American Stroke Association, Feb. 9-11

The annual International Stroke Conference of the American Heart Association/American Stroke Association was held from Feb. 9 to 11 in New Orleans and attracted participants from around the world, including cerebrovascular research and practice experts. The conference featured presentations that emphasized basic, clinical, and translational medicine and provided insight into the prevention, management, and treatment of stroke.

In one study, Akhil Jain, M.D., of the Mercy Catholic Medical Center in Darby, Pennsylvania, and colleagues found that young marijuana users who have a history of stroke or transient ischemic attack (TIA) remain at significantly higher risk for future stroke.

The authors used the National Inpatient Sample to identify 161,390 hospitalized patients, between 18 and 44 years of age, who had been hospitalized for any reason between October 2015 and 2017 and whose health records indicated a previous stroke or TIA. Among hospitalized patients, the investigators found that 6.9 percent of those with cannabis use disorder were hospitalized for a recurrent stroke compared with only 5.4 percent of patients without cannabis use disorder. After adjusting for demographic factors and relevant preexisting medical conditions, patients with cannabis use disorder were 48 percent more likely to have been hospitalized for recurrent stroke than those without the disorder.

"Cannabis use disorder was most prominent among males, young White adults, young Black adults, those who lived in low-income neighborhoods, and in the Northeast and Southern regions of the United States," Jain said. "It is essential to increase awareness among younger adults of the adverse impact of chronic, habitual use of marijuana, especially if they have established cardiovascular disease risk factors or previous stroke episodes."

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In another study, Neal S. Parikh, M.D., of Weill Cornell Medicine in New York City, and colleagues found that cigarette exposure is detrimental to cognitive brain health, regardless of whether a person has other risk factors for suboptimal brain health.

After performing a cross-sectional analysis of nationwide health survey data, the researchers found that higher blood levels of a marker of cigarette smoking were associated with worse performance on a cognitive test in a nationally representative sample of 60- to 80-year-old Americans.

"Surprisingly, the association between smoking and cognition did not differ based on the presence or absence of hypertension or diabetes, both of which independently negatively impact brain health," Parikh said. "It is never too late to quit. Old individuals, who are at risk of cognitive impairment and dementia, should receive aggressive smoking-cessation interventions, regardless of whether they have other risk factors for dementia."

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Michelle C. Johansen, M.D., Ph.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues found that myocardial infarction (MI) is associated with a faster decline in global cognition, memory, and executive function during the years following the event.

The authors evaluated data from participants across six population-based cohort studies with different measures of cognition. The data were harmonized to allow for consistent cognitive measures across all cohorts, and the authors specifically used linear mixed-effects models with time-varying incident MI variable (intercept) and a follow-up time after MI variable (slope) to determine how the cognitive trajectories changed at the time of and after incident MI. The researchers observed little decline in any measure of cognition in the short term after an MI; however, they did observe faster declines in memory, executive functioning, and global cognition in the years following the MI.

"We believe that effective interventions to prevent the initial MI event are likely to reduce the rate of cognitive decline among these individuals," Johansen said.

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ASA: Endovascular Therapy Studied in Large Ischemic Stroke

THURSDAY, Feb. 16, 2022 (HealthDay News) -- Patients with large cerebral vessel occlusion and sizable strokes on imaging have better functional outcomes at 90 days, but more intracranial hemorrhages, with endovascular therapy plus medical care versus medical care alone, according to a study published online Feb. 9 in the New England Journal of Medicine to coincide with the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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ASA: Scoring System May Predict Stroke Risk in COVID-19 Inpatients

TUESDAY, Feb. 8, 2022 (HealthDay News) -- A new scoring system helps predict the risk for stroke among adults hospitalized with COVID-19, according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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ASA: BP Telemonitoring Aids Stroke Survivors in Underserved Areas

TUESDAY, Feb. 8, 2022 (HealthDay News) -- Remote blood pressure monitoring and telehealth visits improve outcomes for stroke survivors who live in historically under-resourced communities, according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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ASA: Less Bleeding Seen With Tenecteplase for Ischemic Stroke

FRIDAY, Feb. 4, 2022 (HealthDay News) -- For patients with ischemic stroke, use of tenecteplase for thrombolysis is associated with a lower rate of symptomatic intracranial hemorrhage than alteplase, according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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ASA: Stroke Rates Down in Elderly, Up in Young Adults in the U.S.

THURSDAY, Feb. 3, 2022 (HealthDay News) -- Although age-standardized stroke burden measures decreased or remained stable from 1990 to 2019 in the United States, the incidence of stroke is increasing among young adults in the South and Midwest, according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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ASA: Myocardial Infarction May Hasten Cognitive Decline in Adults

THURSDAY, Feb. 3, 2022 (HealthDay News) -- Significantly faster declines in global cognition, memory, and executive function are seen following incident myocardial infarction, according to a study presented at the American Stroke Association International Stroke Conference, held from Feb. 9 to 11 in New Orleans.

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