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Groundbreaking Blood Test Could Revolutionize Stroke Diagnosis and Treatment

Stroke is the leading cause of disability worldwide and the second leading cause of death
Stroke is the leading cause of disability worldwide and the second leading cause of death. (CREDIT: Creative Commons)


Stroke is the leading cause of disability worldwide and the second leading cause of death. Timely intervention is crucial to prevent severe outcomes. A recent study led by Brigham and Women’s Hospital, part of the Mass General Brigham healthcare system, has introduced a promising new diagnostic tool.


This test, which combines blood-based biomarkers with a clinical score, can accurately identify patients experiencing large vessel occlusion (LVO) strokes. The findings were published in the journal Stroke: Vascular and Interventional Neurology.


 
 

“We have developed a game-changing, accessible tool that could help ensure that more people suffering from stroke are in the right place at the right time to receive critical, life-restoring care,” said senior author Joshua Bernstock, MD, PhD, MPH, a clinical fellow in the Department of Neurosurgery at Brigham and Women’s Hospital.



Most strokes are ischemic, meaning they result from an obstruction in blood flow to the brain. LVO strokes, a severe form of ischemic stroke, occur when a major brain artery is blocked. This blockage deprives the brain of oxygen and nutrients, causing cell death within minutes. Swift treatment with mechanical thrombectomy, a surgical procedure to remove the blockage, is essential for these cases.


 
 

“Mechanical thrombectomy has allowed people that otherwise would have died or become significantly disabled be completely restored, as if their stroke never happened,” Bernstock explained. “The earlier this intervention is enacted, the better the patient’s outcome is going to be. This exciting new technology has the potential to allow more people globally to get this treatment faster.”


In previous research, the team targeted two proteins found in capillary blood: glial fibrillary acidic protein (GFAP), associated with brain bleeds and traumatic brain injury, and D-dimer.


 

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The current study demonstrated that combining the levels of these biomarkers with field assessment stroke triage for emergency destination (FAST-ED) scores could accurately identify LVO strokes while distinguishing them from conditions like brain bleeds, which require different treatments.


This prospective, observational diagnostic accuracy study involved 323 patients coded for stroke in Florida between May 2021 and August 2022.


 
 

The study found that combining GFAP and D-dimer levels with FAST-ED scores within six hours of symptom onset allowed for the detection of LVO strokes with 93 percent specificity and 81 percent sensitivity. Notably, the test ruled out all patients with brain bleeds, suggesting its potential use in detecting intracerebral hemorrhage in the field.


The present work prospectively validated the potential utility of previously defined glial fibrillary acidic protein and d‐dimer cutoff levels (ie, 213 pg/mL and 600 ng/mL, respectively), demonstrating their value for discrimination of LVO stroke from differential diagnoses during code stroke workups.
The present work prospectively validated the potential utility of previously defined glial fibrillary acidic protein and d‐dimer cutoff levels (ie, 213 pg/mL and 600 ng/mL, respectively), demonstrating their value for discrimination of LVO stroke from differential diagnoses during code stroke workups. (CREDIT: Stroke: Vascular and Interventional Neurology)

Bernstock's team sees promising applications for this diagnostic tool in low- and middle-income countries, where advanced imaging may not be available. It could also be valuable in assessing patients with traumatic brain injuries.


 
 

The researchers are now conducting another prospective trial to evaluate the test's performance in ambulances. They have also designed an interventional trial to expedite stroke patient triage, enabling direct intervention without standard imaging.



“In stroke care, time is brain,” Bernstock emphasized. “The sooner a patient is put on the right care pathway, the better they are going to do. Whether that means ruling out bleeds or ruling in something that needs an intervention, being able to do this in a prehospital setting with the technology that we built is going to be truly transformative.”


 
 

This new diagnostic tool could significantly enhance stroke care, especially in regions with limited access to advanced medical imaging. By enabling rapid, accurate diagnosis in the field, it promises to improve outcomes for stroke patients worldwide.




 


For more science and technology stories check out our New Discoveries section at The Brighter Side of News.


 

Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.


 
 

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