Science News

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

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

• 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