Revolutionary Blood Test Could Distinguish Between Ischemic and Hemorrhagic Strokes
In a significant medical breakthrough, a blood test conducted in a prehospital setting shows promise in rapidly distinguishing between ischemic and hemorrhagic strokes. This test could enable more rapid, targeted treatment, potentially improving patient outcomes.
The test measures glial fibrillary acidic protein (GFAP), a protein found in the brain that is released into the bloodstream when brain cells are damaged or destroyed. GFAP is already utilized to assess traumatic brain injuries.
“Our findings suggest that this blood test may allow some hemorrhagic and ischemic stroke patients to be identified and treated by paramedics in the ambulance without needing a CT scan,” said Dr. Love-Preet Kalra, a neurologist at RKH Klinikum Ludwigsburg, Germany. “This could be very exciting as we know that earlier intervention with specific treatments in both types of strokes can lead to better outcomes.”
Understanding Ischemic and Hemorrhagic Strokes
The study involved collecting prehospital blood samples from 353 patients suspected of acute stroke. Researchers measured GFAP concentrations using the handheld i-STAT Alinity device from Abbott.
Results indicated that GFAP levels were significantly elevated in patients with intracerebral hemorrhage (ICH) compared to those with ischemic stroke and stroke mimics. In moderate or severe neurologic deficit strokes (NIHSS > 6), a GFAP value below 30 pg/mL could exclude ICH.
This distinction could enable paramedics to administer thrombolysis in the ambulance to patients with ischemic stroke, direct severe stroke patients to thrombectomy-capable centers, and initiate early blood pressure reduction for patients with hemorrhagic stroke.
Potential Applications and Future Directions
The study also found that patients with ICH associated with anticoagulant use had higher GFAP levels, indicating potential for early administration of anticoagulant antidotes.
Dr. Kalra highlighted that current testing involves sample collection in the prehospital setting but analysis in the hospital laboratory. However, upcoming technological advancements will allow GFAP testing in whole blood, making point-of-care tests feasible for ambulance use.
Additional research, including larger multicenter trials, is essential to validate these findings and further develop this critical technology.
Expert Opinion
Dr. Louise D. McCullough, chief of neurology at Memorial Hermann-Texas Medical Center and co-director of UTHealth Neurosciences, expressed enthusiasm for the study results.
“It was really surprising to me that a point-of-care test could differentiate ischemic stroke from hemorrhagic stroke. This is very important because the treatment for these two diseases is very different,” she commented.
Conclusion and Future Impact
The potential of this blood test to differentiate between ischemic and hemorrhagic strokes in real-time could revolutionize stroke treatment. Early and accurate diagnosis could lead to faster and more targeted interventions, ultimately improving patient outcomes.
While further research is needed, this groundbreaking technology represents a significant step forward in stroke care and could potentially save many lives.
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