Yatsu Day Symposium highlights advances in stroke care
For decades, researchers and clinicians have worked to find better ways to prevent stroke, reduce the risk of recurrence, and improve recovery for patients.
The latest advances bringing those goals closer to reality were at the center of the 16th Yatsu Day Symposium, hosted by the UTHealth Houston Institute for Stroke and Cerebrovascular Disease(external link).
Nearly 200 people attended the annul symposium, which brings together experts to discuss emerging areas in stroke research and care. This year’s program focused on new and evolving approaches to stroke prevention and treatment, including GLP-1 receptor agonists, new anticoagulants, cholesterol-lowering therapies, cell-based treatments, artificial intelligence, and nutrition.
“This symposium is dedicated to stroke and stroke care,” said Sean Savitz, MD, director of the Institute for Stroke and Cerebrovascular Disease and the Frank M. Yatsu, MD, Chair in Neurology at McGovern Medical School at UTHealth Houston. “We always pick a topic that’s dedicated to something new, a new cutting-edge area in the fields that people have brought interest in.”
New tools for stroke prevention
The first presentations examined treatments that could expand the options available to clinicians for patients at risk of an initial or recurrent stroke.
Chigozirim Izeogu, MD, MPH, assistant professor in the Department of Neurology at McGovern Medical School, discussed growing evidence surrounding GLP-1 receptor agonists, which have received widespread attention for treating Type 2 diabetes and obesity.
Beyond controlling blood sugar and appetite, GLP-1 receptor agonists can affect inflammation, the cardiovascular system, and blood vessels, creating interest in their potential role in stroke prevention.
Izeogu explained that clinical trials have shown reductions in cardiovascular events and ischemic stroke, particularly among people with Type 2 diabetes, obesity, or cardiovascular disease. She said evidence is strongest for patients who already have one of these diseases, while more research is needed before the medications can be recommended specifically for stroke prevention in patients without diabetes or obesity.
Anjail Sharrief, MD, professor of neurology, followed with a look at Factor XI inhibitors, a new class of anticoagulants being studied as a way to reduce clot formation without significantly increasing the risk of bleeding.
With current therapies, stroke survivors remain at risk for another stroke. However, Sharrief highlighted results from the phase 3 OCEANIC-STROKE trial, which found that adding the Factor XIa inhibitor asundexian to standard antiplatelet therapy reduced recurrent ischemic stroke by 26% without a significant increase in major bleeding.
The trial findings show a potential strategy for long-term secondary stroke prevention, but Sharrief said questions remain about when treatment should begin, how long it should continue, access to the medication, and whether its benefits will extend to underrepresented populations.
Christie Ballantyne, MD, section chief of cardiology and cardiovascular research at Baylor College of Medicine, shifted the focus of the symposium to treatment options for cholesterol.
Ballantyne discussed evidence surrounding increasingly aggressive lowering of LDL cholesterol and concerns that very low levels could have unintended consequences. He reviewed evidence from clinical trials that support intensive cholesterol management for patients with cardiovascular risks and discussed new therapies that can help patients reach cholesterol levels that have been difficult to achieve.
Exploring what comes next
Savitz’s presentation offered a look into the future with a presentation on cell-based therapies for stroke and neurological disorders.
Unlike conventional drugs that act on specific molecular targets, cell-based treatments can influence several processes at once. Savitz discussed research involving bone marrow-derived cells that can release biological factors, alter immune responses, protect neurons, and promote the formation of new neurons and blood vessels.
Savitz said studies have produced encouraging findings, allowing researchers to begin moving some approaches into clinical trials; however, the therapies are investigational and are not approved treatment for stroke.
The future of stroke research may also depend on tools that allow researchers to interpret large amounts of biomedical data. Wenjin Zheng, PhD, professor at McWilliams School of Biomedical Informatics at UTHealth Houston, discussed the growing role of artificial intelligence and high-performing computing in biomedical research and drug development.
Zheng demonstrated how powerful graphics processing units can be used to analyze large datasets, develop models that continuously update a patient’s disease risk, and accelerate the search for potential drug therapies. His work includes research through the NIH BRAIN Initiative using single-cell sequencing to better understand the different cells that make up the brain.
Returning to fundamentals
The symposium closed by discussing some of the most accessible tools for stroke prevention: diet, exercise, and lifestyle choices.
Wesley Tucker, MD, PhD, instructor at the University of Alabama at Birmingham, examined evidence behind commonly used vitamins and supplements, including multivitamins, fish oil, magnesium, vitamin D, B vitamins, and herbal supplements.
Despite claims surrounding supplements, Tucker said evidence supporting most of them for stroke prevention remains limited. Supplementation can be appropriate to address deficiencies or specific clinical needs, but it should not replace interventions with stronger supporting evidence.
Tucker mentioned that healthy diets and regular physical activity continue to demonstrate clear benefits for stroke prevention. He highlighted evidence supporting Mediterranean-style diets and noted that stroke risk declines as physical activity increases, beginning even when people move from no activity to relatively small amounts.
From medications nearing approval to experimental cell therapies and AI, the Yatsu Day Symposium highlighted how quickly the tools available for stroke prevention and treatment are evolving.
