International Stroke Conference 2019 (ISC 2019)

Glucose control within 12 hours of stroke onset: How low can you go?

Elvira Manzano, 20190304220000

The perception that the more aggressive glucose control is the better the patient will be doesn’t hold true in the multicentre SHINE* trial. Intensive glucose control at a target of 80–130 mg/dL with intravenous (IV) insulin did not improve outcomes in patients with ischaemic stroke. Instead, it carried an increased risk of severe hypoglycaemia.

Breast cancer survivors have increasing stroke risk with survivorship

Elaine Soliven, 20190226000000

Breast cancer survivors saw increasing risk of stroke along with growing duration of survivorship, particularly during the post-menopausal period, according to a study presented at ISC 2019.

Intensive/guideline-directed BP-lowering after ischaemic stroke yield similar functional outcomes

Roshini Claire Anthony, 20190225140203

Among patients with a recent acute ischaemic stroke treated with thrombolytic therapy, intensive blood pressure (BP)-lowering conferred no additional benefit in functional recovery compared with guideline-recommended BP-lowering, despite a reduced risk of intracranial haemorrhage with intensive therapy, according to results of the ENCHANTED* trial.

Stroke dovetails with spikes in opioid misuse, infective endocarditis

Elvira Manzano, 20190225090000

Hospitalization rates for stroke increased by 20 percent each year between 2008 and 2015, according to a large US study, and these incidents were apparently tied to spikes in opioid misuse and cases of drug-related infective endocarditis.

Minimally-invasive surgery may not be optimal for stroke

Audrey Abella, 20190222100000

The evacuation of moderate-to-large brain bleeds using stereotactic catheter aspiration and the thrombolytic agent alteplase (ie, MISTIE* approach) was no better than standard medical therapy in providing functional improvement post-stroke, according to the results of the MISTIE III trial presented at ISC 2019. However, this strategy appears to hold promise in reducing mortality risk.

New study EXTENDs tPA window to 9 hours in select stroke patients

Pearl Toh, 20190221190010

Patients presenting within 9 hours from stroke onset or with wake-up stroke can still benefit from thrombolytic therapy based on automated computed tomography (CT) perfusion imaging-guided patient selection, according to the EXTEND* study presented at ISC 2019.

Smoking has no benefit on ICH outcomes

Roshini Claire Anthony, 20190221140201

Nicotine may not have a neuroprotective effect on intracerebral haemorrhage (ICH) as previously suggested in animal studies, with former or current smokers demonstrating no difference in post-ICH functional outcomes compared with non-smokers, according to findings from the US-based ERICH* study.

ANNEXA-4 confirms andexanet efficacy, safety for antithrombotic-related acute bleeding

Roshini Claire Anthony, 20190220140307

Andexanet alfa effectively reduced anti-factor Xa activity in patients who experienced acute bleeding while on a factor Xa inhibitor*, results from the ANNEXA-4** study showed.

Nitroglycerin patch fails to improve post-stroke functional outcomes

Audrey Abella, 20190220095740

Prehospital, transdermal delivery of the nitric oxide (NO) donor nitroglycerin did not reduce blood pressure (BP) and post-stroke disability in patients with suspected ultra-acute stroke, according to the results of the RIGHT*-2 trial presented at ISC 2019, thus debunking the conventional belief that early NO administration to supplement the low vascular NO concentrations may benefit acute stroke.

Hydrogel coil trumps standard coil for aneurysm recurrence

Pearl Toh, 20190219190010

Treatment with the second-generation hydrogel coils significantly reduces the rate of aneurysm recurrence compared with standard platinum coils, with no increase in adverse events, reveals the HEAT* study presented at ISC 2019.