, 2017 to February 1, 2020, consecutive patients were prospectively enrolled. Clinical data, laboratory data, imaging data and follow-up infections morbidity were compared between 2 groups according to modified Rankin scale (mRS) scores (mRS < 3 and ≥ 3) at 1 month. The binomial logistic analysis was used to determine independent factors of 1-month prognosis. Short-term functional outcome, mortality and infection rates in massive stroke with and without persistent inflammation were compared. Results One hundred thirty-nine patients with massive stroke were included from 800 patients. We found that admission blood glucose levels (p = 0.005), proportions of cerebral hemispheric (p = 0.001), posterior circulatory (p = 0.035), and lacunar (p = 0.022) ischemia were higher in poor outcome patients; neutrophil-to-lymphocyte ratio (odd ratio = 1.87, 95%CI 1.14–3.07, p = 0.013) and blood glucose concentrations (odd ratio = 1.34, 95%CI 1.01–1.79, p = 0.043) can independently predict the short-term prognosis in massive stroke patients. We also found that the incidence of pulmonary infection (p = 0.009), one-month mortality (p = 0.003) and adverse outcomes (p = 0.0005) were higher in patients with persistent inflammation. Conclusions This study suggested that persistent inflammation is associated with poor prognosis, 1-month mortality and the occurrence of in-hospital pulmonary infection and that higher baseline inflammation level predicts short-term poor outcomes in massive stroke.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Participants Enrollmentmentioning

confidence: 99%

Persistent inflammation worsens short-term outcomes in massive stroke patients

Hou

Wang

et al. 2021

BMC Neurol

View full text Add to dashboard Cite

show abstract

“…Acute ischaemic stroke (AIS) is the most common type of cerebrovascular disease. Despite the availability of antithrombotic drugs and endovascular treatment in most cases, AIS remains a major public health issue that poses a significant health burden 2 . Brain ischaemia is regarded as a process of delayed neuronal cell death.…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…Despite the availability of antithrombotic drugs and endovascular treatment in most cases, AIS remains a major public health issue that poses a significant health burden. 2 Brain ischaemia is regarded as a process of delayed neuronal cell death. Diminished cerebral blood flow triggers the "ischaemic cascade" that results in intracellular calcium overload, an increased number of abnormal free radicals and cytotoxic oedema to facilitate cell destruction.…”

Section: What Is Known and Objectivementioning

confidence: 99%

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Chen

Lin

et al. 2021

J Clin Pharm Ther

View full text Add to dashboard Cite

What is known and objective Edaravone is a new antioxidant and hydroxyl radical scavenger. Although there is evidence that it improves clinical outcomes of patients with acute ischaemic stroke (AIS), it is not yet widely accepted for treatment of AIS in Western countries. We further investigated the efficacy and safety of edaravone through this meta‐analysis of randomized controlled clinical trials (RCTs). Method Pubmed, Embase, Web of Science and Cochrane Library were screened up to December 2020 for original articles from SCI journals that published in English. RCTs that compared edaravone versus placebo or no intervention in adult patients and reported the efficacy or safety of edaravone were regarded as eligible. Mortality was regarded as the primary outcome and the improvement of neurological impairment was regarded as the secondary outcome. Safety evaluation was conducted according to the incidence of adverse events. Review Manager 5.3 was employed to perform the assessment of the risk of bias and data synthesis. The Cochrane risk of bias tool for randomized controlled trials was employed to assess the risk of bias. Results and discussion Seven randomized controlled trials with 2069 patients were included. For the incidence of mortality, the pooled RR for studies that evaluated edaravone after three‐month follow‐up was 0.55 (95% Cl, 0.43‐0.7, I2 = 0, P < 0.01). The pooled RR for improvement of neurological impairment at the three months follow‐up was 1.54 (95% CI, 1.27‐1.87, I2 = 0, P < 0.01) in four RCTs. On subgroup analysis of studies that were conducted in Asia, the RR was 1.56 (95% CI, 1.27‐1.90, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in Europe was 1.32 (95% CI, 0.64‐2.72; P = 0.45); the pooled RR for studies that used edaravone for two weeks was 1.42 (95% CI, 1.10 to 1.83, I2 = 0%; P < 0.01); the pooled RR for studies that used edaravone for one week was 1.64 (95% CI, 1.24‐2.16, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in patients with mean age equal to or over 60 years was 1.52 (95% CI, 1.24‐1.87, I2 = 0%; P < 0.01); and the pooled RR for studies that conducted in patients with mean age less than 60 was 1.80 (95% CI, 1.05‐3.08, I2 = 0%; P = 0.03). For the incidence of any treatment‐related adverse events, the pooled RR for studies that evaluated edaravone during treatment was 0.83 (95% CI, 0.51‐1.34, I2 = 0, P = 0.43). The difference of the incidence of any treatment‐related adverse events between two groups was not statistically significant. What is new and conclusion The limited studies indicate that edaravone can improve neurological impairment with a survival benefit at three‐month follow‐up, regardless of the mean age and course of treatment. It is worthy of promotion in the clinical treatment of AIS in Asian countries. More well‐designed RCTs with larger sample sizes are needed to determine the benefits of edaravone in patients from Western countries.

show abstract

“…First, self-reported medical history of dyslipidemia was under-reported. Second, with the recognition ASCVD (atherosclerotic cardiovascular disease), patients with history of stroke/ TIA or CHD/MI would be recommend taking statins for prevention of stroke recurrence, according to the Chinese Stroke Association guidelines (27).…”

Section: Discussionmentioning

confidence: 99%

Guideline-directed low-density lipoprotein management in high-risk ischemic stroke or transient ischemic attack admissions in China from 2015 to 2019

Yang

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

Background: Lowering low-density lipoprotein cholesterol (LDL-C) is crucial for secondary stroke prevention in stroke patients with preexisting cardiovascular diseases (CVD) or cerebrovascular diseases (CeVD). However, data on attainment of guideline-recommended LDL-C levels are lacking. Methods: We analyzed data from the Chinese Stroke Center Alliance (CSCA) program for patients with ischemic stroke and transient ischemic attack (TIA) hospitalized between August 2015 and July 2019. Participants were classified into different disease groups according to preexisting CeVD (stroke/TIA) or CVD [coronary heart disease (CHD) or myocardial infarction (MI)].

show abstract

Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases

Cited by 232 publications

References 29 publications

Persistent inflammation worsens short-term outcomes in massive stroke patients

Persistent inflammation worsens short-term outcomes in massive stroke patients

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Guideline-directed low-density lipoprotein management in high-risk ischemic stroke or transient ischemic attack admissions in China from 2015 to 2019

Contact Info

Product

Resources

About