Results of an international, randomized controlled research study show that mechanical thrombectomy, which is an endovascular treatment to remove a stroke-causing blood clot in the brain, is effective in some patients even when performed within 6 to 24 hours after a stroke.

The findings of the study were presented in late May at the European Stroke Organization Conference 2017 in Prague. Rush University Medical Center is the only Illinois site, one of seven sites in the U.S, and one of only 22 sites in the world to participate in the international study called the DAWN trial where severe stroke patients underwent a thrombectomy after the six hour time window.

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A sequential multiple assignment randomized (SMART) trial allows researchers to test two hypotheses at once.

The new trial method is being used in clinical trials across the industry.

“SMART trials allow you to get to two questions at once and can potentially be more efficient,” says William Meurer, M.D., associate professor of emergency medicine and neurology at Michigan Medicine and a member of the Michigan Center for Integrative Research in Critical Care. “You may find answers you wouldn’t normally find using a normal trial design.”

Meurer is the lead author on a study published in the Journal of Stroke and Cerebrovascular Diseases that investigated if the trial design could be used specifically to study stroke treatment.

“In stroke, we are often treating the patient with a tissue plasminogen activator drug upfront to dissolve a blood clot in the brain,” Meurer says. “Sometimes, that blood clot doesn’t dissolve. What do you do next?”

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Men and women with the lowest education level had higher lifetime risks of cardiovascular disease than those with the highest education level, according to a new study published by JAMA Internal Medicine.

One of the most important socioeconomic factors contributing to cardiovascular disease (CVD) is educational inequality. Calculating the lifetime risk of CVD according to educational levels is one way to convey the importance of educational attainment.

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CTVNews.ca Staff
Published Wednesday, June 7, 2017 12:21PM EDT
Last Updated Wednesday, June 7, 2017 9:29PM EDT

A new report warns that the rates of stroke are increasing among Canadian young adults faster than among older adults.

The risk of a stroke increases with age, which is why 80 per cent of all strokes happen to those over 60. But an increasing percentage of hospital admissions for stroke are occurring among patients between the ages of 20 and 59, the Heart & Stroke 2017 Stroke Report reveals.

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Action Plan Stroke Europe

The Action Plan for Stroke in Europe 2018 to 2030 will be of major importance for the prevention of stroke in Europe and the implementation of adequate stroke services.

Two previous consensus conferences on stroke management in Europe have been held in 1994 and 2006. Both conferences were organised by the European Stroke Council (1994) and the International Stroke Society (2006) in cooperation with WHO EURO. The consensus documents (The Helsingborg Declaration 1996 and 2006) were utilised as the basis for setting up and planning stroke services. The declarations reviewed current evidence, set up fixed targets, and identified prioritized areas of research.

A third consensus conference is scheduled to take place in Munich in 2018, building on the experience and the format of the previous conferences. The conference will be organized by the European Stroke Organisation, in cooperation with the patient organisation Stroke Alliance for Europe (SAFE). The World Stroke Organization will be asked to endorse the conference.

There will be seven domains of the Action Plan, five from the Helsingborg Declaration, plus Primary Prevention and Life after Stroke.

1. Primary Prevention
2. Organization of Stroke Services
3. Management for Acute Stroke
4. Secondary prevention and organized follow-up
5. Rehabilitation
6. Evaluation of Stroke Outcome and Quality Assessment
7. Life after stroke

Each domain of the Action Plan will have 1 chairperson, and 7 other members. For each domain, there will also be two additional persons who will be responsible for the identification of the Prioritized Research Areas. Each domain will include a review of the 2006 target results, an analysis of what worked and what did not, an update of current state of the art, proposals for 2030 targets, and the identification of Prioritized Research Areas.
Besides the Prioritized Research Areas of the first six domains (without life after stroke), there will also be a separate group who will be in charge of identifying Prioritized Research Areas for translational stroke research.

⦁ Translational Research Priorities Group

The Action Plan will be led by a 12-member steering committee, 6 of whom will constitute the core working group. Members of the steering committee will include representative(s) from WHO EURO.
The draft documents will be prepared prior to the ESOC 2018 in Gothenburg.

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