Researchers Encouraged By Results of Stroke Pilot Study

Amy Waddell, [email protected], (310) 794-8672

Embargoed for use until 9:00 AM CST, Feb.7, 2002

NOTE: UCLA researchers, Los Angeles City Fire officials and patients are available for interviews.

UCLA Researchers Encouraged By Results of Stroke Pilot Study

Field Administration of Stroke Therapy-Magnesium (FAST-MAG) Trial Shows Promising Results for Drug that May Protect the Brain

Since "time is brain" when treating stroke victims, UCLA Medical Center researchers are encouraged by a pilot study showing magnesium sulfate administered early in the field by paramedics may actually protect the threatened brain and lead to a better recovery.

The study's goal demonstrated that this treatment - when initiated by paramedics in the field - was not only safe, but could also be delivered much more quickly compared to the usual approach of waiting until the patient was in the hospital. UCLA's Field Administration of Stroke Therapy-Magnesium (FAST-MAG) trial was performed in conjunction with the Los Angeles City Fire Department Emergency Medical System and paramedics using UCLA as a base station.

"This is the first time in the world that paramedics treated stroke patients in the field, on the way to the hospital, with a drug that may protect the brain," explained Dr. Jeffrey Saver, study investigator, neurologist and co﷓director of the UCLA Stroke Center. "We are very excited about the potential of these early findings."

The pilot study, conducted from May 2000 to January 2002, included 20 patients aged 44--89 years categorized as likely stroke victims according to the Los Angeles Pre-hospital Stroke Screen (LAPSS). While in the field with the patients, paramedics consulted with UCLA physicians and nurses to administer the potentially neuroprotective drug. In some cases, they continued to administer the drug while en-route to UCLA. Magnesium sulfate works by dilating brain blood vessels and by preventing buildup of damaging calcium in injured nerve cells.

The findings, presented today at the American Stroke Association's 27th International Stroke Conference in San Antonio, TX, showed magnesium sulfate was started 2 hours 40 minutes faster as a result of field administration by paramedics rather than by doctors and nurses upon the patient's arrival at the hospital.

The drug was also started within 60 minutes of symptom onset in several patients-- far faster than any previous trial of brain protective drugs for stroke patients.

Overall, the trial showed that paramedic administration of magnesium sulfate in acute stroke patients is feasible and safe and allows for delivery of drugs to the patient more rapidly within the critical first 1-2 hours after symptoms begin. It is hoped that eventually, it will become common practice for paramedics to administer this drug in the field.

Dr. Saver noted that the study was possible because of the unique relationship between the UCLA Stroke Center team and the Los Angeles City paramedics who have been specially trained in the recognition of stroke. The National Institutes of Health (NIH) supported the study. The study's lead investigators from UCLA were Dr. Saver, Dr. Sidney Starkman, emergency medicine/neurology, Dr. Chelsea Kidwell, neurology and Dr. Marc Eckstein, medical director of the Los Angeles City Fire Department.

"The L.A. City Fire department is extremely pleased to be part of what we hope will be cutting-edge research in the acute care of stroke patients," added Dr. Eckstein. "We hope that findings of this study will set the standard for pre-hospital care of stroke patients world-wide."

A larger, placebo-controlled trial of magnesium sulfate administered in the field within two hours of symptom onset is planned.

-UCLA-