{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T03:01:21Z","timestamp":1773802881621,"version":"3.50.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Emerging yet contrasting evidence from animal and human studies associates ischemic preconditioning with improvement of subsequent stroke severity, although long\u2010term outcome remains unclear. The purpose of this study was to analyze how preceding cerebral ischemic events influence subsequent stroke severity and outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Data for this retrospective cohort study were extracted from ASTRAL (Acute Stroke Registry and Analysis of Lausanne). This registry includes a sample of all consecutive patients with acute ischemic strokes admitted to the stroke unit and\/or intensive care unit of the Lausanne University Hospital, Switzerland. We investigated associations between preceding ischemic events (transient ischemic attacks or ischemic strokes) and the impact on subsequent stroke severity and clinical improvement within 24\u00a0hours, measured through National Institute of Health Stroke Scale, as well as 3\u2010month outcome, determined through a shift in the modified Rankin Scale. Of 3530 consecutive patients with ischemic stroke (43% women, median age 73\u00a0years), 1001 (28%) had \u22651 preceding cerebral ischemic events (45% transient ischemic attack, 55% ischemic stroke; 31% multiple events). After adjusting for multiple prehospital, clinical, and laboratory confounders, admission stroke severity was significantly lower in patients preconditioned through a preceding ischemic event, but 24\u2010hour improvement was not significant and 3\u2010month outcome was unfavorable.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Preceding ischemic events were independently associated with a significant reduction in subsequent stroke severity but worsened long\u2010term clinical outcome. These results, if confirmed by future randomized studies, may help design neuroprotective strategies. The unfavorable effect on stroke outcome is probably a consequence of the cumulative disability burden after multiple ischemic events.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020129","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T09:17:26Z","timestamp":1628846246000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Preconditioning by Preceding Ischemic Cerebrovascular Events"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2414-2367","authenticated-orcid":false,"given":"Pamela N.","family":"Correia","sequence":"first","affiliation":[{"name":"Neurology Service Stroke Center Department of Clinical Neurosciences Lausanne University Hospital Lausanne Switzerland"},{"name":"Stroke Unit Neurology Service Cantonal Hospital of Biel Biel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivo 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