Browsing by Author "Akinyemi J. O."

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Echocardiographic abnormalities and determinants of 1-month outcome of stroke among West Africans in the SIREN Study
(American Heart Association, 2019) Adeoye A. M.; Ovbiagele B.; Akinyemi J. O.; Ogah O. S.; Akinyemi R.; Gebregziabher M.; Wahab K.; Fakunle A. G.; Akintunde A.; Adebayo O.; Aje A.; Tiwari H. K; Arnett D.; Agyekum F.; Appiah L. T.; Amusa G.; Olunuga T. O.; Akpa O.; Sarfo F. S.; Akpalu A.; Jenkins C.; Lackland D.
Background-—Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1-month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results-—We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1-month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2_14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P=0.018) and septal (16.8 versus 19.1, P<0.001) and posterior wall thickness at systole (18.9 versus 21.5, P=0.004). Over 90% of patients with stroke had abnormal left ventricular (LV) geometry with eccentric hypertrophy predominating (56.1%). Of 13 candidate variables investigated, only baseline abnormal LV geometry (concentric hypertrophy) was weakly associated with 1-month disability (unadjusted relative risk, 1.80; 95% CI, 0.97–5.73). Severe LV systolic dysfunction was significantly associated with increased 1-month mortality (unadjusted relative risk, 3.05; 95% CI, 1.36–6.83). Conclusions-—Nine of 10 patients with acute stroke had abnormal LV geometry and a third had systolic dysfunction. Severe LV systolic dysfunction was significantly associated with 1 month mortality. Larger studies are required to establish the independent effect and unravel predictive accuracy of this association
Level and determinants of pharmacovigilance programme awareness in Nigeria: A multilevel analysis
(Academic journals, 2017) Alo O. D.; Akinyemi J. O.; Akpa M. O.; Yusuf O. B.; Fagbamigbe A. F.; Bamgboye E. A.; Adebayo S. B.; Kawu I.; Agbi P.; Ezire O.
Previous studies have reported poor awareness of the Pharmacovigilance Programme (PP) among health professionals in Nigeria but similar information on the general population is unavailable. This study was designed to investigate the individual and contextual factors associated with awareness of the PP among the general population. The study utilised data collected in the 2012 National HIV and AIDS and Reproductive Health and Serological Survey which were collected through a multi-stage cluster survey among women aged 15-49 years and men aged 15-64 years across all the states in Nigeria. Data on regulatory activities about food and drugs as well as household and individual characteristics were extracted and analyzed using descriptive statistics and multilevel logistic regression. Mean age of the respondents was 31.45±11.8 years. Females constituted 50.1% while 68.7% resided in rural areas. Only 26.0% of the respondents were aware of the PP and this was significantly higher among those with higher education (57.7%) and those who have seen/heard any campaign on Adverse Drug Reactions (ADRs) (79.7%). Participants who had seen/heard any campaign on ADRs were more likely to be aware of the PP (Odd Ratio [OR]: 32.85, 95% Confidence Interval [CI]: 29.13–36.57). Tertiary education (OR: 4.29, 95% CI: 3.51–5.07), and secondary education (OR= 2.35, 95%C.I= 2.0–2.70) significantly increased PP awareness. Participants who were employed and those who resided in urban communities were more likely to be aware of the PP in Nigeria. Generally, awareness of the PP in Nigeria is low. Awareness campaigns should be re-packaged to reach rural dwellers and those with lower education.
Prevalence and prognostic features of ECG abnormalities in acute stroke
(Elsevier Ltd, 2017) Adeoye A. M.; Ogah O. S.; Ovbiagele B.; Akinyemi R.; Shidali V.; Agyekum F.; Aje A.; Adebayo O.; Akinyemi J. O.; Kolo P.; Appiah L. T.; Iheonye H.; Kelechukwu U.; Ganiyu A.; Olunuga T. O.; Akpa O.; Olagoke O. O.; Sarfo F. S.; Wahab K.; Olowookere S.; Fakunle A.; Akpalu A.; Adebayo P. B.; Nkromah K.; Yaria J.; Ibinaiye P.
Background: Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke out comes have not been previously characterized in Africans. Objectives: The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods: We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results: Patients’ mean age was 58.4 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p ¼ 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p ¼ 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions: About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability
Randomized trial of an intervention to improve blood pressure control in stroke survivors
(American Heart Association, Inc., 2020) Owolabi M. O.; Gebregziabher M.; Akinyemi R. O.; Akinyemi J. O.; Akpa O.; Olaniyan O.; Salako B. L.; Arulogun O.; Tagge R.; Uvere E.; Fakunle A.; Ovbiagele B.
BACKGROUND: We conducted the first-of-its kind randomized stroke trial in Africa to test whether a THRIVES (Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke) intervention improved blood pressure (BP) control among patients with stroke. METHODS AND RESULTS: Intervention comprised a patient global risk factor control report card, personalized phone text-messaging, and educational video. Four hundred patients recruited from 4 distinct medical facilities in Nigeria, aged ≥18 years with stroke-onset within one-year, were randomized to THRIVES intervention and control group. The control group also received text messages, and both groups received modest financial incentives. The primary outcome was mean change in systolic BP (SBP) at 12 months. There were 36.5% females, 72.3% with ischemic stroke; mean age was 57.2±11.7 years; 93.5% had hypertension and mean SBP was 138.33 (23.64) mmHg. At 12 months, there was no significant difference in SBP reduction from baseline in the THRIVES versus control group (2.32 versus 2.01 mmHg, P=0.82). In an exploratory analysis of subjects with baseline BP >140/90 mmHg (n=168), THRIVES showed a significant mean SBP (diastolic BP) decrease of 11.7 (7.0) mmHg while control group showed a significant mean SBP (diastolic BP) decrease of 11.2 (7.9) mmHg at 12 months. CONCLUSIONS: THRIVES intervention did not significantly reduce SBP compared with controls. However, there was similar significant decrease in mean BP in both treatment arms in the subgroup with baseline hypertension. As text-messaging and a modest financial incentive were the common elements between both treatment arms, further research is required to establish whether these measures alone can improve BP control among stroke survivors