| 1. |
Takuya Kiyohara, Yasuhiro Kumai, Tomohiro Yubi, Eiichi Ishikawa, Yoshinobu Wakisaka, Tetsuro Ago, Takanari Kitazono, Association between Early Cognitive Impairment and Short-Term Functional Outcome in Acute Ischemic Stroke., Cerebrovascular diseases (Basel, Switzerland), 10.1159/000524839, 1-7, 2022.06, BACKGROUND: Little is known about the association between poststroke cognitive impairment (PSCI) and functional outcome in the acute care phase of ischemic stroke and the influence of the clinical condition of acute stroke on this association. We examined this issue, taking into account stroke-related factors, in a hospital-based prospective study of patients with acute ischemic stroke. The same analysis was also performed after subsequent rehabilitation to investigate whether the association observed in the acute care phase persisted after that. For comparison, the same analysis was performed for pre-stroke dementia (PreSD). METHODS: We included in the study a total of 923 patients with acute ischemic stroke who were admitted to a hospital from 2012 to 2020 in Japan. Cognitive function was assessed using the Mini-Mental State Examination and Raven's Colored Progressive Matrices test at an average of 6.3 days after stroke onset. The subjects were divided into three groups with normal cognition, PSCI, and PreSD. Study outcome was a poor functional outcome, defined as a modified Rankin Scale score of ≥3 at the end of acute care (median 21 days after admission). Among total subjects, 460 were also assessed for poor functional outcome after rehabilitation (median 77 days after admission). A logistic regression model was applied in this study. RESULTS: Patients with PSCI and PreSD had higher median National Institute of Health Stroke Scale scores than those with normal cognition (median [IQR]: 3 [2-6], 4 [2-12], and 2 [1-4], respectively). The age- and sex-adjusted cumulative incidence of poor functional outcome was significantly higher in patients with PSCI and PreSD than in those with normal cognition in the acute care and rehabilitation phases. In the acute care phase, these associations remained significant after adjustment for stroke-related factors and other confounders (multivariable-adjusted odds ratio [95% CI] for PSCI vs. normal cognition: 3.28 [2.07-5.20]; for PreSD: 2.39 [1.40-4.08]). Similar results were observed in the rehabilitation phase (for PSCI: 2.48 [1.31-4.70]; for PreSD: 3.92 [1.94-7.92]). CONCLUSIONS: Our findings suggest that PSCI, as well as PreSD, is possibly associated with the development of poor functional outcome in the acute care phase of ischemic stroke, and this association continues thereafter.. |
| 2. |
Takuya Kiyohara, Tetsuro Ago, Can calcium channel blockers prevent ischemic stroke in nonvalvular atrial fibrillation patients?-the optimal choice of antihypertensive drug for subtype-specific stroke prevention., Hypertension research : official journal of the Japanese Society of Hypertension, 10.1038/s41440-022-00907-2, 45, 6, 1076-1078, 2022.06. |
| 3. |
Takuya Kiyohara, Ryu Matsuo, Jun Hata, Kuniyuki Nakamura, Yoshinobu Wakisaka, Masahiro Kamouchi, Takanari Kitazono, Tetsuro Ago, Takao Ishitsuka, Setsuro Ibayashi, Kenji Kusuda, Kenichiro Fujii, Tetsuhiko Nagao, Yasushi Okada, Masahiro Yasaka, Ooboshi Hiroaki, Tsuyoshi Omae, Kazunori Toyoda, Hiroshi Nakane, Hiroshi Sugimori, Shuji Arakawa, Kenji Fukuda, Jiro Kitayama, Shigeru Fujimoto, Shoji Arihiro, Junya Kuroda, Yoshihisa Fukushima, Yasuhiro Kumai, Ryu Matsuo, β-Cell Function and Clinical Outcome in Nondiabetic Patients With Acute Ischemic Stroke, Stroke, 10.1161/STROKEAHA.120.031392, 52, 8, 2621-2628, 2021.08, [Figure: see text].. |
| 4. |
Takuya Kiyohara, Masahiro Kamouchi, Yasuhiro Kumai, Toshiharu Ninomiya, Jun Hata, Sohei Yoshimura, Tetsuro Ago, Yasushi Okada, Takanari Kitazono, Takao Ishitsuka, Shigeru Fujimoto, Setsuro Ibayashi, Kenji Kusuda, Shuji Arakawa, Kinya Tamaki, Seizo Sadoshima, Katsumi Irie, Kenichiro Fujii, Yasushi Okada, Masahiro Yasaka, Tetsuhiko Nagao, Hiroaki Ooboshi, Tsuyoshi Omae, Kazunori Toyoda, Hiroshi Nakane, Hiroshi Sugimori, Kenji Fukuda, Ryu Matsuo, Junya Kuroda, Yoshihisa Fukushima, ABCD3 and ABCD3-I Scores Are Superior to ABCD2 Score in the Prediction of Short- and Long-Term Risks of Stroke After Transient Ischemic Attack, Stroke, 10.1161/strokeaha.113.003077, 45, 2, 418-425, 2014.02, Background and Purpose—
Several risk scores have been developed to predict the stroke risk after transient ischemic attack (TIA). However, the validation of these scores in different cohorts is still limited. The objective of this study was to elucidate whether these scores were able to predict short-term and long-term risks of stroke in patients with TIA.
Methods—
From the Fukuoka Stroke Registry, 693 patients with TIA were followed up for 3 years. Multivariable-adjusted Cox proportional hazards model was used to assess the hazard ratio of risk factors for stroke. The discriminatory ability of each risk score for incident stroke was estimated by using C-statistics and continuous net reclassification improvement.
Results—
The multivariable-adjusted Cox proportional hazards model revealed that dual TIA and carotid stenosis were both significant predictors for stroke after TIA, whereas abnormal diffusion-weighted image was not. ABCD3 (C-statistics 0.61) and ABCD3-I (C-statistics 0.66) scores improved the short-term predictive ability for stroke (at 7 days) compared with the ABCD2 score (C-statistics 0.54). Addition of intracranial arterial stenosis (at 3 years, continuous net reclassification improvement 30.5%; P
Conclusions—
The present study demonstrates that ABCD3 and ABCD3-I scores are superior to the ABCD2 score for the prediction of subsequent stroke in patients with TIA. Addition of neuroimaging in the ABCD3 score may enable prediction of long-term stroke risk after TIA.. |
