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Early Treatment With Clot-Busting Drug Best After Stroke
Date:5/14/2010

of a positive outcome were good. However, when the drug was given later, the chances of a strong recovery rapidly declined.

In fact, patients given tPA within 90 minutes after suffering a stroke were more than 2.5 times more likely to have a good recovery, compared with similar patients who did not get the drug. Moreover, patients who got tPA 4.5 hours after their stroke had only a 22 percent chance of a good recovery, compared with patients who never got tPA, the researchers found.

Lees and colleagues also found that patients given the drug after 4.5 hours of the onset of a stroke were more likely to die.

These findings mean that patients have more time to get to the hospital, Lees said. "The message for the doctors is we can't waste a moment once the patient has arrived in starting treatment, so there is more time for the patients and less time for the doctors."

Dr. Steven R. Levine, a professor of neurology at Mount Sinai School of Medicine in New York City and co-author of an accompanying journal editorial, agreed that "the sooner you get treatment for your stroke, the more likely you are to have minimal or no disability from it."

For every 90 minutes you wait to get treated, you reduce your chances of a good recovery by a factor of two, he noted. "For every 10 minutes you wait, that's about 20 million brain cells that are dying," Levine said.

Everybody needs to know about stroke and what to do, Levine said. The first thing is to call 911, he said.

"Time is brain. That's really the message," he said.

Another expert, Dr. Larry B. Goldstein, director of the Duke Stroke Center at Duke University, said that "this combined analysis is consistent with the prior analysis based on a smaller number of trials and reinforces the benefit of treatment with tPA on carefully selected patients with acute ischemic stroke."

It also reinforces the need to begin treatment as soon as possible
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