Thrombolysis for Acute Ischemic Stroke: Experience in Dubai, and Comparison of Arab with Non-Arab Population

Khan, Mohammed M.

doi:10.15406/jnsk.2016.04.00156

Cited by 6 publications

(12 citation statements)

References 22 publications

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“…The mortality in our cohort was 9.5%, which is higher than the 6.8% mortality reported in the Dubai cohort 8 and the 2.3% mortality reported in the SITS-MENA registry. 7 A considerably higher mortality of 17% at three months was reported in the original NINDS rtPA trial [NINDS rtPA].…”

Section: Discussioncontrasting

confidence: 73%

“…The GWTG-Stroke initiative also reported improvement in the DTN time from 82 minutes to 71 minutes when guidelines were implemented. 10 The mean DTN times reported in the study from Dubai was 64.1 minute 8 whereas that reported in the SITS-MENA registry was 54 minutes. 7 Endovascular thrombectomy has become the standard of care for patients with LVO-related strokes.…”

Section: Discussionmentioning

confidence: 88%

“…Recently, results from the Safe Implementation of Treatment in Stroke )SITS(-Middle East and North African )MENA( registry for IV thrombolysis were published, 7 and a report from Dubai described the use and outcomes of thrombolysis in 176 patients. 8 A stroke unit was formally established in our tertiary care center in 2012, although thrombolysis treatment was already offered prior to that. Here, we report our experience on thrombolysis in acute ischemic stroke from January 2012 to December 2018.…”

Section: Discussionmentioning

confidence: 99%

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Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia

Khatri

Alskaini

Aldayel

et al. 2021

NSJ

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Objectives: To present the experience on stroke thrombolysis of a tertiary care center in Riyadh, KSA. Methods: Cross-sectional, observational study of patients thrombolyzed between January 2012 and December 2018. Results: Thrombolysis was performed in 148 patients )mean age: 58.2±14.5 years(, 94 )63.5%( of them were men. The median onset-to-door time was 81 minutes, and 25% of the patients arrived within 1 hour. The median National Institute of Health Stroke

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia

Khatri

Alskaini

Aldayel

et al. 2021

NSJ

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“…However, it is not clear how many of these patients had LVOs. Traditionally the UAE has had a younger age of onset for stroke with male predominance as a result of poorly controlled vascular risk factors amongst expatriate migrant male workers 23 , 24 However our comparison to historical controls confirms an even younger age of onset. COVID-19 has had more severe systemic involvement amongst males 3 which could manifest as more ischemic strokes related to endothelial injury and hypercoagulable state.…”

Section: Discussionmentioning

confidence: 51%

Clinical characteristics and admission patterns of stroke patients during the COVID 19 pandemic: A single center retrospective, observational study from the Abu Dhabi, United Arab Emirates

John

Hussain

Piechowski-Jóźwiak

et al. 2020

Clinical Neurology and Neurosurgery

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Highlights When comparing stroke admissions from March 1 st -May 10 th in 2019 and 2020 at a single comprehensive stroke center in Middle East, there was a 41.9% increase in stroke admissions in 2020. A higher rate of large vessel occlusion (LVO) and significant delay in initiation of mechanical thrombectomy after hospital arrival was observed in 2020. Among all COVID-19 admissions in 2020, 5.24% patients suffered stroke including 3.21% with ischemic and 2% with hemorrhagic stroke. Patients with COVID-19 and ischemic stroke were significantly younger, predominantly male, had fewer vascular risk factors, had more severe clinical presentation, and higher rate of LVO ccompared to ischemic stroke patients without COVID-19 For hemorrhagic stroke, COVID-19 patients did not differ from non-COVID-19 patients.

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“…In 2014, a review by Mehndiratta et al reported that there is an increase in incidence of ischemic stroke subtypes in Asian countries, since Arab countries have identical epidemiological characteristics to other Asian countries, that would suggest an increase in ischemic stroke in Arab countries as well [7]. Moreover, reports from a population-based screening program indicate that there is a very high risk for cardiovascular disease, especially diabetes and obesity in the United Arab Emirates [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Neuroinflammation: friend and foe for ischemic stroke

Jayaraj

Azimullah

Beiram

et al. 2019

J Neuroinflammation

987

695

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Stroke, the third leading cause of death and disability worldwide, is undergoing a change in perspective with the emergence of new ideas on neurodegeneration. The concept that stroke is a disorder solely of blood vessels has been expanded to include the effects of a detrimental interaction between glia, neurons, vascular cells, and matrix components, which is collectively referred to as the neurovascular unit. Following the acute stroke, the majority of which are ischemic, there is secondary neuroinflammation that both promotes further injury, resulting in cell death, but conversely plays a beneficial role, by promoting recovery. The proinflammatory signals from immune mediators rapidly activate resident cells and influence infiltration of a wide range of inflammatory cells (neutrophils, monocytes/macrophages, different subtypes of T cells, and other inflammatory cells) into the ischemic region exacerbating brain damage. In this review, we discuss how neuroinflammation has both beneficial as well as detrimental roles and recent therapeutic strategies to combat pathological responses. Here, we also focus on time-dependent entry of immune cells to the ischemic area and the impact of other pathological mediators, including oxidative stress, excitotoxicity, matrix metalloproteinases (MMPs), high-mobility group box 1 (HMGB1), arachidonic acid metabolites, mitogen-activated protein kinase (MAPK), and post-translational modifications that could potentially perpetuate ischemic brain damage after the acute injury. Understanding the time-dependent role of inflammatory factors could help in developing new diagnostic, prognostic, and therapeutic neuroprotective strategies for post-stroke inflammation.

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Thrombolysis for Acute Ischemic Stroke: Experience in Dubai, and Comparison of Arab with Non-Arab Population

Cited by 6 publications

References 22 publications

Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia

Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia

Clinical characteristics and admission patterns of stroke patients during the COVID 19 pandemic: A single center retrospective, observational study from the Abu Dhabi, United Arab Emirates

Neuroinflammation: friend and foe for ischemic stroke

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