Presenter of 1 Presentation
LVO-CHECK: A RAPID POINT-OF-CARE BLOOD TEST TO REFER LVO PATIENTS FROM THE AMBULANCE TO THE THROMBECTOMY CENTER
Abstract
Background and Aims
Several tools such as clinical scales or individual blood biomarkers are being used to identify LVO patients out of the hospital and shift them directly to thrombectomy centers. However, their accuracy is suboptimal. We aimed to validate a new panel of blood biomarkers in a rapid Point-of-Care (POCT) format to be used to triage LVO patients.
Methods
Patients with suspected stroke (< 6h) were enrolled (n=197) and blood samples collected at ED. A 10 biomarkers panel was measured by immunoassays to select combinations of biomarkers associated with LVO. Best final candidates with available commercial POCTs were FABP/NT-proBNP in combination with simple clinical data (age, NIHSS, etc). Those results were prospectively replicated in BIO-FAST study that recruited n=300 patients with stroke suspicion onset < 6h in an ambulance network serving two thrombectomy centers (Biomarkers for Initiating Onsite and Faster Ambulance Stroke Therapies, ClinicalTrials.gov identifier: NCT04612218).
Results
Median NIHSS =7 (3-15), ASPECTS =10 (9-10) and blood samples obtention since stroke onset =2.16 hours (1.08, 5.25). Final diagnosis percentage was ischemic stroke (65.9%), hemorrhagic stroke (17.0%) and mimics (17.0%). Of the whole cohort 34.1% fulfilled LVO strict definition. LVO-check was 95% specific and 70% sensitive for LVO. Even using more simple scales such as Cincinnati instead of NIHSS the test showed good accuracy (100% specificity & 50% sensitivity).
Conclusions
LVO check is a rapid (10´) blood test that with a very high specificity and high sensitivity might allow referring LVO patients to thrombectomy centers or even attempting direct shift to the angio-suite.