Biomedical subjects

J Kokkinos

Publications and source records attributed to J Kokkinos.

4 recordsLinked to original sources

PubMed1995

Recurrent stroke and thrombo-occlusive events in the antiphospholipid syndrome.

We prospectively studied 81 consecutively identified patients with antiphospholipid antibodies (aPLs) who developed focal cerebral ischemia over a 7-year period. The mean age of this cohort was approximately a decade younger than the average atherothromboembolic stroke victim and women were more commonly involved than men. The frequency of conventional stroke risk factors was lowest in the group of stroke patients with the highest levels of IgG cardiolipin immunoreactivity. Other serological abnormalities associated with aPL (false-positive Venereal Disease Research Laboratory test, thrombocytopenia, prolonged activated partial thromboplastin time [aPTT]) were more common in the group with over 100 GPL units (high positive). Patients with the highest IgG anticardiolipin titers had the shortest times to subsequent thrombo-occlusive events. The most common recurrent event was cerebral infarction, often occurring within the first year of follow-up during a mean prospective follow-up of 3 years. Over one-half of the cohort had at least one recurrent thrombo-occlusive event during follow-up. This distinct syndrome of cerebral ischemia should be recognized for its younger age at onset, predominance of women, high risk of recurrent thrombo-occlusive events, and the possible use of the IgG anticardiolipin antibody titer for prognosis.

Adult↗

PubMed1995

The Warfarin-Aspirin Symptomatic Intracranial Disease Study.

We conducted a retrospective, multicenter study to compare the efficacy of warfarin with aspirin for the prevention of major vascular events (ischemic stroke, myocardial infarction, or sudden death) in patients with symptomatic stenosis of a major intracranial artery. Patients with 50 to 99% stenosis of an intracranial artery (carotid; anterior, middle, or posterior cerebral; vertebral; or basilar) were identified by reviewing the results of consecutive angiograms performed at participating centers between 1985 and 1991. Only patients with TIA or stroke in the territory of the stenotic artery qualified for inclusion in the study. Patients were prescribed warfarin or aspirin according to local physician preference and were followed by chart review and personal or telephone interview. Seven centers enrolled 151 patients; 88 were treated with warfarin and 63 were treated with aspirin. Median follow-up was 14.7 months (warfarin group) and 19.3 months (aspirin group). Vascular risk factors and mean percent stenosis of the symptomatic artery were similar in the two groups, yet the rates of major vascular events were 18.1 per 100 patient-years of follow-up in the aspirin group (stroke rate, 10.4/100 patient-years; myocardial infarction or sudden death rate, 7.7/100 patient-years) compared with 8.4 per 100 patient-years of follow-up in the warfarin group (stroke rate, 3.6/100 patient-years; myocardial infarction or sudden death rate, 4.8/100 patient-years). Kaplan-Meier analysis showed a significantly higher percentage of patients free of major vascular events among patients treated with warfarin (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

Possible association of ischemic stroke with phentermine.

BACKGROUND AND PURPOSE: Some commonly used anorexiants, including methamphetamine and phenylpropanolamine, have been associated with stroke. Because phentermine is an anorexiant with a chemical structure similar to that of amphetamines, similar side effects might be expected. CASE DESCRIPTIONS: Two patients using phentermine (one was also using phendimetrazine) developed ischemic cerebrovascular disease. One suffered a cerebral infarct with angiographic evidence of vasculopathy involving multiple vascular beds. The other patient developed headache and a hemisensory disturbance of 7 days' duration. CONCLUSIONS: Phentermine, and possibly phendimetrazine, should be considered an anorexiant and sympathomimetic drug that can be associated with ischemic cerebrovascular disease.

Adult↗

PubMed1993

Stroke.

Illicit drugs, appetite suppressants, decongestants, and anabolic steroids may cause stroke. Drug abuse is a common cause of stroke in young patients. Mechanisms are varied, but it is particularly important to seek out infective endocarditis and most importantly, cerebral aneurysms, vascular malformations, and cardiac disorders in cocaine abusers. Drug-induced vasoconstriction, hypertension, or vasculitis probably contributes significantly to most patients' strokes. Tobacco smoking and heavy chronic alcohol consumption are independent risk factors for stroke; moderate drinking seems to protect from stroke in white patients. Oral contraceptives may increase the risk of stroke in female patients over 35 years of age who also have other risk factors.

Adult↗