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The burgeoning field of stroke and cerebrovascular disease is following in the footsteps of advances in cardiology. In more than 450 presentations at the 28th International Stroke Conference, investigators reported new data on acute and prevention-based clinical trials, novel interventional approaches, public and professional education, and emerging risk factors.
In the Thomas Willis lecture, Charles P. Warlow, MD, of the University of Edinburgh, Edinburgh, United Kingdom, emphasized the role of large randomized clinical trials and meta-analyses as the most important tools for advancing our knowledge of stroke therapy. He cited the failure of the many neuroprotection trials to produce any definitive information, noting poor study design with too few patients. Dr. Warlow suggested proceeding with large randomized trials that examine new treatments and technologies early in their development before practice becomes entrenched.
In a plenary address, Joseph P. Broderick, MD, of the University of Cincinnati, Cincinnati, Ohio, discussed the changes necessary to bring about new effective therapies to reduce the stroke burden. The prevalence of many lifestyle-associated factors, such as obesity, diabetes, hypertension, and hypercholesterolemia, is growing. The challenges of an aging population and soaring treatment costs also must be overcome. Dr. Broderick further noted that treatments must be implemented more quickly following stroke, and are likely to involve combinations of medical and interventional therapies. Future interventions will also need to focus on public education and improving reimbursement for acute stroke treatment.
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