Andrea Arismendez was having a normal day on the job in April 2022, working at a nursing home in El Campo, Texas, when she decided to sit down for her lunch break with a coworker.
When Arismendez started slurring her speech, her coworker grew concerned and brought over a nurse, who said Arismendez was having a stroke. The nurse called 911, and an ambulance took the 38-year-old to a hospital in Wharton, Texas.
Arismendez was later airlifted via Memorial Hermann Life Flight to Memorial Hermann-Texas Medical Center.
“That’s all I remember – I sort of blacked out during the flight,” she said. “I was shocked. I’ve been healthy my whole life and never had to go to the doctor for any health emergency. I was scared that I’d done something wrong.”
While at Memorial Hermann, doctors determined Arismendez had suffered an acute ischemic stroke caused by blood clot that traversed a hole in her heart, known as a patent-foramen ovale (PFO).
Having experienced the stroke less than three hours before being admitted to the hospital, she qualified for the Multi-arm Optimization of Stroke Thrombolysis (MOST) clinical trial, which is investigating which blood thinner – argatroban or epitifibatide – improves recovery among acute ischemic stroke patients treated with standard-of-care thrombolysis within three hours of symptom onset. Thrombolysis includes the clot-busting medication called tissue plasminogen activator (tPA).
Andrew Barreto, MD, an associate professor of neurology with McGovern Medical School at UTHealth Houston, and James Grotta, MD, director of stroke research with the Clinical Institute for Research and Innovation at Memorial Hermann-TMC, are leading the national, randomized trial at Memorial Hermann.
“Over the past 10 years, Dr. James Grotta and I have taken a generic blood thinner – argatroban – and combined it with tPA,” Barreto said. “The phase 2 trial looked very promising, so we partnered with a physician in England, who enrolled 90 patients in a trial that found the treatment was safe, as well as a 79% probability that the two drugs together were superior to just tPA alone. We partnered with another institution in Cincinnati, applied to the National Institutes of Health (NIH) for a large phase 3 trial, and received $29 million in funding for the largest-team stroke therapy trial in U.S. history.”
The study includes more than 70 hospital sites throughout the U.S. and will involve 1,200 patients. UTHealth Houston is the No. 2 enrolling site for the trial, which will continue for the next four years.
Arismendez’s mother enrolled her daughter in the study. Though Arismendez was unconscious during her participation, she felt healthy enough to be discharged from the hospital one week later.
During her hospital stay, doctors also performed a PFO closure procedure to repair the hole in her heart.
Without any lasting effects from the stroke, she’s been able to appreciate spending time with her family, especially her two teenage sons, two cats, and dog.
“I feel like my normal self, like nothing happened,” Arismendez said. “I’m glad I found out what it was and what was causing it. I see the doctor every three months or so.”
Barreto said the MOST trial highlights UTHealth Houston’s record of excellence in stroke care.
“We’re consistently funded by the NIH as one of the primary sites for cutting-edge stroke treatments and new therapies,” he said. “And we’re performing.”
Grotta said Arismendez’s case also illustrates the importance of being able to recognize the signs of stroke, including sudden weakness or numbness on one side of the face or body, or impaired speech.
“Andrea’s successful treatment and recovery would not have been possible if her coworker didn’t recognize the stroke and call 911,” Grotta said. “If you recognize the symptoms of a stroke in yourself of someone else, call 911 immediately.”
For more information about the MOST trial, visit clinicaltrials.gov.
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