Similar improvements were seen in other performance measures, he said.

The hospitals in the study handle about 40 percent of all the ischemic strokes that occur in the United States, Fonarow said. Whether the same improvement in meeting treatment guidelines occurred in other hospitals is unknown, he said.

It's also not possible to say whether the increased adherence to therapy guidelines resulted in better outcomes for those getting treatment, since the study was not designed to measure outcomes, Fonarow said. "We just followed patients to hospital discharge," he said. "Additional studies after their release from hospital would be necessary to determine outcomes."

But an improvement in outcomes might be expected, since some of the recommended therapies, such as long-term use of cholesterol-lowering drugs, are designed to prevent new strokes, Fonarow said.

Some other studies are looking at long-term outcomes of stroke treatment, he said. "We would like to see the remarkable improvement that occurred from 2003 to 2009 continue," Fonarow said. "We will be looking at age-related differences in other kinds of strokes."

An ongoing effort is under way to try to collect data on stroke treatment in hospitals not in the program, said Dr. Ralph Sacco, professor and chair of neurology at the University of Miami and president-elect of the American Heart Association.

"The American Heart Association has been a big proponent in generating state-supported systems of care, and there is an increasing proportion of the U.S. population that is in closer proximity to stroke centers," Sacco said.

The "Get With The Guidelines" program "has been a tremendous success in improving evidence-based higher-quality care for acute stroke," he said.

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