Analysis of ‘Stroke Deaths 30 days hospital admission.’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://www.kaggle.com/mpwolke/cusersmarildownloadsstrokecsv on 14 February 2022.

--- Dataset description provided by original source is as follows ---

Context

Deaths occurring in hospital and after discharge between 0 and 29 days (inclusive) of an emergency admission to hospital with a stroke. This indicator is available for males, females and persons at the following breakdowns: England/Region of residence/Local authority of residence/County of residence/London authority of residence/Provider

https://digital.nhs.uk/data-and-information/publications/clinical-indicators/compendium-of-population-health-indicators/compendium-hospital-care/current/deaths-within-30-days/deaths-within-30-days-of-emergency-admission-to-hospital-stroke-indirectly-standardised-rate-all-ages-annual-trend-f-m-p#

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Content

Some people with stroke die before they can be admitted to hospital. There are variations in death rates among those who survive long enough to be admitted, and some of these deaths may potentially be preventable. The National Service Framework for older people cites evidence that people who have strokes are more likely to survive if admitted promptly to a hospital-based stroke unit with treatment and care provided by a specialist coordinated stroke team within an integrated service. The National Health Service (NHS) may be helped to prevent some of these deaths by seeing comparative figures and learning lessons from follow-up investigations.

Legacy unique identifier: P02167

Acknowledgements

digital.nhs.uk

Photo by K. Mitch Hodge on Unsplash

Inspiration

Stroke cases among Covid-19 patients outside the risk group that puzzle American doctors. Studies attempt to unravel the relationship between strokes and younger people infected with coronavirus

--- Original source retains full ownership of the source dataset ---

The Stroke Recovery in Underserved Populations 2005-2006 study was created to address the National Institute on Aging (NIA) Request For Application entitled "Research on Mind-Body Interactions and Health" (RFA OD-03-008). It addressed the NIA interest in "the impact of optimism, happiness, or a positive attitude on well-being and health; and social functioning and health." The study examined how positive emotion (e.g., joy, gratitude, love, contentment) and social networks independently and interactively contribute to recovery of functional status after stroke within two underserved groups. The specific study aims were to: Examine recovery of functional status (motor and cognitive function), for White, African American and Hispanic persons with stroke discharged from rehabilitation facilities Examine the contributions of positive emotion and social networks on recovery of functional status (motor and cognitive function), for White, African American, and Hispanic persons with stroke discharged from rehabilitation facilities; and Examine the interaction between positive emotion and social networks on recovery of functional status (motor and cognitive function) for White, African American, and Hispanic persons with stroke discharged from rehabilitation facilities. The data were collected by the IT Health Track at four time points: at admission and discharge from rehabilitation facility, and 80-180 days and 365-425 days after discharge. These data emphasize recovery of motor and cognitive functional status, positive emotion, and social networks The dataset contains 226 variables and 1219 cases from 11 rehabilitation facilities across the United States. face-to-face interview; telephone interviewThis study was funded by the National Institute on Aging through grant number R01AG024806-05S1.To protect the anonymity of respondents, all variables that could be used to identify individuals have been masked or recoded. For details regarding these changes, please refer to the Codebook Notes provided in the ICPSR Codebook in this data collection.Please note that this data collection contains duplicate records. ICPSR created a CASEID variable which is a unique case identifier. Variable PAT_ID accounts for the duplicate records, while variable CASEID allows data users to analyze the data for each case.All four of the longitudinal time points are included in the dataset. The following variable ending indication the time point associated with the variable. "_A" refers to admissions "_D" refers to discharge "_F" refers to 3 month follow-up "_Y" to the 12 month follow-up The purpose of this study was to address the National Institute on Aging RFA "Research on Mind-Body Interactions and Health." The study aimed to identify and examine factors that may contribute to a narrowing of the health disparities that currently exist between underserved minority groups, African Americans and Hispanics, and whites. The study strives to contribute important insights into why some individuals with stroke do well and others do poorly. The researchers targeted 16 rehabilitation facilities from the across Unites States with the objective of obtaining a large sample of racial and ethnic minorities represented. Data were collected by the IT Health Track at four time points: at admission and discharge from the rehabilitation facility, and 80-180 days and 365-425 days after discharge. Response Rates: Of the 16 rehabilitation facilities contacted, 11 participated in the study. Of the eligible respondents from those facilities 85 percent participated in the study. The study acquired responses from 1206 unique respondents: 906 whites, 199 blacks, 74 Hispanics and 27 respondents who identify as another race. Presence of Common Scales: Center for Epidemiologic Studies Depression Scale (CESD) DUKE-UNC Functional Social Support Functional Independence Measure (FIM) Documentation for the computation of the DUKE-UNC Functional Social Support Scale was not provided. Some of the topics highlighted in the data include the following: Demographics Stroke Symptoms Stroke Comorbidities Functional Recovery Social Support Community Partipation Emotional Well-being The data were convenience sampled from 11 rehabilitation facilities that were targeted to obtain responses from African American, Hispanic and White persons. Individuals with stroke who checked into rehabilitation facilities in the United States in 2005. Smallest Geographic Unit: rehabilitation facility Datasets: DS1: Stroke Recovery in Underserved Populations 2005-2006 [United States]

PIONEER geography The West Midlands (WM) has a population of 5.9million & includes a diverse ethnic, socio-economic mix. There is a higher than average % of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. There are particularly high rates of physical inactivity, obesity, smoking & diabetes. WM has a high prevalence of COPD, reflecting the high rates of smoking and industrial exposure. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS. This is the SAMBA dataset from 4 NHS hospitals. EHR University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: All patients from 2015 onwards, curated to focus on Stroke. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (admissions, wards and discharge outcomes), presenting complaints, therapies, all physiology readings (pulse, temperature, blood pressure, screening for dysphagia, all sample analysis results (urine specimens, blood specimens), all prescribed & administered treatments and all outcomes. Available supplementary data:
More extensive data including granular serial physiology, bloods, conditions, interventions, treatments. Ambulance, 111, 999 data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services

Background and purposeStroke survivors present limited levels of physical activity (PA) and participation in everyday activities although the specific interaction between PA and participation in these individuals is still uncertain. This study aimed to analyse the relationship between PA and participation in everyday activities among Spanish mild stroke survivors.MethodsA total of 130 mild stroke survivors (61.3 ± 12.4 years, 35% female) with preserved walking ability and without cognitive and communication impairments participated in this cross-sectional study involving several rehabilitation centres from Spain. Self-reported levels of PA were reported by the International Physical Activity Questionnaire - short form (IPAQ-SF). Objective PA measures were monitored with the wristband Fitbit Inspire 2, recording the average steps/day and kilocalories/day. Participation and activity satisfaction levels were measured with the Satisfaction with Daily Occupations-Occupational Balance (SDO-OB) and participation retention through Activity Card Sort (ACS).ResultsACS total score showed a weak correlation with self-reported PA (rho = 0.324) and moderate correlations with kilocalories/day and average steps/day (rho ≥ 0.581), while stronger correlations were found for the ACS subdomain of instrumental activities (rho ≥ 0.640) compared to the subdomains of leisure activities and social participation (rho ≤ 0.454). SDO-OB participation showed moderate correlations with kilocalories/day, and average steps/day (rho ≥ 0.647), and a weak correlation with self-reported PA (rho = 0.303). Weaker correlations were found for SDO-OB satisfaction with objective PA measures (rho = 0.407) and self-reported PA (rho = 0.254). Relationships between variables were explored by calculating Spearman correlation coefficients.Discussion and conclusionsThe objective and self-reported measures of PA in mild stroke survivors have a bilateral relationship with their current participation levels and the retained instrumental activities of daily living. However, the weaker correlations with leisure and social participation may suggest that promoting PA alone without integrating it into daily activities relevant to the stroke survivor may be insufficient to achieve comprehensive goals during rehabilitation programs.

Background: Extended immobility has been associated with medical complications during hospitalization. However no clear recommendations are available for mobilization of ischemic stroke patients. Objective: As early mobilization has been shown to be feasible and safe, we tested the hypothesis that early sitting could be beneficial to stroke patient outcome. Methods: This prospective multicenter study tested two sitting procedures at the acute phase of ischemic stroke, in a randomized controlled fashion (clinicaltrials.org registration number NCT01573299). Patients were eligible if they were above 18 years of age and showed no sign of massive infarction or any contra-indication for sitting. In the early-sitting group, patients were seated out of bed at the earliest possible time but no later than one calendar day after stroke onset, whereas the progressively-sitting group was first seated out of bed on the third calendar day after stroke onset. Primary outcome measure was the proportion of patients with a modified Rankin score [0–2] at 3 months post stroke. Secondary outcome measures were a.) prevalence of medical complications, b.) length of hospital stay, and c.) tolerance to the procedure. Results: One hundred sixty seven patients were included in the study, of which 29 were excluded after randomization. Data from 138 patients, 63 in the early-sitting group and 75 in the progressively-sitting group were analyzed. There was no difference regarding outcome of people with stroke, with a proportion of Rankin [0–2] score at 3 months of 76.2% and 77.3% of patients in the early- and progressive-sitting groups, respectively (p = 0.52). There was also no difference between groups for secondary outcome measures, and the procedure was well tolerated in both arms. Conclusion: Due to a slow enrollment, fewer patients than anticipated were available for analysis. As a result, we can only detect beneficial/detrimental effects of +/- 15% of the early sitting procedure on stroke outcome with a realized 37% power. However, enrollment was sufficient to rule out effect sizes greater than 25% with 80% power, indicating that early sitting is unlikely to have an extreme effect in either direction on stroke outcome. Additionally, we were not able to provide a blinded assessment of the primary outcome. Taking these limitations into account, our results may help guide the development of more effective acute stroke rehabilitation strategies, and the design of future acute stroke trials involving out of bed activities and other mobilization regimens.

Percentage of emergency admissions to any hospital in England occurring within 30 days of the last, previous discharge from hospital with specific diagnosis: indirectly standardised by age, sex, method of admission and diagnosis group. The following diagnoses are used: ● Fractured proximal femur (based on ICD-10 codes: S72.0, S72.1 and S72.2) for all ages broken down by gender: male only, female only and persons ● Stroke (based on ICD-10 codes: I61* to I64*) for all ages broken down by gender: male only, female only and persons. Results for each of these groups are also split by the following geographical and demographic breakdowns: ● Local authority of residence. ● Region. ● Area classification. ● NHS and private providers. ● NHS England regions. ● Deprivation (Index of Multiple Deprivation (IMD) Quintiles, 2019). ● Sustainability and Transformation Partnerships (STP) & Integrated Care Boards (ICB) from 2016/17. ● Clinical Commissioning Groups (CCG) & sub-Integrated Care Boards (sub-ICB). All datasets are annual trends indirectly standardised against 2013/14.

Objective: To examine whether the incidence, comorbidity, and mortality of first-time ischemic stroke changed in Denmark between 1996-2016 overall and according to age and sex using a nationwide cohort design.

Methods: In this cohort study, 224,617 individuals >18 years admitted with first-time ischemic stroke between 1996-2016 were identified using Danish nationwide registries. We calculated annual age-standardized incidence rates and absolute 30-day and 1-year mortality risks. Further, we calculated annual incidence rate ratios using Poisson regression, odds ratios for 30-day mortality using logistic regression, and hazard ratios for 1-year mortality using Cox regression.

Results: The overall age-standardized incidence rates of ischemic stroke per 1,000 person-years increased from 1996 (2.70 [95%CI,2.65-2.76]) to 2002 (3.25 [95%CI,3.20-3.31]) and then gradually decreased to below the initial level until 2016 (1.99 [95%CI,1.95-2.02]). Men had higher incidence rates than women in a...

This analysis presents a rigorous exploration of financial data, incorporating a diverse range of statistical features. By providing a robust foundation, it facilitates advanced research and innovative modeling techniques within the field of finance.

Hikma Pharmaceuticals (HIK): A Stroke of Value in a Volatile Market?

Financial data:

• Historical daily stock prices (open, high, low, close, volume)

• Fundamental data (e.g., market capitalization, price to earnings P/E ratio, dividend yield, earnings per share EPS, price to earnings growth, debt-to-equity ratio, price-to-book ratio, current ratio, free cash flow, projected earnings growth, return on equity, dividend payout ratio, price to sales ratio, credit rating)

• Technical indicators (e.g., moving averages, RSI, MACD, average directional index, aroon oscillator, stochastic oscillator, on-balance volume, accumulation/distribution A/D line, parabolic SAR indicator, bollinger bands indicators, fibonacci, williams percent range, commodity channel index)

Machine learning features:

• Feature engineering based on financial data and technical indicators

• Sentiment analysis data from social media and news articles

• Macroeconomic data (e.g., GDP, unemployment rate, interest rates, consumer spending, building permits, consumer confidence, inflation, producer price index, money supply, home sales, retail sales, bond yields)

Potential Applications:

• Stock price prediction

• Portfolio optimization

• Algorithmic trading

• Market sentiment analysis

• Risk management

Use Cases:

• Researchers investigating the effectiveness of machine learning in stock market prediction

• Analysts developing quantitative trading Buy/Sell strategies

• Individuals interested in building their own stock market prediction models

• Students learning about machine learning and financial applications

Additional Notes:

• The dataset may include different levels of granularity (e.g., daily, hourly)

• Data cleaning and preprocessing are essential before model training

• Regular updates are recommended to maintain the accuracy and relevance of the data

PurposeType 2 diabetes and sedentary behavior pose serious health risks in stroke survivors. Using a co-creation framework, this study aimed to develop an intervention in collaboration with stroke survivors with type 2 diabetes, relatives, and cross-sectoral health care professionals to reduce sedentary behavior and increase physical activity.Materials and methodsThis qualitative explorative study used a co-creation framework consisting of a workshop and focus group interviews with stroke survivors with type 2 diabetes (n = 3), relative (n = 1), and health care professionals (n = 10) to develop the intervention. A content analysis was used to analyze data.ResultsThe developed “Everyday Life is Rehabilitation” (ELiR) intervention consisted of a tailored 12-week home-based behavior change intervention with two consultations of action planning, goal setting, motivational interviewing, and fatigue management including education on sedentary behavior, physical activity, and fatigue. The intervention has a minimalistic setup using a double-page paper “Everyday Life is Rehabilitation” (ELiR) instrument making it implementable and tangible.ConclusionsIn this study, a theoretical framework was used to develop a tailored 12-week home-based behavior change intervention. Strategies to reduce sedentary behavior and increase physical activity through activities of daily living along with fatigue management in stroke survivors with type 2 diabetes were identified.

Introduction:This study investigated upper extremity (UE) recovery predictors in post-stroke patients undergoing task-oriented training (TOT) rehabilitation. The data were collected at the Don Gnocchi Foundation hospitals in Italy between 2011 and 2015. Ethical approval was obtained, and all participants provided informed consent.Methods:Participants: 64 participants were recruited.Intervention: Participants received 25 sessions of TOT (45 minutes each, five days/week) as an adjunct to standard therapy. TOT focused on functional tasks with real-life objects and was progressively adapted to individual needs.Outcome Measures:Fugl-Meyer Assessment - Upper Extremity (FMA-UE): To assess impairment (ICF body function domain).15-item Action Research Arm Test (ARAT-15): To assess activity/performance (ICF activity domain).Quick version of the Disability of the Arm, Shoulder, and Hand questionnaire - 9 items (Q-DASH-9): To assess participation restrictions (ICF participation domain).Predictor Variables: Age, sex (i.e., male, female), dominance of the affected side (affected bodyside; i.e., dominant; non-dominant), chronicity (i.e., chronic; subacute), injury typology (i.e., ischemic; hemorrhagic), injury localization (i.e., cortical; sub-cortical), and baseline scores on the FMA-UE, ARAT-15, and Q-DASH-9.Data Analysis:Descriptive statistics were used to summarize data.Wilcoxon signed-rank test was used to compare pre- and post-intervention scores.Effect sizes were calculated using matched-pairs rank-biserial correlation.Participants were classified as "Responders" or "Non-responders" based on achieving minimally clinically important differences (MCID) in outcome measures.Stepwise binary logistic regression models were developed to identify predictors of responder status. A bidirectional approach was employed, starting with an empty model. Predictors were added (forward selection) or removed (backward elimination) one at a time based on whether their inclusion improved the Akaike information criterion (AIC).Model accuracy was assessed using McFadden’s pseudo-R2, Scaled Brier Score, Receiver Operating Characteristic curve (AUC), and Hosmer–Lemeshow test.Subgroup sensitivity analysis was performed to assess model robustness.

Purpose: This prospective, single-blinded, parallel, stratified, randomized clinical trial via telehealth aimed to investigate the impact of Startle Adjuvant Rehabilitation Therapy (START) on aphasia, apraxia of speech (AOS), and quality of life in individuals with chronic stroke. The study hypothesized that START would have a greater effect on AOS-related measures and more severe individuals.Method: Forty-two participants with poststroke aphasia, AOS, or both were randomly assigned to the START or control group. Both groups received 77-dB GET READY and GO cues during a word repetition task for three 1-hr sessions on consecutive days. The START group additionally received 105-dB white noise GO cues during one third of trials. The Western Aphasia Battery–Revised, Apraxia Battery for Adults, Stroke Impact Scale, and Communication Outcomes After Stroke scale were administered at Day 1, Day 5, and 1-month follow-up.Results: START improved performance on some subtests of the Western Aphasia Battery (Comprehension, Repetition, Reading) and measures of AOS (Diadochokinetic Rate, Increasing Word Length) in individuals with moderate/severe aphasia, whereas moderate/severe controls saw no changes. Individuals with mild aphasia receiving START had improved Reading, whereas mild controls saw improved Comprehension. The START group had increased mood and perceived communication recovery by Day 5, whereas controls saw no changes in quality of life.Conclusions: This study is the first to evaluate the impact of training with startling acoustic stimuli on clinical measures of aphasia and AOS. Our findings suggest START can enhance both nontrained speech production and receptive speech tasks in moderate/severe aphasia, possibly by reducing poststroke cortical inhibition. Our findings should be considered carefully, as our limitations include small effect sizes, within-group variability, and low completion rates for quality-of-life assessments and follow-up visits. Future studies should explore a mechanism of action, conduct larger and longer Phase 2 clinical trials, and evaluate long-term retention.Supplemental Material S1. Example of a session for a participant in the START group.Swann, Z., Tesman, N., Rogalsky, C., & Honeycutt, C F. (2023). Word repetition paired with startling stimuli decreases aphasia and apraxia severity in severe-to-moderate stroke: A stratified, single-blind, randomized, Phase 1 clinical trial. American Journal of Speech-Language Pathology, 32(6), 2630–2653. https://doi.org/10.1044/2023_AJSLP-22-00296

IntroductionHemiparesis is the main sensorimotor deficit after stroke. It can result in limitations in Activities of Daily Living (ADL) and social participation. Hemiparesis can be treated with behavioral techniques of intensive use of the affected arm, such as constraint-induced movement therapy (CIMT), however, it remains unclear whether motor improvement can lead to increases in the domains of activity and participation.ObjectiveIdentify whether CIMT is superior to usual techniques to enhance activity and participation outcomes in stroke survivors.MethodsA systematic review with meta-analysis was conducted, based on the PRISMA guidelines. Search databases were: PubMed, LILACS, Embase, SciELO, Cochrane Library, Scopus, Medline, and Web of Science, with no language restriction. Meta-analysis was performed with Review Manager (version 5.3), significance level p ≤ 0.05.ResultsA total of 21 articles were included for analysis. Superior effects were observed on motor function and performance in activities of daily living of individuals treated with CIMT. The outcomes measures utilized were: Fugl-Meyer Assessment (p = 0.00001); Wolf motor function test (p = 0.01); Modified Barthel Index (p = 0.00001); Motor Activity log (MAL) Amount of use (AOU) (p = 0.01); MAL Quality of movement (QOM) (p = 0.00001); Action Research Arm Test-ARAT (p = 0.00001); and FIM (p = 0.0007).ConclusionOur results show that CIMT results in more significant gains in the functional use of the upper limb in ADL and functional independence, demonstrating superior activity and participation results in stroke survivors when compared to conventional therapies.

BackgroundDespite the known associations of dietary magnesium intake and estimated glomerular filtration rate (eGFR) with cardiovascular diseases, their combined effects on stroke risk remain unclear. Therefore, this study aims to explore the associations of dietary magnesium intake and eGFR with stroke risk.MethodsThe National Health and Nutrition Examination Survey (NHANES) data of 37,637 adult participants (≥18 years) from 2003 to 2018 was analyzed. Dietary magnesium intake was categorized as low (≤ 254 mg/day) and normal (> 254 mg/day) based on experimental data. Multiple logistic regression analyses and interaction tests were conducted to assess the associations of dietary magnesium intake and eGFR with stroke risk, with a focus on the interaction between different chronic kidney disease (CKD) stages based on eGFR levels and dietary magnesium intake. Additional analyses included multiplicative interaction analysis, restricted cubic spline analysis, and subgroup evaluations by age, sex, and ethnicity.ResultsDietary magnesium intake and eGFR were inversely correlated with the risk of stroke. Participants with low dietary magnesium intake had a higher stroke risk than those with normal magnesium intake (odds ratio [OR] 1.09, 95% confidence interval [CI]: 1.03–1.42). Likewise, low eGFR was associated with an elevated stroke risk compared with normal eGFR (OR 1.56, 95% CI: 1.15–2.13). Furthermore, the two factors showed a multiplicative interaction effect on stroke risk (OR 1.05, 95% CI: 1.01–1.09). We observed a significant interaction between stage G3 CKD and low dietary magnesium intake (OR 1.05, 95% CI: 1.01–1.09), suggesting a potential association with stroke risk. However, similar associations were not observed for stages G4 and G5, possibly due to the smaller number of participants with G4 and G5 CKD. The restricted cubic spline analysis revealed a non-linear relationship between dietary magnesium intake, eGFR, and stroke risk. The interaction between magnesium deficiency and low eGFR persisted in participants aged >60 years, as well as in females, non-Hispanic Black people, and people of other races.ConclusionDietary magnesium intake and eGFR correlate negatively with stroke prevalence. Moreover, there was an interaction between dietary magnesium intake and stroke prevalence across different CKD stages. Further large-scale prospective studies are needed to analyze the potential relationship between dietary magnesium intake, eGFR, and stroke.

This prospective observational study aimed to assess the impact of behavioral therapy on dysphagia in patients with acute ischemic stroke undergoing nasogastric tube feeding. The study was conducted between June 2020 and May 2022 at the Neurological Center of Bach Mai Hospital, Vietnam, with a sample size of 230 patients divided into two groups: a normal and a behavioral therapy group. The normal therapy group received routine care and treatment based on standard protocols, while the behavioral therapy group underwent daily swallowing exercises for approximately 60 minutes. The Gugging Swallowing Screen (GUSS) was utilized to screen individuals with dysphagia, and the difference-in-differences (DID) method was adopted to estimate the effect of behavioral therapy on dysphagia patients. The study concluded that behavioral therapy improved dysphagia in patients with acute ischemic stroke undergoing nasogastric tube feeding. This study highlights the potential of behavioral therapy as an effective intervention for dysphagia rehabilitation in stroke patients.

BackgroundAspirin is a cornerstone medication for acute ischemic stroke (AIS), but its efficacy varies significantly among individuals. This study aimed to develop a pharmacogenetic polygenic response score (PgxRS) to predict the incidence of adverse outcomes in aspirin-treated AIS patients.MethodsWe conducted a retrospective study involving 828 AIS patients who received aspirin therapy. Fifteen candidate single nucleotide variants (SNPs) in genes related to aspirin’s mechanism of action, transport, metabolism, and platelet function were genotyped. The association between SNPs and the risk of unfavorable prognosis (defined as modified Rankin Scale score >1 at 90 days) was assessed using logistic regression analysis. Multivariable models incorporating SNPs and clinical factors were developed to predict adverse outcomes.ResultsThe rs1045642GG genotype in the ABCB1 gene was significantly associated with a lower risk of unfavorable prognosis, while the rs1371097T allele in the P2Y1 gene was linked to a higher risk. A prediction model incorporating these two SNPs along with clinical variables demonstrated moderate diagnostic accuracy for predicting unfavorable prognosis (AUC = 0.78, 95% CI: 0.74–0.81).ConclusionOur findings suggest that rs1045642 and rs1371097 genotypes contribute to variability in aspirin response among AIS patients. The developed PgxRS, incorporating these SNPs and clinical factors, can potentially aid in risk stratification and guide personalized antiplatelet therapy decisions. However, further validation in larger, diverse cohorts is warranted.

Introduction: Glaucoma may be related to ischemic stroke (IS) and poor outcomes after IS in observational studies, while the causal association remains unclear. Methods: We obtained single nucleotide polymorphisms (SNPs) related to glaucoma from the gene-wide association study (GWAS) conducted by the FinnGen consortium. The GWAS included a total of 13,614 cases and 295,540 controls. The summary-level of datasets regarding IS were collected from the MEGASTROKE consortium, including 34,217 cases and 406,111 controls. Furthermore, we acquired summary statistics datasets for functional outcomes following IS from the GWAS meta-analysis conducted by the GISCOME consortium, which involved 6,021 individuals. The genetic association estimates for functional outcomes at 90 days after IS were evaluated by the modified Rankin Score (mRS), including 3,741 cases with good functional outcomes (mRS=0-2) and 2,280 subjects with poor functional outcomes post-stroke (mRS=3-6). Inverse variance weighting (IVW) was used as the primary method, complemented by sensitivity analyses for pleiotropy and increasing robustness. Results: Genetically, glaucoma is associated with an increased risk of IS (odds ratio [OR]=1.08, 95% confidence interval [CI] = 1.02-1.14, P = 0.0039), as well as poor prognosis after IS with adjustment for severity (OR=1.64; 95% CI=1.27-2.13, P=0.0001) and functional outcome after IS (OR=1.45, 95% CI=1.12-1.87, P=0.0038). Through sensitivity analyses, we confirmed the robustness of the results. In addition, we did not identify any causal association between IS, functional outcome after IS, and glaucoma in reverse analysis. Conclusion: Our study provides evidence suggesting a potential genetic causal relationship between glaucoma and an increased risk of IS, as well as a poor functional outcome following IS. Future studies are necessary to confirm these findings.