2019 AHA ISC Stroke News Day 2

THURSDAY | FEBRUARY 7, 2019 INSIDE 2019 ISC EXHIBITORS AND MAP PAGES 8-9 SAVE THE DATE FOR INTERNATIONAL STROKE CONFERENCE 2020 February 19-21, 2020 | Los Angeles Experts to address link between chronic kidney disease and stroke W ith increasing evidence of the relationship between chronic kidney disease, the brain and stroke, it’s time clinicians “pay attention,” said Branko Huisa-Garate, MD, assistant professor of neurosciences at the University of California, San Diego. “It is time for researchers to be aware of this connection and look into it in far more detail than has ever been done,” said Huisa-Garate, who will moderate Friday’s session. “Clinicians also need to be aware of the growing evidence of relationships between kidney disease and the brain in their patients. We all need to do a better job of seeing our patients as a whole, under- standing that what happens in different parts of the kidney affects the brain and not look at just one organ in isolation.” Chronic kidney disease is more than a risk factor for cardiovascular disease and stroke. Metabolic and vascular changes stemming from even the early stages of kidney disease Demel see KIDNEY , page 10 Doctors may unknowingly undertreat women for stroke, neurologist says M any physicians unaware of gender- based differences in stroke risks, treatments and outcomes are unknowingly undertreating women who need anticoagulation therapy out of undue concerns over frailty, according to Stacie Demel, DO, PhD. “When you find AFib, you typically put that person on anticoagulation to reduce stroke risk,” said Demel, assistant professor of neurology and rehabilitation medicine at the University of Cincinnati Medical Center in Ohio. “But men may be more likely to be placed on anticoagulants than women. But underuse of these medications in women may play a role in stroke incidence at age 80 and older.” Demel will co-moderate Friday’s session with Dawn O. Kleindorfer, MD, professor of neurology and director of the Comprehensive Stroke Center at the University of Cincinnati. Presenters will discuss the latest findings on: • Stroke in young women • Peri-menopausal changes in stroke risk • Stroke in post-menopausal women • Effects of marital status on stroke Chronic Kidney Disease and Stroke 7-8:30 a.m. Friday Kalakaua Ballroom A UPCOMING SESSION Debate honors tPA pioneer I f you could ask the namesake of the Justin A. Zivin Memorial Session about tPA versus TNK, he would probably say there’s no debate. “Justin would have looked at the biological rationale for using TNK,” said Patrick Lyden, former fellow and long- time collaborator of Zivin, “and he would have said, ‘Listen, it works! Why aren’t we using it?’” Lyden, MD, professor of neurol- ogy at Cedars-Sinai in Los Angeles, will moderate Friday’s debate that pits FDA-approved rtPA (alteplase) against newcomer TNK (tenecteplase). Both are recombinant tissue plasminogen activa- tors, with rtPA nearly identical to wild type tPA and TNK, a genetically modified mutant of the wild type. Zivin, who died last year at age 71, wrote the seminal paper on tPA that demonstrated it was an effective thrombolytic for stroke using an animal model. The article, published in Science in 1985, also challenged the contempo- rary thinking that efficacy in stroke treatment equaled open arteries. Zivin’s model made neurological function the key outcome. “Before Justin’s article, we fumbled about scoring open arteries and quanti- fying lesion volumes,” Lyden wrote in a tribute to Zivin. “The article provided the foundation for later successful human trials in thrombolysis.” Years on, Zivin and Lyden showed that TNK was effective in the same animal model. Atrial fibrillation is an important risk factor for stroke, especially in older adults. But the risk of stroke associated with AFib is significantly higher in women than in men. see WOMEN , page 10 Science & Technology Hall hours 8:30 a.m.-3 p.m. Thursday Stroke in Women Throughout the Life Course: An International Perspective 7-8:30 a.m. Friday Room 315 UPCOMING SESSION Huisa-Garate It is time for researchers to be aware of this connection and look into it in far more detail than has ever been done. Branko Huisa-Garte, MD Zivin The Justin A. Zivin Memorial Session: The Tried and Tested vs. the New Kid on the Block: The tPA vs. TNK Debate 8:45-10:15 a.m. Friday Kalakaua Ballroom C UPCOMING SESSION see DEBATE , page 6 strokeconference.org #ISC19 @AHAmeetings facebook.com/ahameetings