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Life
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Etiology, Prediction and Prognosis of Ischemic Stroke
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Etiology, Prediction and Prognosis of Ischemic Stroke

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 4715

Special Issue Editors

Dr. Vida Abedi

E-Mail Website
Guest Editor
Department of Public Health Science, Penn State College of Medicine, Hershey, PA, USA
Interests: machine learning; clinical informatics; healthcare innovation; EHR/EMR mining; natural language processing; complex diseases; outcome prediction; health disparity; machine learning-enabled decision support system; stroke; transient ischemic attack; cerebrovascular medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Ramin Zand

E-Mail Website
Guest Editor
Department of Neurology, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
Interests: stroke; cerebrovascular medicine; clinical informatics; atrial fibrillation; EHR; health disparity; neuroimaging; outcome prediction; machine learning and artificial intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Jiang Li

E-Mail Website
Guest Editor
Department of Molecular and Functional Genomics, Weis Center for Research, Geisinger Health System, Danville, PA, USA
Interests: genomics; precision medicine; polygenic risk score (PRS); outcome prediction; EHR/EMR mining

Special Issue Information

Dear Colleagues,

Ischemic stroke is a significant global health challenge, prompting the need for comprehensive exploration. This Special Issue endeavors to collate pioneering research on the etiology, prediction, and prognosis of ischemic stroke.

We welcome submissions of papers that underscore the genetic, lifestyle, and environmental factors contributing to ischemic stroke, and highlight the innovative biomarkers and imaging methodologies for early detection and better prognosis. Additionally, we encourage articles addressing the methodological advancements, particularly in the context of cerebrovascular diseases.

With the aim of promoting team science and fostering collaboration, this Special Issue invites researchers and experts from all relevant fields to enrich our comprehension of ischemic stroke while advancing prevention and treatment strategies through cutting-edge methodologies and multimodal data.

Dr. Vida Abedi
Dr. Ramin Zand
Dr. Jiang Li
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ischemic stroke
  • recurrent stroke
  • etiology
  • machine learning
  • artificial intelligence
  • subtyping
  • prediction
  • prognosis
  • genetic risk factors
  • lifestyle factors
  • environmental factors
  • biomarkers
  • cerebrovascular diseases
  • prevention
  • treatment strategies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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18 pages, 3855 KiB  
Article
Is Thrombectomy Effective for Large Vessel Occlusion Stroke Patients with Mild Symptoms? Meta-Analysis and Trial Sequential Analysis
by Kuan-Chih Chen, Te-Wei Li, Ji-Kuan Huang, Cheng-Chieh Huang, Siang-Yan Zhang, Chih-Hung Chen, Zong-Syuan Lin, Po-Huang Chen and Hong-Jie Jhou
Life 2024, 14(10), 1249; https://doi.org/10.3390/life14101249 - 1 Oct 2024
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Abstract
Background: Endovascular treatment (EVT) is an established method for managing large vessel occlusion (LVO), but its efficacy in patients with mild stroke (National Institutes of Health Stroke Scale [NIHSS] score < 6) remains debated. Given the clinical problem of early neurological deterioration in [...] Read more.
Background: Endovascular treatment (EVT) is an established method for managing large vessel occlusion (LVO), but its efficacy in patients with mild stroke (National Institutes of Health Stroke Scale [NIHSS] score < 6) remains debated. Given the clinical problem of early neurological deterioration in approximately 10% of mild stroke patients, understanding the role of EVT in managing these patients is crucial. Our objective was to perform a meta-analysis with trial sequential analysis (TSA) focusing on mild stroke patients with LVO to determine whether EVT offers better outcomes than best medical therapy alone. Methods: A comprehensive search of PubMed, Cochrane, and Embase databases up to 12 December 2023 identified 14 retrospective and prospective cohort studies, including a total of 4436 patients with NIHSS scores less than 6 and presenting with LVO. Studies were categorized into crossover and non-crossover groups to prevent overestimation of the treatment effect. In the crossover group, patients initially treated with BMT were moved to EVT upon clinical deterioration. In the non-crossover group, patients remained in their initially assigned treatment. Meta-analysis and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was achieving an excellent functional outcome, defined as a modified Rankin scale (mRS) score of 0–1 at 3 months. Secondary outcomes included good (mRS 0–2) and favorable (mRS 0–3) functional outcomes. Safety outcomes were symptomatic intracerebral hemorrhage (sICH) and mortality at 3 months. Results: In the crossover group, EVT did not significantly improve excellent functional outcomes, and TSA results were inconclusive. Conversely, in the non-crossover group, EVT significantly improved the excellent functional outcome rates at 3 months (65.0% vs. 53.7%; OR 1.62; 95% CI 1.13 to 2.32), supported by TSA. EVT increased the risk of sICH in both crossover and non-crossover groups, while mortality rates did not significantly differ between EVT and BMT groups. Conclusions: Our research indicates that thrombectomy may not significantly help mild stroke patients in recovering functional status and could increase the risk of sICH. The disparity in results between crossover and non-crossover studies highlights the critical need for the prompt identification of patients at risk of early neurological deterioration to minimize negative outcomes. Additional randomized controlled trials are essential to optimize the application of EVT in this patient population. Full article
(This article belongs to the Special Issue Etiology, Prediction and Prognosis of Ischemic Stroke)
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14 pages, 522 KiB  
Article
An Exercise Prescription for Patients with Stroke and Sarcopenia Based on the Modified Delphi Study
by Jae Wan Yoo, Geun-Young Park, Hae-Yeon Park, Yeun Jie Yoo, Mi-Jeong Yoon, SeungYup Song, Kyung Hyun Park, Hooman Lee, Sangui Choi, Sun Im and Seong Hoon Lim
Life 2024, 14(3), 332; https://doi.org/10.3390/life14030332 - 1 Mar 2024
Cited by 1 | Viewed by 1712
Abstract
Background: We aimed to develop a consensus on the need for and priorities of exercise to treat preexisting sarcopenia with hemiplegic stroke. Methods: A modified three-round Delphi study was conducted. The panelists responded to the questionnaire on a 7-point Likert scale. Responses were [...] Read more.
Background: We aimed to develop a consensus on the need for and priorities of exercise to treat preexisting sarcopenia with hemiplegic stroke. Methods: A modified three-round Delphi study was conducted. The panelists responded to the questionnaire on a 7-point Likert scale. Responses were returned with descriptive statistics in the next round. Consensus was defined as >75% agreement (score of 5–7) with a median > 5. The percentage of strong agreement (score of 6–7) and Kendall’s coefficient of concordance were calculated to demonstrate a more refined interpretation of the consensus. Results: Fifteen panelists contributed to all rounds. The need for exercise was demonstrated. The consensus was reached on 53 of 58 items in the first round and all items in the second and final rounds. The percentage of strong agreement was high for all but eight items. Conclusions: This study is the first Delphi study to investigate the need for and priorities of exercise for treating preexisting sarcopenia in stroke hemiplegia. We present a standard recommendation including 57 priorities and a strong recommendation including 49 priorities. The eight items that were excluded reflected factors that are less important to hemiplegic patients with poor balance, cognitive decline, or mental vulnerability. Full article
(This article belongs to the Special Issue Etiology, Prediction and Prognosis of Ischemic Stroke)
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Other

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14 pages, 2098 KiB  
Systematic Review
Thrombectomy for Ischemic Stroke Beyond 24 Hours: A Meta-Analysis
by Hao-Tse Chiu, Po-Huang Chen, Yen-Yue Lin, Li-Yu Yang, Cho-Hao Lee, Che-Yu Guan and Hong-Jie Jhou
Life 2025, 15(4), 556; https://doi.org/10.3390/life15040556 - 28 Mar 2025
Viewed by 389
Abstract
Background: The DEFUSE-3 and DAWN studies established the benefits of endovascular therapy for patients with stroke with large vessel occlusion in a 6–24 h time window. However, the effectiveness of endovascular therapy performed beyond 24 h remains uncertain. The purpose of this meta-analysis [...] Read more.
Background: The DEFUSE-3 and DAWN studies established the benefits of endovascular therapy for patients with stroke with large vessel occlusion in a 6–24 h time window. However, the effectiveness of endovascular therapy performed beyond 24 h remains uncertain. The purpose of this meta-analysis is to evaluate the difference in prognosis between thrombectomies performed beyond 24 h and within 24 h from ischemic stroke onset. Methods: A systematic review was conducted using the PubMed, Cochrane, and Embase databases from database inception until 1 February 2024. Odds ratios with 95% confidence intervals were calculated. Results: This study included seven cohort articles involving 6137 participants who received endovascular therapy, with 395 patients in the beyond 24 h group and the remainder in the within 24 h group. The results for functional independence, successful reperfusion, any intracranial hemorrhage, symptomatic intracranial hemorrhage, and 90-day mortality rates were similar between the two groups, with odds ratios of 1.06 (95% confidence interval: 0.51–2.19), 1.03 (0.72–1.48), 0.88 (0.64–1.21), 0.76 (0.41–1.40), and 1.32 (0.55–3.19), respectively. Furthermore, all trial sequential analysis results were inconclusive. Conclusions: Functional independence, successful reperfusion, mortality, and intracranial hemorrhage rates did not significantly differ between endovascular therapies performed beyond and within 24 h from ischemic stroke onset. Therefore, endovascular therapy may be considered for patients experiencing ischemic stroke for more than 24 h. However, randomized controlled trials and more cohort studies are needed to confirm these conclusions. Full article
(This article belongs to the Special Issue Etiology, Prediction and Prognosis of Ischemic Stroke)
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