United States – Stroke is a condition in which neurologists refer to the critical importance of time where brain cells begin to die in as little as 15 minutes.
Thus, it is essential to determine which type of stroke the patient has suffered as soon as possible. But the new study of an experimental blood test may help in the process, as reported by Reuters.
Breakthrough Study
Researchers at Brigham and Women’s Hospital in Boston say their diagnostic test can distinguish between a rare, highly deadly stroke and other types.
The test then provides the doctors with the go-ahead for mechanical thrombectomy – an invasive procedure used to remove the clot from the large artery supplying the LVO.
“Mechanical thrombectomy has allowed people that otherwise would have died or become significantly disabled to be completely restored as if their stroke never happened,” senior study author Dr. Joshua Bernstock explained in a hospital news release.
“The earlier this intervention is enacted, the better the patient’s outcome is going to be,” added Bernstock, a clinical fellow in the hospital’s department of neurosurgery. “This exciting new technology has the potential to allow more people globally to get this treatment faster.”
Bernstock’s team already knew that various types of stroke generate different biomarkers in the blood when they happen.
They looked at two proteins in particular: GFAP has long been associated with brain bleeding and traumatic brain injury; the other is called D-dimer.
Blood tests that measure those proteins can help rule out a bleeding stroke since both bleeding and LVOs may have similar symptoms.
Validation and Efficacy
Combining the field assessment of stroke triage for emergency destination (FAST-ED) score with a blood test might help in identifying a patient with the potential for an LVO within minutes, Bernstock and his colleagues said.
The team applied this theory to patient data from 323 subjects in Florida who were treated for stroke between 2021 and 2022.
“Combining the levels of the [blood] biomarkers GFAP and D-dimer with FAST-ED data less than six hours from the onset of symptoms allowed the test to detect LVO strokes with 93 percent specificity and 81 percent sensitivity,” the researchers reported.
Ninety-three percent specificity implies that the diagnostic tool identified an LVO absence 93% of the time, and 81% sensitivity means that the tool accurately captured the actual presence of an LVO 81% of the time.
The new diagnostic strategy may be “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,” Bernstock said.
His team also thinks the test might help identify or eliminate instances of brain bleeds in emergency cases. It might be especially useful in poorer countries where it might be impossible to have high-tech diagnostic scans at all.
The findings were published May 17 in Stroke: Journal of Vascular and Interventional Neurology journal, as reported by Reuters.
Future Implications
The researchers now want to evaluate the usefulness of the new test in ambulances.
“The sooner a patient is put on the right care pathway, the better they are going to do,” Bernstock said. “Whether that means ruling out bleeds or ruling in something that needs an intervention, being able to do this in a pre-hospital setting with the technology that we built is going to be truly transformative.”