Alexandros A. Polymeris
A5007119825- Acute Ischemic Stroke Management
- Atrial Fibrillation Management and Outcomes
- Intracerebral and Subarachnoid Hemorrhage Research
- Venous Thromboembolism Diagnosis and Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Intracranial Aneurysms: Treatment and Complications
- Medication Adherence and Compliance
- Cardiac Arrhythmias and Treatments
- Neurosurgical Procedures and Complications
- Blood Pressure and Hypertension Studies
- Traumatic Brain Injury and Neurovascular Disturbances
- Neurological Disorders and Treatments
- Antiplatelet Therapy and Cardiovascular Diseases
- Long-Term Effects of COVID-19
- Neurological Disease Mechanisms and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Lipoproteins and Cardiovascular Health
- Cardiac tumors and thrombi
- Esophageal and GI Pathology
- Pharmaceutical industry and healthcare
- Cerebrovascular and genetic disorders
- Osteomyelitis and Bone Disorders Research
- Cancer-related cognitive impairment studies
- Apelin-related biomedical research
University of Basel
2016-2025
University Hospital of Basel
2016-2025
Beth Israel Deaconess Medical Center
2025
Harvard University
2025
University College London
2022-2023
University Hospital of Bern
2017-2023
University of Bern
2017-2023
Felix Platter-Hospital
2016-2022
Biomedical Research Institute
2022
Laboratory for Biomedical Neurosciences
2022
It is not known whether patients with atrial fibrillation (AF) ischemic stroke despite oral anticoagulant therapy are at increased risk for further recurrent strokes or how ongoing secondary prevention should be managed.
International guidelines recommend avoiding intravenous thrombolysis (IVT) in patients with ischemic stroke who have a recent intake of direct oral anticoagulant (DOAC). To determine the risk symptomatic intracranial hemorrhage (sICH) associated use IVT DOAC ingestion. This international, multicenter, retrospective cohort study included 64 primary and comprehensive centers across Europe, Asia, Australia, New Zealand. Consecutive adult received (both without thrombectomy) were included....
<h3>Objective:</h3> In patients with recent acute ischemic stroke (AIS) and atrial fibrillation, we assessed the starting time of direct, non–vitamin K antagonist oral anticoagulants (DOACs) for secondary prevention, rate intracranial hemorrhage (ICH), recurrent events during follow-up. <h3>Methods:</h3> We included consecutive nonvalvular fibrillation admitted to our hospital AIS or TIA (index event) who received prophylaxis DOAC vitamin antagonists (VKAs). Follow-up was at least 3 months....
<h3>Importance</h3> Predicting the duration of poststroke dysphagia is important to guide therapeutic decisions. Guidelines recommend nasogastric tube (NGT) feeding if swallowing impairment persists for 7 days or longer and percutaneous endoscopic gastrostomy (PEG) placement does not recover within 30 days, but, our knowledge, a systematic prediction method exist. <h3>Objective</h3> To develop validate prognostic model predicting recovery need enteral feeding. <h3>Design, Setting,...
Background Prehospital delay reduces the proportion of patients with stroke treated recanalization therapies. We aimed to identify novel and modifiable risk factors for prehospital delay. Methods Results included an ischemic confirmed by diffusion-weighted magnetic resonance imaging, symptom onset within 24 hours hospitalized in Stroke Center University Hospital Basel, Switzerland. Trained study nurses interviewed proxies along a standardized questionnaire. was defined as >4.5 between...
We compared outcomes after treatment with direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients atrial fibrillation (AF) a recent cerebral ischemia.We conducted an individual patient data analysis of seven prospective cohort studies. included AF ischemia (<3 months before starting anticoagulation) minimum follow-up 3 months. analyzed the association between type anticoagulation (DOAC versus VKA) composite primary endpoint (recurrent ischemic stroke [AIS],...
Background and Purpose- Despite treatment with oral anticoagulants, patients nonvalvular atrial fibrillation (AF) may experience ischemic cerebrovascular events. The aims of this case-control study in AF were to identify the pathogenesis risk factors for events occurring during non-vitamin K antagonist anticoagulants (NOACs) therapy stroke prevention. Methods- Cases consecutive who had acute NOAC treatment. Controls did not have NOACs Results- Overall, 713 cases (641 strokes 72 transient...
To investigate the aetiology, subsequent preventive strategies and outcomes of stroke despite anticoagulation in patients with atrial fibrillation (AF). We analysed consecutive AF an index imaging-proven ischaemic vitamin K-antagonist (VKA) or direct oral anticoagulant (DOAC) treatment across 11 centres. classified aetiology as: (i) competing mechanism other than AF-related cardioembolism; (ii) insufficient (non-adherence low activity measured drug-specific assays); or, (iii) cardioembolism...
The "1-3-6-12-day rule" for starting direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation after acute ischemic stroke or transient attack recommends timings that may be later than used clinical practice. We investigated more practical optimal timing of DOAC initiation according to severity. combined data prospective registries Japan, Stroke Acute Management Urgent Risk-factor Assessment and Improvement-nonvalvular (September 2011 March 2014) RELAXED (February...
In patients with atrial fibrillation who suffered an ischemic stroke while on treatment nonvitamin K antagonist oral anticoagulants, rates and determinants of recurrent events major bleedings remain uncertain.This prospective multicenter observational study aimed to estimate the bleeding their in follow-up consecutive acute cerebrovascular event anticoagulant treatment. Afterwards, we compared estimated risks between whom therapy was changed those continued original treatment.After a mean...
Evidence-based hemostatic treatment for intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOACs) is lacking. Tranexamic acid (TXA) an antifibrinolytic drug potentially limiting hematoma expansion. We aimed to assess the efficacy and safety of TXA in NOAC-ICH.We performed a double-blind, randomized, placebo-controlled trial at 6 Swiss stroke centers. Patients NOAC-ICH within 12 hours symptom onset 48 last NOAC intake were randomized (1:1) receive...
Background We investigated outcomes in patients with intracerebral haemorrhage (ICH) according to prior anticoagulation treatment Vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs) or no anticoagulation. Methods This is an individual patient data study combining two prospective national stroke registries from Switzerland and Norway (2013–2019). included all consecutive ICH both registries. The main were favourable functional outcome (modified Rankin Scale 0–2) mortality at 3...
Whether infarct size modifies the treatment effect of early vs late direct oral anticoagulant (DOAC) initiation in people with ischemic stroke and atrial fibrillation is unknown.
Background: Data comparing the specific reversal agent andexanet alfa with non-specific treatments in patients non-traumatic intracerebral hemorrhage (ICH) associated factor-Xa inhibitor (FXaI) use are scarce. Aim: The study aimed to determine association between of compared rate hematoma expansion and thromboembolic complications FXaI-associated ICH. Methods: We performed an individual patient data analysis combining two independent, prospective studies: ANNEXA-4 (180 receiving alfa,...
Serum neurofilament light chain (sNfL) is increasingly used as a neuroaxonal injury biomarker in the elderly. Besides age, little known about how other physiological factors like renal function and body mass index (BMI) alter its levels. Here, we investigated association of estimated glomerular filtration rate (eGFR) BMI with sNfL large sample elderly patients atrial fibrillation (AF).This cross-sectional analysis from Swiss-AF Cohort (NCT02105844). We measured using an ultrasensitive...
We assessed the efficacy and safety of mechanical thrombectomy (MT) in adult stroke patients with anterior circulation large vessel occlusion presenting late time window not fulfilling DEFUSE-3 (Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging trial) DAWN 24 After a Mismatch Between Deficit Infarct inclusion criteria.Cohort study adults admitted between hours after last-seen-well 5 participating Swiss centers 2014 2021. was computer tomography or magnetic...
Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after (AFDAS). However, it is unknown whether this difference confounded by pre-existing anticoagulation, which most common in KAF and also indicates high risk.
Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate hemorrhage in patients atrial fibrillation treated vitamin K antagonists, direct oral anticoagulants, antiplatelets, combination therapy (i.e. concurrent anticoagulant antiplatelet).
Uncertainty remains regarding antithrombotic treatment in cervical artery dissection. This analysis aimed to explore whether certain patient profiles influence the effects of different types treatment.
Women have a worse outcome after stroke compared with men, although in intravenous thrombolysis (IVT)-treated patients, women seem to benefit more. Besides sex differences, age has also possible effect on functional outcome. The interaction of the IVT-treated patients relation remains complex. purpose this study was compare IVT between and men regard large multicenter European cohort reflecting daily clinical practice acute care.Data were obtained from registries 12 tertiary hospitals....
Standard operating procedures (SOP) incorporating plasma levels of rivaroxaban might be helpful in selecting patients with acute ischemic stroke taking suitable for IVthrombolysis (IVT) or endovascular treatment (EVT).This was a single-center explorative analysis using data from the Novel-Oral-Anticoagulants-in-Stroke-Patients-registry (clinicaltrials.gov:NCT02353585) including (September 2012 to November 2016). The SOP included recommendation, consideration, and avoidance IVT if were <20...
Information about rivaroxaban plasma level (RivLev) may guide treatment decisions in patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) taking rivaroxaban.In a multicenter registry-based study (Novel Oral Anticoagulants Stroke Patients collaboration; ClinicalTrials.gov: NCT02353585) of while rivaroxaban, we compared RivLev AIS ICH. We determined how many had ≤ 100ng/ml, indicating possible eligibility for thrombolysis, ICH ≥ 75ng/ml, making them possibly eligible...