https://caltcm.memberclicks.net/assets/documents/acc_aha_chf_2013_guidelines.pdf

2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...

/pdf/guidelines-for-the-early-management-of-patients-with-acute-19udbft6e7.pdf

Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Jeffrey L. Anderson, MD, FACC, FAHA, Chair 

Jonathan L. Halperin, MD, FACC, FAHA, Chair-Elect 

Nancy M. Albert, PhD, RN, FAHA

Biykem Bozkurt, MD, PhD, FACC, FAHA

Ralph G. Brindis, MD, MPH, MACC

Mark A. Creager, MD, FACC, FAHA[#][1]

Lesley H. Curtis, PhD, FAHA

David DeMets, PhD[#][1]

Robert A

/pdf/2014-aha-acc-hrs-guideline-for-the-management-of-patients-1v8ficsqox.pdf

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society

Author(s): Writing Group Members; Mozaffarian, Dariush; Benjamin, Emelia J; Go, Alan S; Arnett, Donna K; Blaha, Michael J; Cushman, Mary; Das, Sandeep R; de Ferranti, Sarah; Despres, Jean-Pierre; Fullerton, Heather J; Howard, Virginia J; Huffman, Mark D; Isasi, Carmen R; Jimenez, Monik C; Judd, Suzanne E; Kissela, Brett M; Lichtman, Judith H; Lisabeth, Lynda D; Liu, Simin; Mackey, Rachel H; Magid, David J; McGuire, Darren K; Mohler, Emile R; Moy, Claudia S; Muntner, Paul; Mussolino, Michael E; Nasir, Khurram; Neumar, Robert W; Nichol, Graham; Palaniappan, Latha; Pandey, Dilip K; Reeves, Mathew J; Rodriguez, Carlos J; Rosamond, Wayne; Sorlie, Paul D; Stein, Joel; Towfighi, Amytis; Turan, Tanya N; Virani, Salim S; Woo, Daniel; Yeh, Robert W; Turner, Melanie B; American Heart Association Statistics Committee; Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association

National Institutes of Health Stroke Scale (NIHSS), measured a few hours to days after stroke onset, is an attractive outcome measure for stroke research. NIHSS at the time of presentation (baseline NIHSS) strongly predicts the follow-up NIHSS. Because of the need to account for the baseline NIHSS in the analysis of follow-up NIHSS as an outcome measure, a common and intuitive approach is to define study outcome as the change in NIHSS from baseline to follow-up (ΔNIHSS). However, this approach has important limitations. Analyzing ΔNIHSS implies a very strong assumption about the relationship between baseline and follow-up NIHSS that is unlikely to be satisfied, drawing into question the validity of the resulting statistical analysis. This reduces the precision of the estimates of treatment effects and the power of clinical trials that use this approach to analysis. ANCOVA allows for the analysis of follow-up NIHSS as the dependent variable while adjusting for baseline NIHSS as a covariate in the model and addresses several challenges of using ΔNIHSS outcome using simple bivariate comparisons (eg, a t test, Wilcoxon rank-sum, linear regression without adjustment for baseline) for stroke research. In this article, we use clinical trial simulations to illustrate that variability in NIHSS outcome is less when follow-up NIHSS is adjusted for baseline compared to ΔNIHSS and how a reduction in this variability improves the power. We outline additional, important clinical and statistical arguments to support the superiority of ANCOVA using the final measurement of the NIHSS adjusted for baseline over, and caution against using, the simple bivariate comparison of absolute NIHSS change (ie, delta).

National Institutes of Health Stroke Scale as an Outcome in Stroke Research: Value of ANCOVA Over Analyzing Change From Baseline

Complexity of the endovascular intervention and clinical outcomes in acute ischaemic stroke–Authors' reply

Background: Spasticity can lead to numerous symptomatic and functional problems that can cause substantial disability. No published studies have quantified the independent effect spasticity has on the health-related quality of life (HRQoL) of stroke survivors. Objective: To assess the hypothesis that spasticity has a negative impact on HRQoL among stroke survivors. Design: In 2005, as part of the Greater Cincinnati/Northern Kentucky Stroke Study, a cohort of 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. Detailed in-person interviews and medical record abstractions were undertaken during the early post-stroke period to capture key information about demographics; pre-stroke level of functioning; social, family, and medical histories; medications; laboratory results; and stroke severity. Follow-up interviews at 3 months, 1 year, and 2 years gathered information on HRQoL as measured by the Short Form-12 (SF-12), EuroQol-5D (EQ-5D), and Stroke Specific Quality of Life (SSQOL). SF-12 scores are divided into mental (MCS) and physical (PCS) components that range from 0 to 100, with higher scores indicating better health. EQ-5D scores range from 0 (death) to 1 (perfect health). SSQOL scores are stroke specific and range between 0 and 5, with lower scores indicating better HRQoL. HRQoL differences between stroke survivors with and without spasticity (as reported by the patient) were cross-sectionally compared using generalized linear models, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities. Results: Of the 460 ischemic stroke patients, 328 had spasticity data available at the 3-month interview, with 54 (16%) reporting spasticity following their stroke. The patients included in the 3-month analysis had a mean age of 66 years; 49% were female, and 26% black. Patients who reported spasticity at 3 months had lower mean PCS, EQ-5D index, and SSQOL total score compared with patients without spasticity (Table). Similar differences in HRQoL were also observed at year 1 and year 2 (data not shown). Conclusions: We found statistically and clinically meaningful differences in HRQoL between stroke survivors with and without spasticity at 3 months, 1 year, and 2 years following stroke. Clinically, these results suggest an opportunity to improve HRQoL among stroke survivors with effective spasticity management.

Abstract 2472: The Negative Impact of Spasticity on the Health-Related Quality of Life of Stroke Survivors

/pdf/low-intensity-monitoring-after-stroke-thrombolysis-during-58udxt0izh.pdf

Low-Intensity Monitoring After Stroke Thrombolysis During the COVID-19 Pandemic.

BackgroundWe examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. Methods and ResultsWe identified stroke c...

/pdf/practice-patterns-for-acute-ischemic-stroke-workup-a-1npulqbrcs.pdf

Pooja Khatri

Papers

National Institutes of Health Stroke Scale as an Outcome in Stroke Research: Value of ANCOVA Over Analyzing Change From Baseline

Complexity of the endovascular intervention and clinical outcomes in acute ischaemic stroke–Authors' reply

Abstract 2472: The Negative Impact of Spasticity on the Health-Related Quality of Life of Stroke Survivors

Low-Intensity Monitoring After Stroke Thrombolysis During the COVID-19 Pandemic.

Practice Patterns for Acute Ischemic Stroke Workup: A Longitudinal Population-Based Study.