Navigation Links
Longer Time Frame for Clot-Busting Drug May Help Beat Stroke

By Amanda Gardner
HealthDay Reporter

MONDAY, July 26 (HealthDay News) -- Extending the time window to treat stroke patients with the clot-dissolving drug tPA from 3 hours to up to 4.5 hours after the onset of stroke doesn't result in any significant delays in treatment and appears to be a safe option for saving lives, new research suggests.

Still, there was a slight increased risk of death and bleeding over a three-month period in patients who received the later treatment -- a finding that reinforces the idea that the treatment should be given as soon as possible after a stroke to ensure better outcomes, said Swedish researchers reporting in the July 26 online edition of The Lancet Neurology.

"We're still targeting to treat as early as you can because that gets the best results," said Dr. Roger Bonomo, director of stroke care at Lenox Hill Hospital in New York City. "But this gets people included in the treatment group who otherwise would have been excluded just because it was 3 hours and 1 minute or 3 hours and 10 minutes after the stroke," he explained.

"The study is saying that the safety is sufficient to warrant continuing to treat patients [with tPA up to 4.5 hours after a stroke] even though these people have more symptomatic hemorrhages," he added.

Tissue plasminogen activator (tPA), also known as the drug alteplase, is an approved treatment for the most common kind of stroke -- ischemic stroke -- in which a blood vessel that supplies blood to the brain is blocked by a blood clot. The three-hour post-stroke time limit was set because of fears that use of the clot-dissolving drug beyond that period might cause dangerous bleeding or other complications.

After the publication of two landmark studies, the American Heart Association, the American Stroke Association and the European Stroke Association revised their guidelines in October 2008 to recommend that tPA be used up to 4.5 hours after the onset of an ischemic stroke.

Since that time, the number of patients being treated this way has surged.

But despite the initial evidence, experts have been worried that using the longer time window in actual practice might result in unnecessary delays in treatment, an increase in the number of intracerebral hemorrhages and still more deaths.

"There were lots of questions and interest in following up on the change in practice," Bonomo said.

The study authors, from the Karolinska Institute in Stockholm, revisited data on 23,942 patients who had participated in a clinical trial investigating the longer time window for using tPA.

By the end of 2009, three times more patients were being treated in the later time period (3 hours to 4.5 hours) than before the change but the average time from admission to treatment stayed the same, at 65 minutes.

Patients treated in the outer time limit were 44 percent more likely to suffer an intracerebral hemorrhage and 26 percent more likely to die within three months. Still, the authors wrote, these increases "are minor and are outweighed by the benefit of the treatment."

According to an accompanying "reflection and reaction" piece, this elevated risk translated into one additional hemorrhage for every 200 patients treated and one extra death for every 333 patients treated.

Alteplase is approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency only for use within the three-hour limit. The accompanying editorial called for regulatory approval to ensure all patients access to the treatment.

The trial was funded partially by Boehringer Ingelheim, which makes alteplase.

More information

The American Stroke Association has more on ischemic stroke.

SOURCES: Roger Bonomo, M.D., director of stroke care, Lenox Hill Hospital, New York City; July 26, 2010, The Lancet Neurology, online

Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Biological clock could be a key to better health, longer life
2. Big Smiles, Longer Lives?
3. Perhaps a longer lifespan, certainly a longer health span
4. Black Women Wait Longer for Breast Cancer Diagnosis, Treatment
5. Canadians Leading Longer, Healthier Lives Than Americans
6. Mayo-led research team develop agents that keep insulin working longer
7. Well-tolerated radiotherapy provides longer life to patients with recurrent brain cancer
8. New Hope for the Sleepless: RealSleep Uses Sound To Help Troubled Sleepers Go To Sleep Faster and Stay Asleep Longer
9. Longer Drug Regimen Still Best Against Breast Cancer
10. Intervention program helps breast cancer patients live longer after recurrence
11. iStayYoung Launches – Live Longer, and Better. Free for Seniors 65+
Post Your Comments:
Related Image:
Longer Time Frame for Clot-Busting Drug May Help Beat Stroke
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library ... City Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ... for fumigation is not a common occurrence, but a necessary one in the event that ...
(Date:6/25/2016)... TX (PRWEB) , ... June 25, 2016 , ... ... the United States, named Dr. Sesan Ogunleye, as the Medical Director of its new ... the facility Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin Johnson has ... he has implemented orthobiologic procedures as a method for treating his patients. The ... first doctors to perform the treatment. Orthobiologics are substances that orthopaedic surgeons use ...
(Date:6/25/2016)... Canada (PRWEB) , ... June 25, 2016 , ... Conventional ... pursuit of success. In terms of the latter, setting the bar too high can ... risk more than just slow progress toward their goal. , Research from ...
(Date:6/24/2016)... Michigan (PRWEB) , ... June 24, 2016 , ... Those ... deal with these feelings, many turn to unhealthy avenues, such as drug or alcohol ... of Marne, Michigan, has released tools for healthy coping following a traumatic event. , ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Research and Markets ... Market - Forecast to 2022" report to their offering. ... method for the patients with kidney failure, it replaces the ... from the patient,s blood and thus the treatment helps to ... chloride in balance. Increasing number of ESRD ...
(Date:6/23/2016)... , June 23, 2016 Research and ... Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data derived ... Assessment of major trends with potential impact on the market ... of market segmentation which comprises of sub markets, regional and ...
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 ... Tomorrow,s Leaders Scholarship is any indication, the future is ... online at by the Diabetes Scholars ... in the way of academic and community service excellence. ... program since 2012, and continues to advocate for people ...
Breaking Medicine Technology: