AI, blood thinners and patient positioning: Exploring late-breaking science at the International Stroke Conference
International Stroke Conference 2024 (ISC 2024) is officially underway in Phoenix, and the three-day event has already featured several key late-breaking presentations. These are some of the biggest headlines out of the conference so far:
Artificial intelligence shows potential to improve outcomes among stroke survivors
One late-breaking presentation compared treatment recommendations for ischemic stroke patients suggested by a new artificial intelligence (AI) model with the advice of hospital-based stroke teams.
The analysis included data from more than 21,000 ischemic stroke patients treated at one of 77 different hospitals in China from January 2021 to June 2023. Overall, researchers found that following AI-based recommendations reduced the risk of new vascular events within three months by nearly 26%.
While 2.9% of patients treated using AI recommendations experienced a vascular event within those first three months, the rate was 3.9% among patients treated using standard post-stroke care.
“This research showed that an artificial intelligence-based clinical decision support system for stroke care was effective and feasible in clinical settings in China and improved patient outcomes,” lead author Zixiao Li, MD, PhD, chief physician, professor and deputy director of neurology at Capital Medical University’s Beijing Tiantan Hospital in Beijing, China, said in a statement. “This type of technology aids neurologists by facilitating the sharing of information between humans and AI, using their combined strengths.”
Blood thinners fail to boost clinical outcomes for stroke patients, surprising researchers
Treating myocardial infarction patients with both blood thinners and clot-busting medications is associated with key benefits, but that may not be the case when it comes to the treatment of ischemic stroke.
Researchers explored data from more than 500 patients treated throughout the United States from October 2019 to July 2023. All patients had experienced a moderately severe stroke, as defined by the National Institutes of Health Stroke Severity Scale. The average was 68 years old, and 50% of patients were women.
All patients received a “standard clot-busting medication” within three hours, but one group also received the blood thinner argatroban within 75 minutes in addition to a 12-hour infusion of argatroban. A second group, meanwhile, was treated with an initial dose of eptifibatide within 75 minutes and then a 2-hour infusion of eptifibatide and a 10-hour infusion of a placebo. The third and final group was the study’s control—those patients received no additional medications other than a placebo.
Overall, the study’s authors found that the two blood thinners did not improve patient outcomes. In fact, the trial was stopped ahead of time due to the lack of benefits. The group did note, however, that the blood thinners were not linked to an increased risk of bleeding into the brain.
“When we began the trial, we believed the medications would improve outcomes, so we were surprised with the negative results,” lead author Opeolu M. Adeoye, MD, MS, chair of the department of medicine at Washington University School of Medicine in St. Louis, Missouri, said in a statement. “However, we designed the trial to allow us to efficiently answer the question for two blood-thinning medications in one trial. We have definitely done that and are pleased with the ability to answer this question.”
Head positioning while patients await thrombectomy makes a significant difference
Positioning a stroke patient’s head flat on the hospital bed before surgery instead of elevating it may go a long way toward improving their recovery.
The analysis focused on 92 ischemic stroke patients who underwent thrombectomy at one of 12 U.S. stroke centers. Patients were randomly chosen to have their head positioned flat or at the typical 30-degree angle. Using the National Institutes of Health Stroke Scale to evaluate each patient multiple times, the researchers found that the flat position was associated with improved stability and clinical improvement. Even one week after discharge, patients who had been positioned with their head flat on the table appeared to have fewer neurological complications than patients who were positioned at an angle.
“Many thrombectomy patients have delays until the procedure can be started, whether due to slow internal hospital processes, multiple patients arriving at the same time or if the patient needs to be transferred to another hospital,” lead author Anne W. Alexandrov, PhD, a professor of nursing and neurology at the University of Tennessee Health Science Center in Memphis, explained in a statement. “Optimizing blood flow to the brain while patients are waiting for surgery, is essential to minimize the risk of neurological deficits and ultimately disability.”
Also, the research team emphasized that positioning a stroke patient’s head in a different way is not treatment—it is a “rescue maneuver” designed to potentially help preserve brain function until surgery can be performed.
ISC 2024
ISC 2024 is an annual meeting hosted by the American Stroke Association, a division of the American Heart Association, that brings together attendees from all over the world to examine the latest research and technology in the worlds of cerebrovascular disease and brain health. Click here for more information. A full schedule of the conference’s late-breaking clinical science presentations is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.