A landmark study published in the New England Journal of Medicine today heralds a new era in stroke treatment across the globe.
EXTEND-IA*, an Australian and New Zealand randomised clinical research study, led by The Royal Melbourne Hospital (RMH), looked at the effectiveness of a new treatment for stroke.
The study involved adding a minimally invasive clot removal procedure called stent thrombectomy to standard clot-dissolving therapy, known as tissue plasminogen activator (tPA).
Royal Melbourne Hospital Neurologist and co-principal investigator, Dr Bruce Campbell, said the study showed a dramatic improvement in restoring blood flow back to the brain, which is critical in the recovery of stroke.
“In 89 percent of patients blood flow to the brain was restored when the clot removal therapy was used compared with 34 percent of patients who had standard clot-dissolving therapy alone,” Dr Campbell said.
“The addition of stent thrombectomy to standard clot-dissolving treatment led to 71 percent of patients returning to independent living, compared with 40 percent in the standard treatment group.
“This is an extremely impressive outcome given these patients had the most severe forms of stroke and dramatically reduces the burden of disability.”
The most common form of stroke is an ischemic stroke, caused by a clot blocking a blood vessel that supplies the brain. Stroke is the leading cause of disability in adults and the number two cause of death worldwide.
The EXTEND-IA trial builds on an earlier Dutch study, MR-CLEAN, which was presented at the 9th World Stroke Congress, Istanbul 25 October 2014 and also published in the New England Journal of Medicine.
Director of The RMH’s Neurointervention and co-principal investigator, Associate Professor Peter Mitchell, described EXTEND-IA and the MR-CLEAN study as a “game-changer’ in the treatment of stroke across the globe.
“In treating stroke it is critically important to restore blood flow as soon as possible, “Associate Professor Mitchell said.
“The patients treated in EXTEND-IA had even better outcomes than in MR-CLEAN. The key differences were improved rates of opening the blocked blood vessel, earlier treatment and the use of more advanced brain imaging to select patients most likely to benefit.
“The new treatment, called stent thrombectomy, is a minimally invasive procedure performed via an angiogram. This involves inserting a small tube into an artery in the groin and feeding it up into the brain to capture the clot and remove it.
“The EXTEND-IA results indicate that stent thrombectomy will help thousands of Australians who suffer from an acute ischemic stroke and the challenge now is to implement stent thrombectomy as a standard treatment for stroke.”
The above story is based on materials provided by Melbourne Health. Note: Materials may be edited for content and length.
Drinking more than two alcoholic beverages daily in middle-age may raise your stroke risk more than traditional factors such as high blood pressure and diabetes, according to new research in the American Heart Association journal Stroke.
In a study of 11,644 middle-aged Swedish twins who were followed for 43 years, researchers compared the effects of an average of more than two drinks daily (“heavy drinking”) to less than half a drink daily (“light drinking”).
The study showed that:
- Heavy drinkers had about a 34 percent higher risk of stroke compared to light drinkers.
- Mid-life heavy drinkers (in their 50s and 60s) were likely to have a stroke five years earlier in life irrespective of genetic and early-life factors.
- Heavy drinkers had increased stroke risk in their mid-life compared to well-known risk factors like high blood pressure and diabetes.
- At around age 75, blood pressure and diabetes appeared to take over as one of the main influences on having a stroke.
Past studies have shown that alcohol affects stroke risk, but this is the first study to pinpoint differences with age.
“We now have a clearer picture about these risk factors, how they change with age and how the influence of drinking alcohol shifts as we get older,” said Pavla Kadlecová, M.Sc., a statistician at St. Anne’s University Hospital’s International Clinical Research Center in the Czech Republic.
Researchers analyzed results from the Swedish Twin Registry of same-sex twins who answered questionnaires in 1967-70. All twins were under age 60 at the start. By 2010, the registry yielded 43 years of follow-up, including hospital discharge and cause of death data.
Researchers then sorted the data based on stroke, high blood pressure, diabetes and other cardiovascular incidences.
Almost 30 percent of participants had a stroke. They were categorized as light, moderate, heavy or non-drinkers based on the questionnaires. Researchers compared the risk from alcohol and health risks like high blood pressure, diabetes and smoking.
Among identical twin pairs, siblings who had a stroke drank more than their siblings who hadn’t had a stroke, suggesting that mid-life drinking raises stroke risks regardless of genetics and early lifestyle.
The study is consistent with the American Heart Association’s recommended limit of two drinks a day for men and one for women. That’s about 8 ounces of wine (two drinks) for a man and 4 ounces (one drink) for a woman.
Regular heavy drinking of any kind of alcohol can raise blood pressure and cause heart failure or irregular heartbeats over time with repeated drinking, in addition to stroke and other risks.
“For mid-aged adults, avoiding more than two drinks a day could be a way to prevent stroke in later productive age (about 60s),” Kadlecová said.
The above story is based on materials provided by American Heart Association.Note: Materials may be edited for content and length.
Looking at Your Risk of Stroke
A simple set of questions for checking your heart health might also help predict your stroke risk, a new study suggests. The finding hints that even small improvements to your lifestyle might help prevent strokes.
Stroke is the fourth leading cause of death nationwide. It occurs when blood vessels that supply the brain become ruptured or blocked. When blood can’t carry nutrients and oxygen to brain cells, the cells stop functioning and die.
A list of 7 key health factors—called Life’s Simple 7 (LS7)—was developed by the American Heart Association to assess health status. LS7 score is measured by looking at the 7 factors: physical activity, diet, weight, blood pressure, blood sugar, cholesterol and smoking. Each of these factors can be categorized as ideal (high score), average (medium score) or poor (low score). A high score on the LS7 has been linked to low rates of cardiovascular disease and death.
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NIH-funded scientists tested to see if the LS7 score could also assess stroke risk. They studied nearly 23,000 people with an average age of 65 years. The researchers found that each “better” category for overall LS7 score corresponded to a 25% drop in stroke risk. Even participants with only one “ideal” factor had a lower stroke risk compared to those with none.
Health status varied widely for each of the 7 factors. For example, most participants (84%) had an ideal status for smoking, but none (0%) had an ideal diet.
The findings suggest that you might reduce stroke risk by improving 1 or more of these 7 factors. Get active; eat healthy foods; have a healthy weight; don’t smoke; control cholesterol; manage blood pressure; and keep blood glucose in check. Learn more about Life’s Simple 7 and use the free assessment tool at this American Heart Association website: http://mylifecheck.heart.org/.
Editors note: Original article can be found here.
Credit: National Institutes of Health
by Elizabeth Renter,
Stroke sufferers are getting younger, say researchers, and this is a serious concern. According to a study published in Neurology, the average age of a stroke sufferer fell from 71 in 1993-1994 to 69 in 2005. The scientists are offering several possible causes, each of which make sense and each are highly preventable. Bottom line: everyone should learn how to prevent a stroke.
Why You Need to Know How to Prevent a Stroke
The study looked at strokes between two periods, 1993-1994 and 2005. The incidence of stroke in people under the age 55 in 1993-1994 was about 13 percent – this compared to 19 percent of them being under the age of 55 in 2005.
Study author Brett Kissela of the University of Cincinnati College of Medicine says that risk factors including diabetes, obesity, and high cholesterol are likely to blame. Interestingly, all of these are preventable through diet and exercise.
As the obesity rates climb in this country and around the world, so do the disease rates. So, it should be no surprise that the age of people suffering from strokes are getting younger and younger, just as the number of young people with liver disease and type 2 diabetes similarly climbs.
So, what can be done? Start by eating more healthful foods and exercising. Treat your body as you would a high-dollar car– giving it the right fuel and enjoying its ability to go.
What to Do and What Not to Do
A stroke occurs when blood supply to the brain is cut off. Keeping the vascular system healthy through exercise, and reducing inflammation and plaque deposits with a natural and holistic diet can do wonders in the prevention of stroke and heart disease.
Also, eliminate things from your life that are known to be related to increased risk of stroke. Eliminate:
- Diet Soda – Researchers found that diet soda consumption was linked to a 44 percent higher chance of heart attack or stroke, up from the 22 percent non-soda drinkers have.
- Depression and Anti-depressants – “Women with a history of depression were 29 percent more likely to have a stroke during six years of follow-up, and this finding held even when researchers controlled for other factors known to increase stroke risk. What’s more, women who took antidepressants had a 39 percent increased risk of stroke,” reports HealthDay News.
At the same time, you can boost your stroke resistance with things like:
- Chocolate – Want to know how to prevent a stroke? Have some chocolate. As reported in the Raw Story, men who ate a chocolate bar each week could lower their stroke risk by 17 percent. Every increase in consumption of 50 grams per week, further reduced risk of stroke by 14 percent, according to the study.
- Magnesium – Researchers evaluated seven studies previously published over the span of 14 years and found that for every addition of 100 milligrams of magnesium a person consumed per day came a reduced risk of an ischemic stroke by 9 percent.
- Optimism – Optimism may be the key to stroke prevention in addition to improving overall health. Researchers pulled 6044 adults over 50 and asked them to rate their level of optimism based on a 16 point scale. When adjusted for age, each addition point on the optimism scale accounted for a 9 percent decrease in acute stroke risk.
We’ve become a society of reactionaries when it comes to our health, treating things as problems arise rather than avoiding the problems altogether. You could be like the majority of people who suffer from a stroke and be shocked when it occurs, thinking it could never happen to you. Or, you can take steps to prevent it through natural health and ensure it never happens to you. Implement these measures on how to prevent a stroke today and share the information with those around you.
Read more: http://naturalsociety.com/how-to-prevent-a-stroke-what-to-do/#ixzz2AnoJNNTV
THE UNIVERSITY OF QUEENSLAND
The review found that quantitative electroencephalogram, which measures the electrical activity of the brain, can help to predict a patient’s long-term outcomes and show whether they’re responding to treatment. Both of these benefits can help to prevent brain damage in stroke patients.
WEDNESDAY, 15 AUGUST 2012
A new study from The University of Queensland shows monitoring the brain of stroke patients using Quantitative EEG (QEEG) studies could inform treatments and therefore minimise brain damage of stroke victims.
EEG stands for electroencephalogram and is a medical test which is used to measure the electrical activity of the brain.
Dr Simon Finnigan from UQ’s Centre for Clinical Research and Professor Michel van Putten from Medisch Spectrum Hospital and University of Twente in the Netherlands, recently reviewed all published QEEG studies of stroke worldwide.
“The main goals of this research were to evaluate key findings, identify common trends and determine what the future priorities should be, both for research and for translating this to best inform clinical management of stroke patients,” Dr Finnigan said.
“Our studies have real potential to eventually contribute to better outcomes for stroke patients and for me this is the ultimate goal,” he said.
The review of outcomes from hundreds of patients has highlighted that QEEG indicators are particularly informative in two ways.
“Firstly they can help predict long-term deficits caused by stroke,” Dr Finnigan said.
“In addition, they could provide immediate information on how patients are responding to treatments and guide decisions about follow-on treatments, even before stroke symptoms change,” he said.
Currently, tissue plasminogen activator (TPA), a drug which can dissolve blood clots, is administered intravenously to stroke patients within 4.5 hours after the onset of symptoms and clinicians wait for visual signs that symptoms are improving.
If this doesn’t occur after approximately one hour, follow-on treatments may be used.
“This is where QEEG could indicate whether or not the brain is responding to the drug. Plus, it could do so up to an hour before the symptoms might improve,” Dr Finnigan said.
“This is a critical difference when “time is brain” and clinicians are trying to get blood back into the brain before it’s too late. If QEEG can enable clinicians to start other treatments faster, this could help minimise brain damage and deficits,” he said.
Dr Finnigan is working with neurologists, Dr Wong, Dr Read and Dr Sheikh and other clinicians at the Royal Brisbane and Women’s Hospital (RBWH).
Editor’s Note: Original news release can be found here.