In patients with insulin-treated diabetes, initiating use of flash glucose monitoring (fCGM) has the potential to improve symptoms of depression, according to findings of a new study from investigators at the University Medical Center Groningen in the Netherlands. 

, have significant implications, the authors note, given the 3-fold and 2-fold higher prevalence of depression among persons with type 1 and type 2 diabetes, respectively, compared with persons without diabetes. 

The authors write, too, that glycemic control is worse among adults with diabetes and comorbid depression and that this population is more likely to have both micro- and macrovascular complications. Further, research identifies the burden of intensive diabetes self-management as a determinant of depression in diabetes.

The authors hypothesize that use of fCGM could alleviate the stress of self-management and so help reduce depression. The existing literature on the relationship, they point out, is scarce and outcomes conflicting. They designed their study to help fill the information voids on the effects of long-term fCGM use and emotional wellbeing among insulin-treated diabetes patients.

Their post-hoc analysis utilized data from the prospective FLAsh monitor REgistry in the NetherLands (FLARE-NL) (2016-2017). A total of 674 persons who had initiated fCGM and continued to use it for 12 months were included in the current study. Half the cohort was men and mean age was 48.2 years. The majority (78.2%) had type 1 diabetes (T1D) and 14.5% had insulin-treated type 2 diabetes (T2D).

For the primary outcome, the investigators designated the difference in the rate of persons with a Short Form-12 Mental Component Score (SF-12 MCS) ≤45 (indicative of a depressive disorder) between baseline and 6 and 12 months after fCGM initiation.

They also investigated changes in MCS over time for the total population and several subgroups. In addition, they assessed the association between the difference in MCS over the study period and other variables.

The average MCS score at baseline was 48.5 which improved to 50.7 after 6 months of fCGM use and rose to 51.3 after 12 months. Average baseline MCS was lower among women (47.1 vs 50 for men), although scores improved over time for both women and men.

At baseline, 235 (34.9%) participants had an SF-12 MCS ≤45. After 6 months, the number of participants with MCS ≤45. decreated to 202 (30.0%) and after 12 months to 173 (25.7%) (P<.01).

Both men and women with baseline MCS scores ≤45 recorded improvments at 6 and 12 months, with scores increasing to 45.2 and 43.6, respectively, after 12 months. Improvements were seen for all baseline HbA1c categories. Further, improvements were significant for participants with depressive disorder at baseline, with numerical, nonsignificant increases in MCS from baseline to 1 year for those with higher baseline scores.

In multivariable analysis, the investigators found that lower MCS and younger age at baseline were the only significant predictors of MCS improvement over 1 year.

The authors observe that their study does provide new information to help better understand the relationship between use of fCGM and amelioration of depressive disorders among persons with diabetes, but add, “Our findings should be interpreted with caution and its [sic] clinical relevance has to be proven in future studies.”

Reference: Bakker JJ, Lameijer A, Guerrero JLF, Bilo HJK, van Dijk PR. 

Commencement of flash glucose monitoring is associated with a decreased rate of depressive disorders among persons with diabetes (FLARENL7). 

BMJ Open Diabetes Res Car. 2022: 10: e002769.doi:10.1136/ bmjdrc-2022-002769

Articles

Flash CGM Initiation May Improve Depression in Persons with Diabetes 

New research found patientcharacteristics associated with discussions of wearable devices during primary care visits include female sex, higher income, and obesity.

On the other hand, patients who were older and with more comorbidities were less likely to talk about wearable devices with their primary care clinician, according to data published in 

Circulation: Cardiovascular Quality and Outcomes

“Wearable devices are common and often record data relevant to cardiac health, including physical activity, heart rate, electrocardiograms, and atrial fibrillation (AF) episodes. The degree to which wearables are discussed in health care settings remains unknown,” wrote researchers from the Massachusetts General Hospital and Harvard Medical School in Boston.

Investigators assessed the mention of wearable devices, such as smartwatches and fitness trackers, in provider notes as a surrogate for how often they are discussed in health care settings. Included in the analysis were over 21 million provider notes across 492 192 patients (mean age, 48 years; 60.7% women; 75.9% White) with 2 primary care visits 1 to 3 years apart between 2005 and October 28, 2019. Expressions used to search for wearable devices included AliveCor Kardia, Apple Watch, Fitbit, Garmin, and generic terms such as “smartwatch,” “fitness tracker,” and “step tracker.”

Patient-level factors associated with device mention were assessed using logistic regression, with covariates including age at cohort entry, sex, race, ethnicity, median zip code income, and baseline comorbidities, according to the study abstract.

The most common comorbidity in this cohort was hypertension (32.3%) followed by hyperlipidemia (24.7%). Also, AF/atrial flutter (AFL) was present in 3.2% of patients and 7.5% of participants had other arrhythmias.

Annual mention of wearable devices increased from 0.0002% of provider notes in 0.0006% of patients in 2005 to 0.14% of notes in 0.89% of patients in 2019. Fitbit was the most common wearable, accounting for 74.1% of all patients with devices, and accounted for a rapid rise in mentions between 2012 and 2016, before declining in 2017, according to researchers.

Patient-level factors associated with device mention were female sex (odds ratio [OR], 1.43; 95% CI, 1.36-1.50), higher income (OR, 1.27 per $50 000; 95% CI, 1.27-1.31), obesity (OR, 2.34; 95% CI, 2.21-2.48), AF/AFL (OR, 1.72; 95% CI, 1.54-1.93), hyperlipidemia (OR, 1.40; 95% CI, 1.33-1.48), other arrhythmias (OR, 1.29; 95% CI, 1.19-1.39), and hypertension (OR, 1.28; 95% CI, 1.21-1.35).

Individuals who self-identified as White experienced higher odds of wearable device mention compared with other races and ethnicities, according to the abstract. Characteristics associated with lower odds of wearable device mention included presence of heart failure, pacemaker/implantable cardioverter defibrillator, peripheral artery disease, stroke/transient ischemic attack, and older age.

Characteristics associated with discussions of wearable devices during primary care visits include female sex, higher income, and obesity, showed new study. 

Sex, Income, and Obesity Among Factors Related to Discussions of Wearable Devices in Primary Care Settings

Patient Care spoke with renowned cardiologist Dr Mikhail Kosiborod and widely-recognized family physician Dr Neil Skolnik, about the expanded indications for sodium-glucose cotransporter-2 (SGLT2) inhibitors and how their availbility creates the perfect opportunity to broaden the scope of type 2 diabetes (T2D) management, with treatment goals that target a patient's full cardiometabolic profile, not elevated blood glucose alone.  

In this final part of the conversation Kosiborod and Skolnik each highlight 3 thoughts for primary care clinicians to keep in mind that will help broaden their view of caring for their patients with T2D.  

For more of the conversation with Drs Kosiborod and Skolnik, please see:  

SGLT-2 Inhibitors Belong to Patients, Not a Specialty or Primary Care: Experts Discuss

Where Should SGLT-2 Inhibitor Therapy Begin? Thoughts from Drs Mikhail Kosiborod and Neil Skolnik

is professor of medicine, University of Missouri Kansas City, vice president, Research, Saint Luke’s Health System, executive director, Cardiometabolic Center Alliance, Director, Cardiometabolic Research and codirector, Haverty Cardiometabolic Center of Excellence, Saint Luke’s Mid America Heart Institute, Kansas City, MO.

is professor of family and community medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.

Videos

Drs Mikhail Kosiborod and Neil Skolnik discuss this unique moment in the history of T2D management that offers treatments to address its broad cardiometabolic impact. 

Beyond HbA1c: Take a Global Approach to Type 2 Diabetes Management, Use all the Tools 

In persons with a diagnosis of chronic obstructive pulmonary disease (

), the trivalent seasonal influenza vaccine (TIV) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) can reduce the risk of hospitalization for acute exacerbations of COPD (AECOPD), 

a, and related illnesses, according to study findings published recently in the journal 

The study authors found similar results whether the 

 were administered separately or together.

As context for their research, investigators from the National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China, point to the gap in research looking at the efficacy of the 2 vaccines, alone or combined, against poor outcomes in COPD. 

Using a self-controlled, before-and-after design, the researchers first recruited patients from hospitals in Tangshan City of Hebei Province in China during September 2018. Eligibility required a diagnosis of COPD and a postbronchodilator forced expiratory volume in 1 second-to-forced vital capacity (FEV

Participants were self-selected into 3 groups based on 

 between October 31, 2019, and November 15, 2019: TIV, PPSV23, or both vaccines.

The final cohort numbered 474 patients who had received at least 1 vaccine. The median age of the patients was 66 years and 285 (60.13%) were aged ≥65 years. The majority (78.48%) were men, and investigators noted that 73.8% were coal miners or former coal miners. COPD was diagnosed most commonly as moderate or severe. 

The vaccine groups were as follows: TIV, n=109; PPSV23, n=69; both, n=296.

During the 2-year follow up period, there were 427 outcome-related events. Of those AECOPD, pneumonia, and hospitalizations accounted for 30.91%; AECOPD and pneumonia, 8.43%; AECOPD and hospitalization, 36.77%; pneumonia and hospitalization, 3.04%; AECOPD, 19.20%; and pneumonia, 1.64%.

, pneumonia, and related hospitalization outcomes before and after vaccination for each group were, respectively:

 for AECOPD, pneumonia, and related hospitalization for each group was, respectively

The largest decrease in incidence density was seen for AECOPD. In addition, incidence densities were greater for older participants (aged ≥65 years) vs younger and were reported to be lower among women.

After multivariable adjustment for age, gender, occupation, COPD severity, smoking status, and underlying disease, the effectiveness of each vaccine and of the combination for preventing AECOPD, pneumonia, and related hospitalization was, respectively:

 70% (95% CI, 49%-82%), 59% (95% CI, 11%-81%), and 58% (95% CI, 26%-76%)

: 54% (95% CI, 26%-71%), 53% (95% CI, 8%-76%), and 46% (95% CI, 8%-69%)

: 72% (95% CI, 62%-79%), 73% (95% CI, 58%-83%), and 69% (95% CI, 57%-77%)

The authors report, also, that vaccine effectiveness was found higher for all 3 variables outside of the nonpharmaceutical intervention period of the COVID-19 pandemic.

They conclude that TIV and PPSV23 vaccines effectively reduced the risk of AECOPD, pneumonia, and related hospitalizations, with the greatest impact in reducing AECOPD.

“Considering consistency of our results with similar studies, we infer that the effectiveness of both vaccines together is superior to effectiveness of TIV alone and that TIV is more effective than PPSV23 alone,” the authors wrote.

They also note several study limitations. Group allocation was by self-selection, which could lead to bias in group composition, limiting the ability to generalize the findings. In addition, they speculate that vaccine effectiveness may have been influenced by nonpharmaceutical intervention due to the COVID-19 pandemic (eg, masking, social distancing).

 Effectiveness of influenza and pneumococcal vaccines on chronic obstructive pulmonary disease exacerbations. 

Respirol. Published online June 15, 2022. doi:10.1111/resp.14309

In persons with COPD, seasonal influenza and PPSV23 vaccines, separately or together, reduced the risk for COPD- and pneumonia-related hospitalizations.  

Influenza, PPSV23 Vaccines May Reduce Risk for COPD Exacerbations, Hospitalizations 

How many fully vaccinated Americans have received a booster dose?

Centers for Disease Control and Prevention (CDC)

47.8% of fully vaccinated persons in the US 

 have received a booster dose of COVID-19 vaccine.

What percentage of people across age groups in the US have been fully vaccinated?

How many cases of COVID-19 have been confirmed in the US?

as of today, June 30, 2022 at 4:20 PM, EDT, there have been:

In the past 28 days, the 3 states with the most new cases are:

 has the highest number of deaths due to COVID-19 with 92 235 reported fatalities, followed by 

How many cases of COVID-19 have been confirmed globally?

Data from the CDC on boosters and US vaccination rates and from the Johns Hopkins COVID-19 interactive map on cases and deaths in the US and worldwide.

COVID-19 Updates: US Vaccinations, Booster Doses, & Global Data as of June 30, 2022

Factors contributing to physicians considering and committing suicide include poor physical and mental health, substance use, relationships, and finances, according to a study from researchers at the University of California San Diego (UCSD) that used a novel approach to characterize specific stressors that precede a clinician suicide

One in 15 physicians reports suicidal ideation, according to a 

, but despite consistent evidence that physicians are more likely than nonphysicians to experience work-related stress leading up to suicide, a clear understanding of what creates that burden is lacking.

The UCSD research team identified 6 overarching themes contributing to physician job stress and suicide.

“There is a lot of work to be done,” corresponding author Kristen Kim, MD, said in the UCSD statement. “But identifying and acknowledging the problem is always the first step towards a solution, and that’s exactly what we’re doing.”

Kim and colleagues used a mixed methods approach to examine narratives from 200 physician suicides, collected by the National Violent Death Reporting System database between 2003 and 2018. The researchers used natural language processing and thematic analysis to interpret data from the reports, identifying 6 primary themes:

An incapacity to work due to deterioration of physical health

Substance use that was jeopardizing employment

The interaction between mental health and work-related issues

“We often overlook the physical health of our health care workers, but poor health can lead to difficulty performing tasks at work, which then leads to job stress and mental health issues,” said Kim, a resident physician in psychiatry at UC San Diego Health.

Kim and the research team outlined both short- and long-term strategies for health care systems to consider.

Short term approaches include improving access for physicians to primary care services, creating ways to minimize scheduling challenges, and addressing physicians’ long-standing concerns about confidentiality. Where they are available, Kim encourages health care providers to access targeted clinician support programs. She describes the UCSD Healer Education Assessment and Referral Program, which provides access to confidential mental health counseling. That program, now serving physicians and nurses at more than 60 medical campuses, was endorsed in the 

Considering long-term solutions, the authors call for broader structural and cultural changes to address workplace stress and poor physician self-care. They suggest, too, that health care systems and medical schools should provide clinicians with additional personal finance education and legal support.

Foremost is cultivating a sense of safety and community among physicians

“The unspoken culture of medicine encourages self-sacrifice, deferred needs and delayed rewards,” Kim said. “We always want to put our patients first, but healers cannot optimally heal unless they themselves are first whole.”

Reference: Kim K, Ye GY, Haddad AM, et al. T

hematic analysis and natural language processing of job-related problems prior to physician suicide in 2003–2018.

 Suicide Life Threat Behav. Published online ahead of print June 29, 2022. doi.org/10.1111/sltb.12896

Suicidal ideation affects 1 in 15 physicians and job-related stress is often a reason for a suicide among them. A new study set out to find specifics. 

Study Pinpoints 6 Job-related Stressors Linked with Physician Suicide 

In a Thursday press release, the US Food and Drug Administration (FDA) recommended the inclusion of a SARS-CoV-2 Omicron component in 

The announcement comes after the FDA’s Vaccine and Related Biological Products Advisory Committee (VRBPAC) one day earlier 

 90% “yes” to recommend that the fall and winter 2022 COVID-19 booster doses target the Omicron variant, which has been the 

 circulating in the US since December 2021.

“As we move into the fall and winter, it is critical that we have safe and effective vaccine boosters that can provide protection against circulating and emerging variants to prevent the most severe consequences of COVID-19,” stated Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research, in the 

. “Following a thorough discussion on June 28, 2022, an overwhelming majority of the advisory committee voted in favor of including a SARS-CoV-2 omicron component in COVID-19 vaccines that would be used for boosters in the U.S. beginning in fall 2022.”

After the VRBPAC meeting, the FDA advised vaccine manufacturers seeking to update their COVID-19 vaccines to develop modified shots that add an Omicron BA.4/5 spike protein component to the current vaccine composition to create a bivalent booster vaccine. The modified vaccines could potentially become available starting in early to mid-fall 2022, added Marks.

“As we expect this coming year to be a transitional period when this modified booster vaccine may be introduced, we have not advised manufacturers to change the vaccine for primary vaccination, since a primary series with the FDA-authorized and approved COVID-19 vaccines provides a base of protection against serious outcomes of COVID-19 caused by circulating strains of SARS-CoV-2,” said Marks.

 findings from clinical trials with modified vaccines containing an Omicron BA.1 component to submit the data to the FDA for evaluation before potential authorization of a modified vaccine with an Omicron BA.4/5 component. “Manufacturers will also be asked to begin clinical trials with modified vaccines containing an omicron BA.4/5 component, as these data will be of use as the pandemic further evolves,” continued Marks.

“In keeping with our commitment to transparency, the FDA will communicate future plans pertaining to the potential authorization or approval of COVID-19 vaccine booster doses with an omicron component,” concluded Marks.

The FDA recommended on Thursday the inclusion of a SARS-CoV-2 Omicron component in COVID-19 vaccine booster doses.

FDA Recommends COVID-19 Booster Doses Optimized for Omicron Variant

Pain caused by lumbar spinal stenosis is believed to result from narrowing of the lumbar spinal canal and/or the neural foramina, which causes pressure on the spinal nerve roots as they exitthe spine. The narrowing is usually considered to be the result of degenerative changes in the spine, such as the development of osteophytes, degeneration of the intervertebral discs, and thickening of spinal ligaments. Degenerative changes are commonly the result of aging, therefore spinal stenosis is primarily a disorder of the geriatric population. However, the explanation of the pain only being related to the impingement of the nerve roots appears to be overly simplistic. As with many other forms of low back pain, there is only a limited correlation between the pain of spinal stenosis and radiologic findings. Although approximately 20% of those older than 60 have lumbar spinal stenosis based on imaging, more than 80% of them appear to be asymptomatic. In the slides below, find important takeaways from a review that may help clinical practice.

Diagnosis and Treatment of Lumbar Spinal Stenosis

Slideshows

A new review summarized the current evidence about diagnosis and treatment of lumbar spinal stenosis. What are the key takeaways for primary care?

In the first known head-to-head study between inhaled glycopyrrolate/ formoterol (GFF) and tiotropium/formoterol (TFF) combinations to treat patients with chronic obstructive pulmonary disease (COPD), GFF was found noninferior to TFF in improving COPD outcomes.

Contemporary Clinical Trials Communications

, study authors from the SRM Institute of Science and Technology in Tamil Nadu, India, write that safety profiles and tolerability also were similar between the 2 treatments.

Inhaled bronchodilators, ie, long-acting ß-agonists (LABAs) and long-acting muscarinic antagonists (LAMA), administered alone or in combination, serve as the “backbone” for management of stable, moderate-to-severe COPD, the authors write. Past research, they observe, supports comparable safety and efficacy of the 2 LAMAs glycopyrrolate and tiotropium, the latter often considered long-term COPD management’s “gold standard” and the former recognized for more rapid onset of action and fewer side effects.

Missing from the literature, however, are studies that directly compare the 2 agents when each is administered in combination with the LABA formoterol, presenting the opportunity for the current study.

The investigators conducted a pilot prospective, open-label, parallel-arm study recruiting patients at a tertiary care hospital in the Chengalpattu district, Tamil Nadu, India. Criteria for participation included age ≥40 years with prior history of smoking and a diagnosis of moderate/severe COPD (GOLD guidelines stage 2 or 3). Enrollment also required a postbronchodilator forced expiratory volume /1s (FEV

) ≥30%/<80% of predicted as well as postbronchodilator FEV

/forced vital capacity (FVC) <0.70 at screening.

The primary study outcome was to demonstrate noninferiority between the 2 therapies in FEV

 at the end of a 12-week treatment period. The secondary study outcome was an improvement in the FEV

/FVC ratio and overall health status. Investigators used spirometry to evaluate FEV

/FVC ratio at baseline, then at weeks 4, 8, and 12. Researchers also evaluated change in health status using the St George’s Respiratory Questionnaire (SGRQ). 

A total of 60 patients with moderate to severe COPD were randomized 1:1 to the GFF group (n=30) or to the TFF group (n=30). Mean age distribution between groups was 52.5 and 69.5 years, respectively; overall, 72% were men. More than half the participants in each group had a positive smoking history and the mean duration of COPD was 4.6 years. The mean post-bronchodilator FEV

 predicted percentage was 61% and the post-bronchodilator FEV

/FVC ratio was 64%. Diabetes was the most common comorbidity across the groups (40%) followed by hypertension (30%). Of the 60 original participants, 58 completed the study.

Reporting on the primary outcome the authors found that for both treatment groups there was a significant difference in average  FEV

 from baseline to week 12, 1.49 ± 0.38 (GFF) and 1.38 ± 0.30 (TFF) (P<.01) and that pairwise comparison of mean  FEV

 showed significant improvement among all pairs of time points (P<.01). The  FEV

/FVC ratios at 12 weeks were 0.67 ± 0.09 (GFF) and 0.75 ± 0.08 (TFF) (

Importantly the authors found that for both treatment groups, there was a significant difference in mean FEV

/FVC ratio values when baseline measures were compared with last follow-up (

 <.01) but that no remarkable variation (p=.14) was observed in FEV

Following treatment, health status assessment per SGRQ demonstrated significant improvement in both groups.

Adverse drug reactions were more common among participants in the TFF arm compared with the GFF arm, according to the study, with dry mouth, constipation, and frequent urination/urinary retention reported most frequently.

In their conclusion the authors state their results demonstrate that treatment of COPD with a GFF combination was noninferior to treatment with a TFF combination for symptom improvement. They add that while safety and tolerability of the 2 combinations were comparable, GFF tolerability was somewhat better and so, they suggest, a GFF combination could be prescribed for those patients unable to tolerate TFF side effects. Further, they note that GFF could be considered for COPD long-term maintenance therapy.

The authors write that their study has limitations, including the small sample size and relatively short duration. Additionally, the open-label design of the study might have led to selection bias.

Reference: Jayanthi N, Krishnan K, Sudhir M, Girija S, et al. 

Comparative study on the effectiveness of glycopyrrolate/formoterol versus tiotropium/formoterol in patients with chronic obstructive pulmonary disease.

 Contemp Clin Trials Commun. Published online May 27, 2022. doi:10.1016/j.conctc.2022.100931

Authors of this first study to compare the combinations head-to-head suggest that the glycopyrrolate combination is appropriate for long-term COPD management. 

Glycopyrrolate/formoterol found Noninferior to Tiotropium/formoterol for Improving COPD Symptoms

A new study of more than 4000 patients who experienced an 

found that fully two-thirds (67%) had at least 1 or more undiagnosed risk factor at the time of the event, the most common being dyslipidemia and hypertension. The results were presented recently at the European Academy of Neurology (EAN) Congress 2022.

“Our findings underline the importance of testing and treating blood fat imbalances such as high cholesterol and triglyceride levels, as well as blood pressure and identifying and treating those with atrial fibrillation and type 2 diabetes”, said lead investigator André Rêgo, of the Lausanne University Hospital in Switzerland, 

As context for their research, Rêgo and colleagues point to the need for more clinical information on the profile of patients with acute ischemic stroke who have previously undiagnosed major vascular risk factors and the underlying mechanisms and frequency of those strokes.

To add to the "scarce" research available, the team conducted a retrospective analysis of data from the Acute Stroke Registry and Analysis of Lausanne, which provided information on all consecutive patients admitted to the Lausanne University Hospital with acute ischemic stroke who presented within 24 hours of symptom onset between January 1, 2003, and December 31, 2018.

After exclusion criteria were applied, the final cohort for analysis numbered 4354 patients. The median age of patients was 70 (IQR, 15.2) years and 44.7% were women.

Of primary interest was the prevalence of previously undiagnosed risk factors and their association with demographic, clinical, therapeutic and, importantly, prognostic variables. Both univariate and multivariate regression models were applied.

Rêgo et al report that 67.7% of patients had at least 1 undiagnosed major risk factor. Among the undiagnosed major risk factors, the most common was 

(10.2%), diabetes mellitus (5.2%), ejection fraction <35% (2.0%), and coronary disease (1.0%). 

Results of the multivariate analysis showed a positive association between lower age, non-Caucasian ethnicity, patent foramen ovale (PFO), contraceptive use (patients aged <55 years) and smoking (patients aged >55 years) and increased likelihood of undiagnosed major risk factors.

The team reports, however, that it found negative associations for antiplatelet use before an ischemic stroke and higher body mass index.

Multivariate analysis to better understand specific stroke mechanisms found frequency was higher for PFO-related stroke and lower for large vessel, lacunar, cardiac, or stroke of multiple coexisting causes. When the researchers evaluated functional outcomes at 12 months and cerebrovascular recurrence, they found no differences based on presence/absence of undiagnosed major risk factors.

The key differences identified between ischemic stroke patients with and without undiagnosed major risk factors, the authors summarize in the study abstract, were younger age, presence of PFO, and both contraceptive and tobacco use in the former group.

“Prior to our study there was scarce clinical information about the frequency, patient profile and stroke mechanisms in patients with acute ischemic stroke with previously undiagnosed major vascular risk factors. We hope that this study will help to identify potential stroke patients that require more intensive prevention techniques and surveillance in the future,” Rêgo added.

Reference: Rego A, Nannoni S, Scherz A, et al. 

Undiagnosed major risk factors in patients with acute ischaemic stroke: clinical profile, stroke mechanisms and outcome.

 Eur J Neurol. 2022;29. Accessed June 29, 2022. Available at: https://www.ean.org/fileadmin/user_upload/ean/congress-2022/EAN2022AbstractBook.pdf

Three-quarters of stroke patients in a Swiss registry had at least 1 undiagnosed risk factor at the time of the event, most commonly hyperlipidemia or hypertension. 