Mai N. Nguyen-Huynh, MD, MAS

People

Extended Window for Thrombectomy - Have we extended our resources appropriately and effectively

Study will evaluate the performance of the RAPID software interpretation of CT perfusion (CTP) studies and determination of qualifications for endovascular therapy (EST). It will include a retrospective case review of prospectively collected data on consecutive stroke patients seen during the extended window for EST and screened with CTP in 2019 and 2020. It will also determine the rate of EST among those screened for the extended window and the rate of favorable 90-day functional outcome (defined as mRS 0-2) among those treated with EST. It will include a retrospective cohort study of prospectively collected data on consecutive Kaiser Permanente patients screened during the EW by telestroke neurologists in the Stroke EXPRESS program and who underwent EST.
Investigator: Nguyen-Huynh, Mai
Funder: 

Nor-Cal-CSC for Northern California Regional Coordinating Center

The Northern California Regional Coordinating Stroke Center (NorCal-CSC) is a joint effort between U.C. San Francisco and selected medical center(s) within Kaiser Permanente as part of the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Trials Network. This project has two aims. First, NorCal-CSC will become a resource to any network principal investigator to plan, initiate, and complete a clinical trial in the neurosciences. Second, NorCal-CSC will provide training opportunities to medical students, residents, fellows, and faculty within the network to plan and conduct clinical trials.
Investigator: Nguyen-Huynh, Mai
Funder: National Institute of Neurological Disorders and Stroke

How Fast is Fast Enough? Assessing Door-to-Needle Times and Outcomes of Stroke Patients Receiving Acute Thrombolysis Therapy Under the Kaiser Permanente Northern California Stroke EXPRESS Program

With stroke treatment, there is a general belief that "time is brain." However, there has been no published data examining specifically the association between door-to-needle times for acute treatment with intravenous alteplase in stroke patients and 90-day outcomes. In 2016, the Kaiser Permanente Northern California Stroke EXPRESS program rolled out at all 21 primary stroke centers with significant improvement in door-to-needle times. This study has two major aims: 1) to determine if there is an association between door-to-needle times and mortality at discharge and at 90-day post-treatment in patients who receive acute thrombolysis treatment with intravenous alteplase at Kaiser Permanente Northern California, and 2) to determine if there is an association between door-to-needle times and 90-day favorable functional outcome (defined as mRS 0-2) in patients who receive acute thrombolysis treatment with intravenous alteplase at Kaiser Permanente Northern California.
Investigator: Nguyen-Huynh, Mai
Funder: The Permanente Medical Group

Predicting Readmission After Stroke Study (PRESS)

Hospital readmissions are a tremendous burden on patients, their families, and the health care system. In 2008, the Centers for Medicare and Medicaid Services began publicly reporting hospital-level, risk-standardized, 30-day readmission and mortality rates for acute myocardial infarction and heart failure. Stroke survivors also have high risk of new illness, worsened known diseases, functional decline, and a high death rate. Readmission rates of 20 to 27 percent within one year have been reported. A systematic review of predictors of hospital readmission after stroke yielded no risk-standardized models for comparing hospital readmission performance or predicting readmission risk after stroke. This project aims to create a risk-adjusted predictive model for re-hospitalization after ischemic stroke using retrospectively and prospectively collected patient-level and hospital-level data, and to validate the model retrospectively and prospectively.
Investigator: Nguyen-Huynh, Mai
Funder: National Institute of Neurological Disorders and Stroke

A Randomized, Double-Blind, Multinational Study to Prevent Major Vascular Events with Ticagrelor Compared to Aspirin in Patients with Acute Ischemic Stroke

The primary objective of the trial is to compare the effect of 90-day treatment with ticagrelor (180 mg [two 90 mg tablets] loading dose on Day 1 followed by 90 mg twice daily maintenance dose for the remainder of the study) vs acetylsalicylic acid (ASA)-aspirin (300 mg [three 100 mg tablets] loading dose on Day 1 followed by 100 mg once daily maintenance dose for the remainder of the study) for the prevention of major vascular events (composite of stroke, myocardial infarction, and death) in patients with acute ischemic stroke or transient ischemic attack.
Investigator: Nguyen-Huynh, Mai
Funder: AstraZeneca PLC

Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial (CREST-2)

Carotid revascularization for primary prevention of stroke (CREST-2) is two independent multi-center, randomized controlled trials of carotid revascularization and intensive medical management versus medical management alone in patients with asymptomatic high-grade carotid stenosis. One trial will randomize patients in a 1-to-1 ratio to endarterectomy versus no endarterectomy, and another will randomize patients in a 1-to-1 ratio to carotid stenting with embolic protection versus no stenting. Medical management will be uniform for all randomized treatment groups and will be centrally directed. The purpose of this trial is to determine the best way to prevent strokes in people who have a high amount of blockage of their carotid artery but no stroke symptoms related to that blockage.
Investigator: Avins, Andrew; Chang, Robert; Nguyen-Huynh, Mai
Funder: National Institute of Neurological Disorders and Stroke

NINDS Stroke Trials Network Northern California Regional Coordinating Stroke Center

The primary goal of the NINDS Stroke Trials Network is to maximize efficiencies to develop, promote and conduct high-quality, multi-site clinical trials focused on key interventions in stroke prevention, treatment, and recovery with the objective to have a balanced portfolio between all three approaches. The aims of the Northern California Regional Coordinating Stroke Center are to: 1) Become a resource to any network PI to plan, initiate and complete a clinical trial in the neurosciences. This will be a joint effort between UCSF and selected medical centers within Kaiser Permanente; and 2) Provide training opportunities to medical students, residents, fellows and faculty within the network to plan and conduct clinical trials.
Investigator: Nguyen-Huynh, Mai
Funder: National Institute of Neurological Disorders and Stroke

How accurate is CT angiography in evaluating intracranial atherosclerotic disease?

Author(s): Nguyen-Huynh MN1; Wintermark M; English J; Lam J; Vittinghoff E; Smith WS; Johnston SC;

​Stroke. 2008 Apr;39(4):1184-8. doi: 10.1161/STROKEAHA.107.502906. Epub 2008 Feb 21.

PubMed abstract

Development of an algorithm to detect methotrexate wrong frequency error using computerized health care data

Author(s): Herrinton LJ; Woodworth TS; Eworuke E; Amsden LB; Liu L; Wyeth J; Petrone A; Menzin TJ; Williams J; Goldfien R; Nguyen M

Pharmacoepidemiol Drug Saf. 2019 Aug 13.

PubMed abstract

Shake Rattle & Roll - Design and rationale for a pragmatic trial to improve blood pressure control among blacks with persistent hypertension

Author(s): Nguyen-Huynh MN; Young JD; Alexeeff S; Hatfield MK; Sidney S

Contemp Clin Trials. 2019 Jan;76:85-92. Epub 2018-11-28.

PubMed abstract

Comparative Trends in Heart Disease, Stroke, and All-Cause Mortality in the United States and a Large Integrated Healthcare Delivery System

Author(s): Sidney S; Sorel ME; Quesenberry CP; Jaffe MG; Solomon MD; Nguyen-Huynh MN; Go AS; Rana JS

Am J Med. 2018 Apr 02.

PubMed abstract

Novel Telestroke Program Improves Thrombolysis for Acute Stroke Across 21 Hospitals of an Integrated Healthcare System

Author(s): Nguyen-Huynh MN; Klingman JG; Avins AL; Rao VA; Eaton A; Bhopale S; Kim AC; Morehouse JW; Flint AC; KPNC Stroke FORCE Team

Stroke. 2018 Jan;49(1):133-139. Epub 2017-12-15.

PubMed abstract

Race-ethnicity on blood pressure control after ischemic stroke: a prospective cohort study

Author(s): Nguyen-Huynh MN; Hills NK; Sidney S; Klingman JG; Johnston SC

J Am Soc Hypertens. 2016 Nov 17.

PubMed abstract

Recent Trends in Cardiovascular Mortality in the United States and Public Health Goals

Author(s): Sidney S; Quesenberry CP; Jaffe MG; Sorel M; Nguyen-Huynh MN; Kushi LH; Go AS; Rana JS

JAMA Cardiol. 2016 Jun 29.

PubMed abstract

Inpatient statin use predicts improved ischemic stroke discharge disposition

Author(s): Flint AC; Kamel H; Navi BB; Rao VA; Faigeles BS; Conell C; Klingman JG; Hills NK; Nguyen-Huynh M; Cullen SP; Sidney S; Johnston SC

Neurology. 2012 May 22;78(21):1678-83.

PubMed abstract

Validation of the Stroke Prognostic Instrument-II in a Large, Modern, Community-Based Cohort of Ischemic Stroke Survivors

Author(s): Navi BB; Kamel H; Sidney S; Klingman JG; Nguyen-Huynh MN; Johnston SC

Stroke. 2011 Dec;42(12):3392-6. Epub 2011 Sep 29.

PubMed abstract

How accurate is CT angiography in evaluating intracranial atherosclerotic disease?

Author(s): Nguyen-Huynh MN1; Wintermark M; English J; Lam J; Vittinghoff E; Smith WS; Johnston SC;

​Stroke. 2008 Apr;39(4):1184-8. doi: 10.1161/STROKEAHA.107.502906. Epub 2008 Feb 21.

PubMed abstract

Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack

Author(s): Johnston SC; Rothwell PM; Nguyen-Huynh MN; Giles MF; Elkins JS; Bernstein AL; Sidney S

Lancet. 2007 Jan 27;369(9558):283-92.

PubMed abstract

National Stroke Association guidelines for the management of transient ischemic attacks

Author(s): Johnston SC1; Nguyen-Huynh MN; Schwarz ME; Fuller K; Williams CE; Josephson SA; Hankey GJ; Hart RG; Levine SR; Biller J; Brown RD Jr; Sacco RL; Kappelle LJ; Koudstaal PJ; Bogousslavsky J; Caplan LR; van Gijn J; Algra A; Rothwell PM; Adams HP; Albers GW;

Ann Neurol. 2006 Sep;60(3):301-13.

PubMed abstract