Ischemic Stroke Research Articles

CeRNA networks in ischemic stroke: a bibliometric analysis

Background and methodIschemic stroke, a leading cause of death and disability worldwide, has been increasingly linked to ceRNA networks, which regulate neuronal damage and recovery. Despite growing interest, a comprehensive bibliometric analysis of ceRNA’s role in stroke remains limited. This study examines the research landscape, key trends, and future directions using Bibliometrix R package, VOSviewer, and CiteSpace. Bibliometrix (Biblioshiny) was used to analyze research growth, author productivity, and global collaboration. VOSviewer facilitated network visualization in co-occurrence, co-citation, and bibliographic coupling analyses, while CiteSpace identified emerging trends and key contributors through citation burst analysis and thematic clustering.ResultsOur analysis revealed a rapid surge in ceRNA-related ischemic stroke research from 2018 to 2024, with China leading in research output and global collaborations. Co-citation analysis identified three major thematic clusters: circRNAs in autophagy, lncRNAs within the ceRNA hypothesis, and the complexity of ceRNA networks in middle cerebral artery occlusion. Bibliographic coupling analysis highlighted five key research domains: lncRNA- and circRNA-mediated ceRNA networks, neurovascular injury, epigenetic regulation, and immune pathogenesis, highlighting their pivotal role in stroke mechanisms and therapeutic strategies. Molecular Medicine Reports ranked as the most influential journal, while Fudan University led institutional contributions. Thematic mapping identified inflammation and biomarkers as emerging research frontiers, suggesting potential novel therapeutic targets.ConclusionThis study provides a comprehensive analysis of ceRNA research in ischemic stroke, highlighting key trends, emerging frontiers, and therapeutic potential. The increasing focus on lncRNA- and circRNA-mediated networks, inflammation, and biomarkers reflects a shift toward precision medicine and innovative therapeutic interventions. These findings establish a foundation for future molecular diagnostics and targeted therapies, bridging the gap between research and clinical practice.

Identification of novel inflammatory response-related biomarkers in patients with ischemic stroke based on WGCNA and machine learning

BackgroundIschemic stroke (IS) is one of the most common causes of disability in adults worldwide. This study aimed to identify key genes related to the inflammatory response to provide insights into the mechanisms and management of IS.MethodsTranscriptomic data for IS were downloaded from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) and differential expression analysis were used to identify inflammation-related genes (IRGs) associated with IS. Hub IRGs were screened using Lasso, SVM-RFE, and random forest algorithms, and a nomogram diagnostic model was constructed. The diagnostic performance of the model was assessed using receiver operating characteristic (ROC) curves and calibration plots. Additionally, immune cell infiltration and potential small molecule drugs targeting IRGs were analyzed. The expression of IRG was verified by qRT-PCR in healthy controls and IS patients.ResultsNine differentially expressed IRGs were identified in IS, including NMUR1, AHR, CD68, OSM, CDKN1A, RGS1, BTG2, ATP2C1, and TLR3. Machine learning algorithms selected three hub IRGs (AHR, OSM, and NMUR1). A diagnostic model based on these three genes showed excellent diagnostic performance for IS, with an area under the curve (AUC) greater than 0.9 in both the training and validation sets. Immune infiltration analysis revealed higher levels of neutrophils and activated CD4 + T cells, and lower levels of CD8 + T cells, activated NK cells, and naive B cells in IS patients. The hub IRGs exhibited significant correlations with immune cell infiltration. Furthermore, small molecule drugs targeting hub IRGs were identified, including chrysin, piperine, genistein, and resveratrol, which have potential therapeutic effects for IS. qRT-PCR evaluation demonstrated that the levels of blood biomarkers (AHR, OSM, and NMUR1) in IS patients could serve as distinguishing indicators between IS patients and healthy controls (P < 0.05).ConclusionThis study confirmed the significant impact of IRGs on the progression of IS and provided new diagnostic and therapeutic targets for personalized treatment of IS.

Associations between short-term exposure to fine particulate matter with ischemic stroke mortality and the role of green space: a time-series study in Zibo, China.

Previous studies on associations between short-term exposure to fine particulate matter (PM2.5) and ischemic stroke (IS) mortality reported inconclusive results. Additionally, whether and how PM2.5 and green space interact to precipitate IS deaths remains unclear. We aimed to examine the impacts of short-term exposure to PM2.5 on IS mortality and the role of green space in the association. We collected data on daily IS deaths, daily PM2.5 concentrations, and monthly normalized difference vegetation index (NDVI) in Zibo City from 2015 to 2019. Generalised additive models were adopted to investigate the short-term impacts of PM2.5 on IS mortality, and subgroup analyses were used to examine effect modification by population characteristics. Stratified analyses by green space levels and joint effect model were conducted to test the interactions of PM2.5 and green space on IS mortality. A total of 10 799 IS deaths were included in our study. Exposure to PM2.5 was associated with an increased risk of IS mortality, with odds ratios (ORs) of 1.0263 (95% confidence interval (CI) = 1.0017, 1.0516) for each interquartile range (IQR) increase in PM2.5 on lag0 and 1.0317 (95% CI = 1.0016, 1.0627) on lag01. The links between PM2.5 and IS mortality were not significantly different across genders, ages, or PM2.5 zones. Furthermore, our results showed that the effects of PM2.5 on IS mortality were higher in low levels of green space. Specifically, for each IQR increase in PM2.5, the ORs (95% CIs) of IS death in the low level and the high level of NDVI were 1.0287 (95% CI = 1.0019, 1.0563) and 0.9934 (95% CI = 0.9296, 1.0615), respectively. In addition, PM2.5 and NDVI exhibited significant interactive effects on IS mortality, with relative excess odds due to interaction (REOI) of greater than 0. Our findings showed that PM2.5 was significantly associated with increasing odds of IS mortality. Furthermore, there were synergetic impacts between PM2.5 and lack of greenness on IS mortality. Our results suggest that expanding green spaces, such as increasing park coverage and street greening, along with regulating industrial emissions to reduce PM2.5 levels, can help prevent premature deaths from IS.

Effects of an exercise-based rehabilitation program in patients with minor ischemic non-disabling stroke or transient ischemic attack.

Ischemic stroke and transient ischemic attack (TIA) present global health challenges. While physical activity is strongly recommended for secondary prevention of these clinical conditions, there's a massive gap between guidelines and the real world. This study aimed to assess the effectiveness, safety, and feasibility of an exercise-based rehabilitation (EBR) program for patients with minor ischemic non-disabling stroke (MINDS) or TIA. Consecutive patients from the Neurology Unit of Mirano - Venice, Italy, diagnosed with MINDS or TIA, underwent a structured EBR program. The program comprised 6 weeks of supervised training in a hospital gym and 12 months of territorial gym training. Safety, feasibility, and effectiveness were evaluated through adverse events, drop-out rates, and improvements in body composition, muscular strength, and cardiopulmonary fitness. The sample comprised 32 patients (mean age 66 years, 81,3% male). No adverse events were reported. During the in-hospital phase of the program, there were no dropouts, while 28% of patients ceased training during the territorial phase. After the in-hospital phase, there were significant improvements in body composition, muscular strength, and cardiopulmonary parameters. These benefits persisted at the 12-month territorial gym phase of the EBR program only for patients who continued training. The structured EBR program demonstrated safety, feasibility, and effectiveness in improving health parameters for MINDS or TIA patients. Such interventions promise to enhance secondary prevention and overall health outcomes in this patient group.

Effects of very early exercise on inflammatory markers and clinical outcomes in patients with ischaemic stroke- a randomized controlled trial

BackgroundApart from the limited evidence of the effects of very early exercise (VEE) on clinical outcomes (COs) in stroke, better knowledge is required to understand the cellular action induced by VEE. This study investigated the effects of VEE on inflammatory markers (IMs) and COs. It further evaluated the association between acute changes in IMs and COs at follow-up in individuals with first-ever mild-to-moderate ischaemic stroke.MethodsA prospective, single-center, single-blind, randomized controlled trial (retrospectively registered: PACTR202406755848901; 10–06-2024) was conducted. Forty-eight patients randomized (1:1) into the VEE group (VEEG) and usual care group (UCG) completed the follow-up. Within 24 h of stroke onset, patients in VEEG underwent 45 min of VEE twice daily, amounting to 1.5 h/d, for seven days while patients in UCG received regular turning and positioning. The levels of IMs including interleukin-6 (IL-6), fibrinogen, leucocytes, neutrophils, lymphocytes, and monocytes were assessed at baseline, 4th, and 7th day for both groups. Thereafter, each patient received 90-min follow-up physiotherapy twice weekly for three months. Motor impairment, physical disability, functional independence, anxiety, depression, and cognition were evaluated at 1st and 3rd month of follow-up.ResultsOn the 4th and 7th day, patients in VEEG show trends of lower levels of IL-6, leucocytes, neutrophils, and monocytes and higher levels of lymphocytes. However, a non-linear effect of VEE on plasma fibrinogen was observed compared to UC. Furthermore, better improvement in motor impairment, physical disability, functional independence, anxiety, depression, and cognition were observed in VEEG. The positive modulation of IMs by VEE was associated with COs over time, including associations between changes in IL-6 at days 4 and 7 and 3-month functional independence (rs = -0.33; p = 0.019; rs = -0.33; p = 0.021), and at day 7 and 3-month motor impairment (rs = 0.30; p = 0.039).ConclusionsInitiating moderate-intensity exercise within 24 h appears beneficial in positively modulating IMs, including IL-6, at the acute stage and improving the physical, motor, cognitive, and affective functions at 1-and 3-month follow-up. The association between exercise-induced acute changes in IMs and improved COs over time highlights the potential role of moderate-intensity VEE in enhancing stroke recovery through positive inflammatory modulation.

Thrombus composition in ischaemic stroke: histological and radiological evaluation, and implications for acute clinical management.

Ischaemic stroke is one of the key causes of morbidity and mortality worldwide. Although rapid reperfusion through thrombolysis or mechanical thrombectomy is the cornerstone of acute management, the efficacy of these interventions is influenced by the underlying composition of the occluding thrombus, which varies widely. Histological examination of retrieved thrombi allows the determination of thrombus composition and may inform aetiology and secondary prevention strategies. Additionally, radiological features may provide valuable pre-treatment insights into thrombus composition to help predict treatment success. This narrative review discusses histological and radiological indicators of thrombus composition, and how this may predict success of thrombolysis and thrombectomy. Furthermore, it discusses how these insights can be applied in the diagnostic work-up of embolic stroke of undetermined source (ESUS), and the potential utility of emerging biomarkers relating to thrombus formation, in order to optimise secondary prevention strategies.

Comprehensive biochemical, molecular and structural characterization of subtilisin with fibrinolytic potential in bioprocessing

Enzyme deployment is proliferating extensively in industries owing to their environmentally friendly and easily degradable attributes. This article undertakes an exhaustive examination of wild subtilisin enzyme, covering purification, biochemical delineation, analytical techniques, and practical implementations. The purification methodology involved partial refinement, anionic exchange, and gel filtration chromatography, culminating in a purification factor of 3.406, corroborated by SDS-PAGE showcasing a molecular weight of ~ 42 kDa. Biochemical scrutiny unveiled the enzyme's response, with an optimal pH at 9 and temperature peak at 60 ℃. Various surfactants, metal ions, organic solvents and inhibitors exhibited notable efficacy. Substrate specificity and kinetics showcased the utmost specificity with N-Suc-F-A-A-F-pNA, registering Km and Vmax values of 0.731 ± 0.5 mM and 0.87 ± 9 × 103 U/mg, respectively. Different bioanalytical techniquesproffered insights into structural and biophysical facets. Practical applications encompassed goat skin depilation, feather disintegration, blood clot dissolution, exemplifying the enzyme's multifaceted utility. To embark upon the elucidation of structure–function relationships, a three-dimensional model was devised through homology modelling, leveraging existing subtilisin structures (PDB: 3WHI). Molecular docking score of − 8.8 kcal/mol and dynamic simulations augmented the comprehension of molecular interactions with N-Suc-F-A-A-F-pNA. This research significantly contributes to unravelling the biochemical intricacies of wild subtilisin and underscores potential industrial and biomedical prowess. Subtilisin can be explored for its thrombolytic potential in several cardiovascular diseases. It may aid in the management of thrombosis by dissolving blood clots in conditions like deep pulmonary embolism, myocardial infarction, ischemic strokes, and in atherosclerosis by breaking down fibrin in arterial plaques, thus preventing heart attacks and strokes.Graphical

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, as potential (off-label) anti-obesity agents and effects on cardiovascular risk: A systematic review and meta-analysis.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are primarily used for the treatment of type 2 diabetes; however, they have also been reported to be effective in weight loss. We conducted a meta-analysis to consolidate evidence from randomized clinical trials assessing the effects of SGLT2 inhibitors, as potential anti-obesity agents, on cardiovascular risk in overweight and obese participants. We searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library for randomized controlled trials involving SGLT2 inhibitors that reported cardiovascular outcomes in overweight and obese individuals. Random-effects models and inverse variance weighting were used to calculate relative risks with 95% confidence intervals (CI). We extracted and analyzed the data from 7 studies, representing 17,810 participants treated with SGLT2 inhibitors and 14,876 participants treated with placebo. The risk of cardiovascular events, including cardiovascular death, myocardial infarction, ischemic stroke, and hospitalization for heart failure, significantly decreased by ~27.8% in participants treated with SGLT2 inhibitors, compared to the placebo group (relative risk = 0.722; 95% CI 0.639-0.821). Significant improvements in cardiovascular outcomes can be expected when SGLT2 inhibitors are used to treat diabetes, chronic kidney disease, or heart failure in overweight and obese individuals.

Rationale and Design of the CREATE Trial: A Multicenter, Randomized Comparison of Continuation or Cessation of Single Antithrombotic Therapy at 1 Year After Transcatheter Aortic Valve Replacement.

Current guidelines and expert consensus recommend lifelong single antiplatelet therapy for patients undergoing transcatheter aortic valve replacement who have no indication for anticoagulation or dual antiplatelet therapy. However, there is no direct evidence from randomized controlled trials supporting this practice. Furthermore, the optimal duration of antiplatelet therapy in this population has not been adequately investigated. CREATE (A Multicenter Randomized Controlled Study to Evaluate Cessation of Antithrombotic Therapy at 1 Year in TAVR Patients-The CREATE Study) is a prospective, multicenter, open-label, randomized controlled trial for patients who have undergone successful transcatheter aortic valve replacement and have no indication for long-term oral anticoagulation or antiplatelet therapy. Eligible patients are free from major bleeding and ischemic events for 1 year postprocedure before being randomized 1:1 to single antiplatelet therapy (control group) or no antiplatelet therapy (experimental group). The primary efficacy end point is the incidence of bleeding events, defined by the VARC-3 (Valve Academic Research Consortium-3) criteria, at 1-year postrandomization. The primary safety end point is a composite of cardiac death, myocardial infarction, and ischemic stroke at 1 year. The trial is powered for both superiority in efficiency and noninferiority in safety. Accordingly, a total of 3380 patients will be enrolled. The CREATE trial aims to assess if stopping antiplatelet therapy at 1-year after transcatheter aortic valve replacement reduces bleeding risk without increasing ischemic events in patients not requiring chronic antithrombotic therapy. URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2400087454.

Comparative effectiveness of potassium-competitive acid blockers and proton pump inhibitors in dual antiplatelet therapy patients: a nationwide cohort study.

Proton pump inhibitors (PPIs) are widely used in combination with dual antiplatelet therapy (DAPT) to reduce the risk of gastrointestinal bleeding; however, some PPIs may interfere with clopidogrel metabolism through CYP2C19 inhibition. Potassium-competitive acid blockers (P-CABs) have emerged as alternatives to PPIs, although their effectiveness in patients receiving DAPT have not been sufficiently explored. This study aimed to compare the effectiveness of PPIs and P-CABs in preventing cardiovascular events and gastrointestinal bleeding among patients receiving DAPT after coronary stent implantation. A retrospective cohort design was employed using nationwide claim data from South Korea. The study included patients who received aspirin-clopidogrel DAPT with PPI or P-CAB for a minimum of 60 days. After applying propensity score matching (PSM) at a 1:1 ratio, survival analysis was conducted. The primary outcome was a composite of acute myocardial infarction, ischemic stroke, revascularization, and in-hospital mortality. Secondary outcomes involved the individual components of the composite outcome and gastrointestinal bleeding. The initial cohort included 39,234 patients in the PPI group and 3,434 in the P-CAB group. After 1:1 PSM, 3,434 patients were included in each group. No statistically significant differences were observed between the PPI and P-CAB groups for the primary outcome (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.68-1.07; p = 0.167) and gastrointestinal bleeding (HR, 1.36; 95% CI, 0.76-2.42; p = 0.3). Both PPIs and P-CABs appear to be viable options for acid suppression in patients undergoing DAPT, with no significant differences in cardiovascular or gastrointestinal outcomes.

Novel Network Analysis of County- and Individual-Level Factors Associated With Functional Outcomes After Stroke.

Social determinants are known to impact stroke risk and poststroke outcomes. Using complexity science, we examined interrelations between county- and individual-level social and clinical determinants influencing stroke functional outcomes. We examined a retrospective cohort of 2 961 664 patients diagnosed with acute ischemic or hemorrhagic stroke from 2218 US hospitals participating in the Get With The Guidelines-Stroke Registry from 2013 to 2019, linked by ZIP code with the county-level institute for health metrics and evaluation data. We constructed multilayer networks, estimating mixed graphical models of 32 nodes representing social and clinical factors. Networks included 4 layers of factors: (1) county-level social, (2) individual-level social, (3) clinical comorbidities, and (4) hospital encounters. Networks were estimated for patients with less favorable (modified Rankin Scale score 3-6) versus favorable (modified Rankin Scale score 0-2) outcomes. We compared network structure and node centrality measures between groups using bootstrap permutation analyses, identifying influential (hub) nodes. The overall influence of social determinants (global connectivity) was greater in patients with less favorable outcomes (P<0.001). Homelessness and Black race were hub nodes, indicating their role in mediating relationships between social and downstream clinical factors in patients with less favorable outcomes. Being uninsured had greater influence (closeness centrality; P<0.001) in patients with less favorable outcomes, indicating its role in amplifying the effects of social determinants. Greater county-level high school completion (P<0.001) and a lower proportion of the population living below the US poverty line (P=0.030) were directly associated with faster onset-to-arrival time in patients with less favorable functional outcomes. The clinical-social determinant network explained 34% of the variance of modified Rankin Scale scores. Social determinants have a substantial influence on functional outcomes after stroke. County-level poverty directly affected onset-to-arrival time and quality of care. Health insurance status and homelessness were influential and modifiable patient-level factors that may serve as critical leverage points for future interventions aimed at improving outcomes.

Assessing Mortality in Patients with Acute Ischemic Stroke: A Turkish Cohort

Assessing Mortality in Patients with Acute Ischemic Stroke: A Turkish Cohort

Vascular injury and occurrence of microthrombi after endovascular therapy for acute ischaemic stroke in a thromboembolic model

BackgroundEndovascular catheters and devices used for thrombectomy in patients who had a stroke can damage the vessel lumen leading to microthrombi. During stroke recanalisation, microthrombi could migrate distally and occlude...

Impact of stroke severity on aspiration pneumonia risks in the medical ward versus the stroke unit: a 10-year retrospective cohort study

ObjectiveAspiration pneumonia is a common complication post-stroke that increases the patient’s duration of stay in hospital, mortality and morbidity. We examined the incidence, clinical characteristics and outcomes among ischaemic stroke-related...

Napkin-ring sign plaques are associated with cerebral small vessel disease

BackgroundFew studies have investigated the association between the carotid artery napkin-ring sign (NRS) and cerebral small vessel disease (CSVD). This study aimed to investigate whether carotid NRS plaque burden and CSVD are associated.MethodsThis retrospective, single-center, cross-sectional study following STROBE guidelines enrolled patients with symptoms or clinical suspicion of anterior circulation acute ischemic stroke (AIS). Plaques were evaluated using preoperative cervicocerebral computed tomography angiography (CTA). Imaging markers of CSVD, such as white matter hyperintensities (WMHs) and perivascular spaces (PVSs), were assessed.ResultsA total of 575 patients (64.9 ± 8.0 years, 378 men) were evaluated. Patients with AIS had a higher percentage of total NRS plaques than those in the control group (144 (37.1%) vs. 45 (24.1%), P = 0.002), and the total NRS amount increased the risk of AIS after adjusting for confounding factors (odds ratio 1.717; 95%CI 1.141–2.584; P = 0.009). A higher WMHs grade was associated with the presence of NRS plaques (P < 0.001) and a higher total NRS area (P < 0.001). A higher PVSs grade was associated with positive remodeling (PR) on the NRS (P = 0.006).ConclusionsAn increased incidence of NRS plaques on CTA was associated with the occurrence of AIS, and the area and PR of NRS plaques were associated with the risk stratification of CSVD.

Exploring the Association Between Serum Neurogranin, Nardilysin, and Ischemic Stroke: A Case-Control Study Conducted in the Emergency Department.

BACKGROUND Ischemic stroke (IS) is a major cause of mortality and disability worldwide. Rapid and accurate diagnosis in the emergency department (ED) is crucial for improving outcomes. Neurogranin (Ng), a postsynaptic protein involved in synaptic plasticity, and Nardilysin (NRDC), a metallopeptidase with neuronal functions, have been linked to various neurological disorders. This study examines their potential diagnostic and prognostic value in IS. MATERIAL AND METHODS This prospective case-control study was carried out in a high-volume ED between June and October 2023. A total of 44 IS patients and 44 healthy controls, matched for age and sex, were included. Serum levels of Ng and NRDC were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses involved receiver operating characteristic (ROC) analysis to assess diagnostic value and comparisons of biochemical parameters between groups. RESULTS Ng levels were significantly higher in IS patients compared to controls (281.12±32.12 pg/mL vs 265.71±24.54 pg/mL, P=0.01), with moderate diagnostic accuracy (area under curve=0.624). Elevated Ng levels were associated with intensive care unit admission (311.50±46.13 pg/mL, P=0.023). NRDC levels showed no significant differences between groups or clinical outcomes. Biochemical parameters, including elevated urea and creatinine and reduced hemoglobin levels, showed the systemic impacts of IS. CONCLUSIONS Ng may have a limited role as a biomarker in IS diagnosis, while its potential prognostic value requires further validation. NRDC did not show significant utility in this study. Larger studies incorporating additional biomarkers are needed to determine whether Ng can provide clinical insights into IS diagnosis and prognosis.

Selective deletion of interleukin-1 alpha in microglia does not modify acute outcome but may regulate neurorepair processes after experimental ischemic stroke.

Inflammation is a key contributor to stroke pathogenesis and exacerbates brain damage leading to poor outcome. Interleukin-1 (IL-1) is an important regulator of post-stroke inflammation, and blocking its actions is beneficial in pre-clinical stroke models and safe in the clinical setting. However, the distinct roles of the two major IL-1 receptor type 1 agonists, IL-1α and IL-1β, and the specific role of IL-1α in ischemic stroke remain largely unknown. Here we show that IL-1α and IL-1β have different spatio-temporal expression profiles in the brain after experimental stroke, with early microglial IL-1α expression (4 h) and delayed IL-1β expression in infiltrated neutrophils and a small microglial subset (24-72 h). We examined for the first time the specific role of microglial-derived IL-1α in experimental permanent and transient ischemic stroke through microglial-specific tamoxifen-inducible Cre-loxP-mediated recombination. Microglial IL-1α deletion did not influence acute outcome after ischemic stroke. However, microglial IL-1α knock out (KO) mice showed reduced peri-infarct vessel density and reactive astrogliosis at 14 days post-stroke, alongside long-term impaired functional recovery. Our study identifies for the first time a critical role for microglial IL-1α on post-stroke neurorepair and recovery, highlighting the importance of targeting specific IL-1 mechanisms in brain injury to develop effective therapies.

Anticoagulation therapy after reperfusion treatment for acute ischemic stroke with non-valvular atrial fibrillation: a multicenter retrospective study

To understand anticoagulation therapy in acute ischemic stroke (AIS) patients with non-valvular atrial fibrillation (NVAF) after receiving reperfusion treatments in the real world. This retrospective study collected basic clinical data, the initiation time of anticoagulation therapy, treatment plans, and prognosis of AIS patients with AF who underwent intravenous thrombolysis (IVT), and/or endovascular thrombectomy (EVT) from January 2019 to January 2022 in four tertiary hospitals in Jiangxi Province. A multivariate logistic regression analysis was used to analyze the factors influencing anticoagulation therapy in these patients. The reasons for delay or non-initiation of anticoagulation therapy were analyzed by questionnaire. A total of 410 patients met the selection criteria, including 168 (41.0%) in the IVT group, 144 (35.1%) in the EVT group, and 98 (23.9%) in the IVT + EVT group. Initiation of anticoagulation therapy within 14 days post-AIS was found in 175 patients in total (42.7%), which is significantly different in three groups (49.7% in IVT group, 30.3% in EVT group, and 20.0% in IVT + EVT groups, P < 0.01). Multivariate logistic regression analysis revealed that prior use of antiplatelet drugs was more common in patients receiving early anticoagulation therapy (OR = 0.122, 95% CI 0.065–0.228, P < 0.01). Patients receiving no anticoagulation had higher-3-days post-reperfusion NIHSS score (OR = 1.109, 95% CI 1.073–1.147, P < 0.01) and more in-hospital haemorrhagic transformation (OR = 2.572, 95% CI 1.423–4.648, P < 0.01). Of all patients, 281 had a favorable 90-day prognosis (mRS score 0–2), including 152 (86.9%) in the early anticoagulation group and 129 (54.9%) in the delay anticoagulation group (P < 0.01). Postoperative 90-day outcomes included 25 (6.1%) cases of recurrent ischemic stroke (P = 0.55) and 27 (6.6%) bleeding events (P = 0.32). Early initiation of anticoagulation therapy improves 90-day outcomes in NVAF post-related AIS patients with related AF after receiving reperfusion treatments; however, the initiation of anticoagulation in most patients might be much later than the currently recommended timing in real world.

Astrocytic BEST1 can serve as a target for functional recovery after ischemic stroke.

Astrocytic BEST1 can serve as a target for functional recovery after ischemic stroke.

Safety and Efficacy of Stem Cell Therapy in Ischemic Stroke: A Comprehensive Systematic Review and Meta-Analysis

Safety and Efficacy of Stem Cell Therapy in Ischemic Stroke: A Comprehensive Systematic Review and Meta-Analysis