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Tsivgoulis G, Triantafyllou S, Palaiodimou L, Grory BM, Deftereos S, Köhrmann M, Dilaveris P, Ricci B, Tsioufis K, Cutting S, Magiorkinis G, Krogias C, Schellinger PD, Dardiotis E, Rodriguez-Campello A, Cuadrado-Godia E, Aguiar de Sousa D, Sharma M, Gladstone DJ, Sanna T, Wachter R, Furie KL, Alexandrov AV, Yaghi S, Katsanos AH. Prolonged Cardiac Monitoring and Stroke Recurrence: A Meta-analysis. Neurology 2022; 98:e1942-e1952. [PMID: 35264426 DOI: 10.1212/wnl.0000000000200227] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Prolonged poststroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of patients with ischemic stroke (IS) with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We evaluated the association between PCM and the institution of stroke preventive strategies and stroke recurrence. METHODS We searched MEDLINE and SCOPUS databases to identify studies reporting stroke recurrence rates in patients with history of recent IS or TIA receiving PCM compared with patients receiving conventional cardiac rhythm monitoring. Pairwise meta-analyses were performed under the random effects model. To explore for differences between the monitoring strategies, we combined direct and indirect evidence for any given pair of monitoring devices assessed within a randomized controlled trial (RCT). RESULTS We included 8 studies (5 RCTs, 3 observational; 2,994 patients). Patients receiving PCM after their index event had a higher rate of AF detection and anticoagulant initiation in RCTs (risk ratio [RR] 3.91, 95% CI 2.54-6.03; RR 2.16, 95% CI 1.66-2.80, respectively) and observational studies (RR 2.06, 95% CI 1.57-2.70; RR 2.01, 95% CI 1.43-2.83, respectively). PCM was associated with a lower risk of recurrent stroke during follow-up in observational studies (RR 0.29, 95% CI 0.15-0.59), but not in RCTs (RR 0.72, 95% CI 0.49-1.07). In indirect analyses of RCTs, the likelihood of AF detection and anticoagulation initiation was higher for implantable loop recorders compared with Holter monitors and external loop recorders. DISCUSSION PCM after an IS or TIA can lead to higher rates of AF detection and anticoagulant initiation. There is no solid RCT evidence supporting that PCM may be associated with lower stroke recurrence risk.
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Affiliation(s)
- Georgios Tsivgoulis
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Sokratis Triantafyllou
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Lina Palaiodimou
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Brian Mac Grory
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Spyridon Deftereos
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Martin Köhrmann
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Polychronis Dilaveris
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Brittany Ricci
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Konstantinos Tsioufis
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Shawna Cutting
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Gkikas Magiorkinis
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Christos Krogias
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Peter D Schellinger
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Efthymios Dardiotis
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Ana Rodriguez-Campello
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Elisa Cuadrado-Godia
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Diana Aguiar de Sousa
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Mukul Sharma
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - David J Gladstone
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Tommaso Sanna
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Rolf Wachter
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Karen L Furie
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Andrei V Alexandrov
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Shadi Yaghi
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
| | - Aristeidis H Katsanos
- From the Second Department of Neurology (G.T., S.T., L.P., A.H.K.) and Second Department of Cardiology (S.D.), School of Medicine, "Attikon" Hospital, First Department of Cardiology (P.D., K.T.), School of Medicine, Hippokration Hospital, and Hygiene, Epidemiology and Medical Statistics, Medical School (G.M.), National and Kapodistrian University of Athens, Greece; Department of Neurology (G.T., A.V.A.), University of Tennessee Health Science Center, Memphis; Duke University School of Medicine (B.M.G.), Durham, NC; Department of Neurology (M.K.), Universitätsklinikum Essen, Germany; Department of Neurology (B.R., S.C., K.L.F.), Alpert Medical School, Brown University, Providence, RI; Department of Neurology (C.K.), St. Josef-Hospital, Ruhr University, Bochum; Departments of Neurology and Neurogeriatry (P.D.S.), Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany; Department of Neurology (E.D.), University of Thessaly, Larissa, Greece; Stroke Unit (A.R.-C., E.C.-G.), Department of Neurology, Group of Research on Neurovascular Diseases, Hospital Del Mar Medical Research Institute. DCEX, Universitat Pompeu Fabra, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (Neurology) (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal; Division of Neurology (M.S., A.H.K.), McMaster University and Population Health Research Institute, Hamilton; Sunnybrook Research Institute and Hurvitz Brain Sciences Program (D.J.G.), Sunnybrook Health Sciences Centre, and Department of Medicine, University of Toronto, Canada; Fondazione Policlinico Gemelli IRCCS (T.S.); Catholic University of the Sacred Heart (T.S.), Institute of Cardiology, Rome, Italy; Clinic and Policlinic for Cardiology (R.W.), University Hospital Leipzig, Germany; and Department of Neurology (S.Y.), New York University School of Medicine, NY
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