Science News
International Stroke Conference 2018
Nursing Symposium & Pre-Con Symposia: Jan. 23, 2018
Sessions: Jan. 24–26, 2018
Los Angeles Convention Center | Los Angeles, Calif.
Blood Pressure Medications at Hospital Discharge
Amanda Lantzy | MedStar Georgetown University Hospital, Washington, DC
- RESULTS: Classes of discharge HTN medications vary widely; not all are GL recommended
- Abstract for Lantzy
- Presentation Slides (PDF) for Lantzy
A Rapid Care Evaluation Transient Ischemic Attack Clinic by Nurse Practitioners
Tina Michele Dvoren-Baker | Medical University of South Carolina, Charleston, SC
- RESULTS: A successful nurse-led rapid access approach to evaluate transient ischemic attack (TIA) didn’t increase or duplicate current resources
- Abstract for Dvoren-Baker
- Presentation Slides (PDF) for Dvoren-Baker
Implementing Community Stroke Outreach Using Peer Educators to Improve Readiness to Act Among Local Community Members
Nataliya Omelchenko | Northwest Community Hospital, Arlington Heights, IL
- RESULTS: "Peer-led" community stroke education provides examples for neuroscience nurses, even in those with limited English fluency; Suggest opportunities to reduce treatment delays
- Abstract for Omelchenko
- Presentation Slides (PDF) for Omelchenko
2018 Acute Ischemic Stroke (AIS) Guidelines
Articles below link to Stroke, a Journal of the American Heart Association
- 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
- Accuracy of Prediction Instruments for Diagnosing Large Vessel Occlusion in Individuals With Suspected Stroke: A Systematic Review for the 2018 AIS Guidelines
- Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 AIS Guidelines
- Editorial: 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke
Visit our AIS Guidelines Science News Page for a look at clinical slides, Top 10 Things to Know, links to AHA News stories and the official AHA Newsroom release, plus related science and professional resources.
Results of the DEFUSE 3 Study
Gregory W Albers | Stanford University Medical Center, Stanford, CA
- RESULTS: Almost 50% of AIS study patients spared disability with endovascular + medical therapy vs. medical therapy alone (large vessel anterior circulation occlusion who have a favorable imaging profile).
- Data Summary (PDF) for Albers
- Abstract for Albers
- Presentation Slides (PDF) for Albers
- Simultaneous publication in NEJM: Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging
- Simultaneous publication in Stroke: Late Window Paradox
- Video Discussion with Gregory W Albers (opens in new window)(link opens in new window)
Tenecteplase Versus Alteplase Before Endovascular Thrombectomy (EXTEND-IA TNK): A Multicenter, Randomized, Controlled Trial
Bruce C Campbell | Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
- RESULTS: Tenecteplase doubled pre-thrombectomy perfusion compared to alteplase and improved functional recovery at 3 months in these ischemic stroke patients.
- Data Summary (PDF) for Campbell
- Abstract for Campbell
- Presentation Slides for Campbell (PDF)
- Video Discussion with Bruce C Campbell (opens in new window)(link opens in new window)
Magnitude of Benefit of Endovascular Thrombectomy 6-24 Hours After Onset in Acute Ischemic Stroke Patients with Clinical-Core Mismatch
Jeffrey L Saver | Geffen School of Medicine at UCLA, Los Angeles, CA
- RESULTS: For AIS patients with clinical-core mismatch, use of endovascular thrombectomy in the 6-24-hour time window improved 90-day disability in 50% of study patients, showed functional independence in over a third, and showed benefit in the later part of the time window.
- Data Summary (PDF) for Saver
- Abstract for Saver
- Presentation Slides (PDF) for Saver
Hyperexcitability and Seizures in Primary Intraventricular Hemorrhage
Christoph Stretz | Yale School of Medicine, New Haven, CT
- RESULTS: EEG electrographic seizures and hyperexcitability were common findings in intraventricular hemorrhage (IVH) patients – may offer intervention opportunities.
- Abstract for Stretz
- Presentation Slides (PDF) for Stretz
Secular Increases in Spontaneous Subarachnoid Hemorrhage during Pregnancy
Kaustubh Limaye | University of Iowa, Iowa City, IA
- RESULTS: Spontaneous subarachnoid hemorrhage (sSAH) in pregnancy numbers trending up with more in African Americans. Outcomes better in pregnant than in non-pregnant women.
- Abstract for Limaye
- Presentation Slides (PDF) for Limaye
The Efficacy and Safety of Cilostazol in Subarachnoid Hemorrhage. A Meta-analysis of Randomized and Non Randomized Studies
Muhammad F Ishfaq | Department of Neurology, University of Tennessee Health Sciences Center, Memphis, TN
- RESULTS: Symptomatic and angiographic vasospasm lower with cilostazol – less risk of new cerebral infarction. More studies needed to confirm effectiveness in subarachnoid hemorrhage.
- Abstract for Ishfaq
- Presentation Slides (PDF) for Ishfaq
Soluble ST2 Predicts Delayed Cerebral Ischemia and Outcome After Subarachnoid Hemorrhage
Zoe Wolcott | Massachusetts General Hospital, Boston, MA
- RESULTS: Small study: after subarachnoid hemorrhage, sST2 predicted delayed cerebral ischemia, mortality, and functional outcomes.
- Abstract for Wolcott
- Presentation Slides (PDF) for Wolcott
Time to Detect Seizures Among Hemorrhagic and Ischemic Stroke Patients Undergoing Continuous EEG (cEEG) Monitoring
Ifrah Zawar | Cleveland Clinic Foundation, Cleveland, OH
- RESULTS: Initial seizure diagnosis may take longer than 24 hours to diagnose for hemorrhagic compared to ischemic stroke patients.
- Abstract for Zawar
- Presentation Slides (PDF) for Zawar
Endothelium-Targeted Deletion of MicroRNA-15a/16-1 Cluster Promotes Post-Stroke Angiogenesis and Improves Long-Term Neurological Functions
Ping Sun | University of Pittsburgh, Pittsburgh, PA
- RESULTS: Endothelial miR-a5a/16-1 may offer a target to improve angiogenesis and long-term neurological functions after AIS.
- Abstract for Sun
Time to Endovascular Treatment and Outcomes in the DAWN Trial
Raul G Nogueira | Emory University School of Medicine, Atlanta, GA
- RESULTS: Clinical core mismatch patients benefit from thrombectomy up to 24 hours, but less chance for good outcomes over time.
- Data Summary (PDF) for Nogueira
- Abstract for Nogueira
- Video Discussion with Raul G Nogueira (opens in new window)(link opens in new window)
First Stroke Reduced 44 Percent by Well Tolerated Medications. Stroke Outcomes From the Heart Outcomes Prevention Evaluation 3 Study
Jackie Bosch | McMaster University, Hamilton, ON, Canada
- RESULTS: Fixed-dose candesartan/HCTZ + low-dose rosuvastatin for primary stroke prevention: 44% risk reduction for intermediate CVD patients.
- Abstract for Bosch
- Presentation Slides (PDF) for Bosch
A Comparison of Direct Aspiration vs. Stent Retriever as a First Approach ("COMPASS"): A Randomized Trial
J Mocco | Mount Sinai Hospital, New York, NY
- RESULTS: Functional outcomes were equivalent (non-inferior) with direct aspiration and stent-retriever in the treatment of patients with cerebral large vessel occlusion.
- Data Summary (PDF) for Mocco
- Abstract for Mocco for Mocco
- Presentation Slides (PDF) for Mocco
- Video Discussion with Mocco (opens in new window)(link opens in new window)
ARISE II Trial Result
Osama Zaidat | Mercy Health St. Vincent Hospital, Toledo, OH
- RESULTS: Novel stent-retriever (EmboTrap®) showed superiority to current FDA devices for recanalization and reperfusion rates in AIS patients. High rates of clinical outcomes at 3 months: Two-thirds of patients had functional independence
- Abstract for Zaidat
- Presentation Slides (PDF) for Zaidat
Subgroup Analyses of the DEFUSE 3 Study
Maarten G Lansberg, Stanford University, Stanford, CA
- RESULTS: All ages benefit from endovascular therapy; imaging trumps time in determining who will benefit from EVT.
- Abstract for Lansberg
- Presentation Slides (PDF) for Lansberg
The Effect of Rivaroxaban with Aspirin on Stroke Outcomes in the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) Trial
Mukul Sharma | Population Health Research Institute, McMaster University, Hamilton, ON, Canada
- RESULTS: The ischemic stroke rate was almost halved with rivaroxaban + aspirin vs. aspirin alone for patients with atherosclerosis.
- Data Summary (PDF) for Sharma
- Abstract for Sharma
- Presentation Slides (PDF) for Sharma
- Video Discussion with Sharma (opens in new window)(link opens in new window)
Ticagrelor with Aspirin on Platelet Reactivity in Minor Stroke or Transient Ischemic Attack (PRINCE Trial)-Final Analysis
Yilong Wang | Beijing Tiantan Hospital, Beijing, China
- RESULTS: For minor stroke or TIA patients, short-term ticagrelor + aspirin reduced platelet reactivity when compared to clopidogrel + aspirin
- Abstract for Wang
- Presentation Slides (PDF) for Wang
Exome Sequence Study on Extreme MRI Markers of Cerebral Small Vessel Disease
Aniket Mishra | University of Bordeaux, Bordeaux, France
- RESULTS: Strategy described to identify genetic predictors of cerebral small vessel disease (CSVD).
- Abstract for Mishra
- Presentation Slides (PDF) for Mishra
Alteplase for the Treatment of Acute Ischemic Stroke in Patients with Low NIHSS and Not Clearly-Disabling Deficits: Primary Results of the PRISMS Trial
Pooja Khatri | University of Cincinnati, Cincinnati, OH
- RESULTS: Incomplete findings suggest that AIS benefits with alteplase may not apply to patients with strokes of minor severity. (Low NIHSS and not clearly-disabling deficits).
- Data Summary (PDF) for Khatri
- Abstract for Khatri
- Presentation Slides (PDF) for Khatri
- Video Discussion with Pooja Khatri (opens in new window)(link opens in new window)
Two-year Safety and Clinical Outcomes in Chronic Ischemic Stroke Patients After Implantation of Modified Bone Marrow-derived Mesenchymal Stem Cells (sb623): A Phase 1/2a Study
Gary K Steinberg | Stanford University, Stanford, CA
- RESULTS: Stem cell implants into chronic ischemic stroke patients with disabilities resulted in neurologic improvement at six months and two years.
- Abstract for Steinberg
- Presentation Slides (PDF) for Steinberg
Short Chain Fatty Acids Mediate the Beneficial Effects of Young Microbiome on Recovery in Aged Mice after Ischemic Stroke
Juneyoung Lee | McGovern Medical School, UTHealth at Houston, Houston, TX
- RESULTS: Young microbiome metabolites aided post-stroke recovery in aged mice. More studies needed to understand the mechanisms.
- Abstract for J. Lee
Neurovascular Disease is the Second Leading Cause of Death in the United States (US): A Modern Disease Burden Analysis
Frances Fan | UCLA Medical Center, Los Angeles, CA
- RESULTS: Use of modern pathophysiology addresses the national and global burden of neurovascular disease – finds it # 2 cause of US death and the 4th leading worldwide cause of disability.
- Data Summary (PDF) for Fan
- Abstract for Fan
- Presentation Slides (PDF) for Fan
Duration of Heightened Stroke Risk after Acute Myocardial Infarction
Alexander E. Merkler | Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
- RESULTS: Acute MI was associated with increased AIS risk in the first month after AMI and the risk probably goes beyond 1 month.
- Data Summary (PDF) for Merkler
- Abstract for Merkler
- Presentation Slides (PDF) for Merkler
Preeclampsia and Early Stroke Incidence in the California Teachers Study
Eliza C. Miller | Columbia University, New York, NY
- RESULTS: Preeclampsia increases early stroke risk.
- Abstract for Miller
- Presentation Slides (PDF) for Miller
Sex Differences in the Effect of Hypertension on Stroke Risk in the REasons for Geographic and Racial Differences in Stroke Study
Tracy E. Madsen | Alpert Medical School of Brown University, Providence, RI
- RESULTS: Women with more elevated BP were found to be at more risk for ischemic stroke. Higher HTN levels = higher IS risk in women.
- Abstract for Madsen
- Presentation Slides (PDF) for Madsen
Exosomal Micrornas From Ischemic Cerebral Endothelial Cells and Neural Stem Cells Regulate Coupling of Neurogenesis and Angiogenesis
Xianshuang Liu | Henry Ford Hospital, Detroit, MI
- RESULTS: miRNA transfer via exosomes may become a therapeutic approach to aid angiogenesis and neurogenesis in ischemic brain tissue.
- Abstract for Liu
- Presentation Slides (PDF) for Liu
Pharyngeal Electrical Stimulation for Early Decannulation in Tracheotomised Stroke Patients with Dysphagia (PHAST-TRAC): A Randomised, Single-blind, Pivotal, Superiority Trial
Philip M Bath | University of Nottingham, Nottingham, United Kingdom
- RESULTS: Electrical pharyngeal stimulation to stroke patients with dysphagia aids early decannulation in in this small trial.
- Data Summary (PDF) for Bath
- Abstract for Bath
- Presentation Slides (PDF) for Bath
DEFUSE 3 Angiographic Results Correlated with Clinical and Imaging Outcomes
Michael P Marks, Stanford Hospital, Stanford, CA
- RESULTS: ‘last seen well’ stroke patients achieved high perfusion rates and functional outcomes in a 6-16 hour extended time window.
- Data Summary (PDF) for Marks
- Abstract for Marks
- Presentation Slides (PDF) for Marks
Final Results of the RHAPSODY Trial
Patrick Lyden | Cedars-Sinai Medical Center, Los Angeles, CA
- RESULTS: A continuous reassessment method was successfully used in the dose-finding step for the neuroprotectant, 3K3A-APC, for AIS patients treated with IV rt-PA, thrombectomy or both. A phase 2 trial will follow for confirmation.
- Data Summary (PDF) for Lyden
- Abstract for Lyden