Browsing by Author "Pucite, Elina"
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Item CARDIOEMBOLIC STROKE IN LATVIA : PREVENTION AND LONG-TERM OUTCOME(Central Bohemia University, 2016) Pucite, Elina; Jurjans, Kristaps; Miglane, Evija; Lurina, Baiba; Kalējs, Oskars; Millers, Andrejs; Priede, Zanda; Department of Neurology and Neurosurgery; Department of Internal DiseasesNTRODUCTION:Untreated non-valvular atrial fibrillation is one of major causes of stroke. The goalof the study was to evaluate the use of antithrombotic medication stroke prevention and assess long-term stroke outcome.METHODS:This study involved 531 cardio embolicstroke patients of thePaul’sStradins Clinical University Hospital, Riga, Latvia,in 2014. After dischargethe patients or their relatives were interviewed by phone after 30, 90, 180, and 365 days. Standardized questions were asked about the patients’abilities and use of prescribed secondary prevention medication. Theresults were compared between patient groups, assigned according to prescribed medications. RESULTS:Of all the patients included in the study,8.9% were using oral anticoagulants before stroke onset. One year after discharge,1.44% of patients were not using any preventivemedication, 23.56%were using antiplatelet agents, 43.27% warfarin,and 31.73% target-specificoralanticoagulants. The one-year mortality ratewas 40.7%. The mortality rate was significantly higher in the patient group using no secondary preventivemedication or antiplatelet agents compared to the patient group that used oral anticoagulants. CONCLUSION:Cardio embolicstroke primary and secondary prevention in Latvia islacking. The study outcomes suggest that action is neededto increase the use of oral anticoagulants in primary stroke prevention in patients with atrial fibrillation. Poor function outcomes, dementia,and patients’incompliance limits the use of oral anticoagulants in secondary preventionItem Health-Related Quality of Life among Patients with Severe Carotid Artery Stenosis(2015-01-01) Pucite, Elina; Šlisers, Marius; Miglāne, Evija; Krieviņš, Dainis; Millers, Andrejs; Blimhena, Inese; Department of Neurology and NeurosurgeryInformation about changes of health-related quality of life (HRQoL) after revascularisation as well how revascularisation procedure influences daily activities, cognitive functioning and general health is controversial. The objectives of our study were to evaluate and describe the HRQoL among patients with severe carotid artery disease; to evaluate the difference of HRQoL between symptomatic and asymptomatic carotid artery disease; and to explore the possible associations between some demographic and clinical characteristics of patients with carotid artery disease and HRQoL. The cross-sectional study included 33 patients who were referred for carotid artery endarterectomy. Data assessment was done one to three days before surgery. The HRQoL was assessed using the Medical Outcome Survey Form 36 (SF-36v2). Patients with symptomatic carotid artery disease had the lowest mean SF-36v2 scores for physical functioning, role-physical, general health and mental health. There was moderate correlation (rs= 0.441) between mean SF-36v2 scores of mental health and Montreal Cognitive Assessment Scale (MoCA) scores. There is also indirect indication for probable correlation between MoCA test scores and mean SF-36v2 scores of social functioning, which might become statistically significant if more patients would be included. Patients with severe carotid artery disease in our study had lower mean SF-36v2 scores for role-physical, for bodily pain and for perception about their health status (general health). HRQoL in patients with severe carotid artery, stenosis was poorer in patients with symptomatic carotid artery disease and was not affected by gender and other clinical characteristics.Item IMPACT OF CAROTID ENDARTERECTOMY ON COGNITIVE PERFORMANCE AND DEPRESSIVE SYMPTOMS(Central Bohemia University, 2016) Pucite, Elina; Slisers, Marius; Miglane, Evija; Krievins, Dainis; Erts, Renars; Jurjans, Kristaps; Krievina, Ildze; Department of Neurology and NeurosurgeryItem Influence of severe carotid stenosis on cognition, depressive symptoms and quality of life(2017) Pucite, Elina; Krievina, Ildze; Miglane, Evija; Erts, Renars; Krievins, Dainis; Department of Neurology and NeurosurgeryBackground: Carotid artery disease is not just a causal risk factor of ischemic stroke, but may predispose patients to depressive symptoms and low health related quality of life (HRQoL). Objectives: The objectives of the present study were to assess the association between severe carotid artery stenosis (CAS) and cognitive impairment, frequency of depressive symptoms and status of HRQoL. Methods: Cross - sectional study involved 55 patients with severe CAS and 54 patients with lower extremity peripheral artery disease (PAD). Cognitive impairment was assessed using Montreal Cognitive Assessment Scale (MoCA), depressive symptoms - PHQ-9 scale. HRQoL was measured using Medical Outcome Survey Short Form version 2 (SF-36v2). Results: Median MoCA score 24 [23;26] was significantly lower in patients with severe CAS than in patients with PAD - 26 [25-28],(p=0.005; effect size r=0.3). There was no statistically significant difference of median PHQ-9 scores the in CAS group (median PHQ-9 score 4.0 [5]) and in the PAD group (median PHQ-9 score 5.5 [7]), (p=0.08, effect size r=0.18). Mean SF-36v2 scores were similar in CAS and PAD groups except for bodily pain (p=0.001, Cohen's d value = 0.77) and vitality (p=0.02, Cohen's d value = 0.49). Conclusion: In summary, our findings indicate that severe CAS could play a role in cognitive decline. Further studies should be conducted using larger patient cohorts without ischemic brain lesions and with balanced vascular risk profiles to investigate impact of CAS on cognition. There was no association between severe CAS and depressive symptoms in the present study. As patients with severe CAS did not exhibit physical symptoms, HRQoL was better for those patients than for patients with lower extremity PAD.Item Ischemic Stroke Due to Middle Cerebral Artery M1 Segment Occlusion : Latvian Stroke Register Data(2015-09-01) Valante, Ramona; Blimhena, Inese; Miglāne, Evija; Millers, Andrejs; Balodis, Arturs; Pucite, Elina; Department of Neurology and NeurosurgeryThe occlusion of middle cerebral artery (MCA) is the most common cause of ischemic stroke. A retrospective single centre analysis of ischemic stroke was conducted using data from the Latvian Stroke Register in the period from January 2013 till December 2014. The study included 478 patients who had confirmed MCA occlusion using computed tomography angiography (CTA). Half of the patients were males-237 (49.6%), average age 69.51, average age of females was 74.58 years. Cardioembolic stroke was the most common cause of MCA M1 segment occlusion in 294 (61.5%) cases. Small cerebral artery occlusion was not a cause of M1 MCA occlusion. The reperfusion therapy group consisted of 209 patients and the conservative therapy group of 269 patients. Both groups presented similar neurological status when they were admitted to hospital. However, the reperfusion therapy group had better neurological status (NIHSS 6.82) than in the conservative therapy group (NIHSS 8.2) at the time period when patients were discharged from hospital (p < 0.05). There were more cases of good functional outcome (39.2%) and less of poor (34.5%) in the reperfusion group, as well as less mortality-7.6%. Middle cerebral artery (MCA) is the most common site of stroke and the most common cause of its occlusion is cardioembolism. There is high incidence of recurrence of stroke due to M1 MCA occlusion. Both groups presented a similar neurological status on admission, but more improvement was seen in the reperfusion therapy group after discharge of patients from hospital. The functional outcome was also better in the reperfusion therapy group.