Miguel Perez-Pinzon, Ph.D., FAHA, Chair, International Stroke Conference 2019 Program Committee, offers overviews and perspective on late breaking science being presented at ISC 2019 in Honolulu.  He is Professor of Neurology/Neuroscience, Director, Cerebral Vascular Disease Research Center, Director, Peritz Scheinberg Cerebral Vascular Laboratory, Vice-Chair for Neurology Basic Science at the Miller School of Medicine, Department of Neurology at the University of Miami, Miami, FL.

copyright American Heart Association

"The first one is about the SHINE trial. It's the Stroke Hyperglycemia Insulin Network Effort and this trial stems from the fact that hyperglycemia's common in acute stroke patients and it's linked to worse functional outcomes when compared with euglycemic stroke patients. So, different points of view regarding the management of hyperglycemia in stroke patients. So they're looking at the efficacy and safety of up to 72 hours of glucose management using IV insulin infusion. This is compared to standard care. So, the primary outcome is 90-day modified ranking scale and compared with severe hyperglycemia and this secondary outcome is looking at 90-day, the NIH Stroke scale and the barbital index and strokes for the quality of life. So, this was a multicenter. They enroll 1,151 patients in 63 sites in the US and it was randomized as normally as it was assigned. So, the main finding was that the intense glucose therapy be IV insulin infusion, lowers the glucose to a target of 80-130 milligrams per deciliter and it doesn't improve outcomes at 90 days compared to the standard glucose control. So, in addition, the intense glucose therapy increases the risk of very low blood glucose or hypoglycemia and requires more resources such as increased supervision for nursing staff. So, those are the main results of the SHINE trial."