Early Clot-Busting Treatment Helps Most Stroke Patients: Study
THURSDAY, Feb. 13, 2014 -- Quick treatment with a clot-busting drug limits brain damage in stroke patients -- even those who are elderly or have had more severe strokes, new research indicates.
The drug -- called tissue plasminogen activator (tPA) -- is widely used, but there is ongoing debate about when to give it and whether it's safe to use in older patients or in those with minor or severe stroke.
A team of British experts reviewed data from more than 6,700 stroke patients who took part in nine clinical trials. They found that tPA reduced patients' risk of long-term disability and that earlier treatment improved outcomes.
The review showed that 33 percent of patients who were given tPA within three hours of the start of stroke symptoms did not have significant disability three to six months later, compared with 23 percent of those who did not receive the drug.
The rates were 35 percent for those who received the drug between three and four and a half hours after the onset of symptoms, and 33 percent for those who received it more than four and a half hours later. The rates were 30 percent and 31 percent, respectively, for patients who weren't given tPA.
The study was presented Wednesday at a meeting of the American Stroke Association in San Diego. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
"Our results may have implications for treatment guidelines on both sides of the Atlantic," study author Jonathan Emberson, senior statistician at the University of Oxford in the United Kingdom, said in an association news release.
"In the United States, use of tPA is currently limited to treatment within three hours, while in some European countries use is limited to patients aged 80 or younger," Emberson said. "The appropriateness of both of these restrictions may be revisited in light of our results."
Study co-author Peter Sandercock, a professor of neurology at the University of Edinburgh in Scotland, said tPA is under-used in stroke patients over age 80. "I am delighted these data support the use of tPA in this somewhat neglected patient group," he said.
About 795,000 Americans suffer a stroke each year, according to the American Stroke Association.
The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.
Posted: February 2014