Navigation Links
Longer Time Frame for Clot-Busting Drug May Help Beat Stroke
Date:7/27/2010

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:
*Name:
*Comment:
*Email:
Related Image:
Longer Time Frame for Clot-Busting Drug May Help Beat Stroke
(Date:4/30/2016)... ... April 30, 2016 , ... Saturday, April ... veterinarians’ global impact on public health. The World Veterinary Association (WVA) and the ... year have selected continuing education with a One Health focus, which emphasizes how ...
(Date:4/30/2016)... ... April 30, 2016 , ... Orlando-based Maximized Living has selected Dr. Nick ... in Rio. Under the care of Maximized Living doctors at the London Olympics ... showing, Maximized Living is sending the largest contingent of elite chiropractors to Rio to ...
(Date:4/29/2016)... , ... April 29, 2016 , ... ... Ten Footwear Foundation, the national charitable foundation serving the footwear industry, has broken ... volunteers representing more than 130 companies across 23 states during the months of ...
(Date:4/29/2016)... (PRWEB) , ... April 29, 2016 , ... On Tuesday, ... hospitals across the Southeast, celebrated the signature of Gov. Nathan Deal on SB 258, ... Geoff Duncan (R - Cumming), offers a 70% tax credit to individuals and corporations ...
(Date:4/29/2016)... ... April 29, 2016 , ... Conditions were ideal for Global ... Park on Sunday, with sunny skies, a light breeze and temperatures in the 60s. ... , The 5k Run and Walk and 1-mile walk were held to increase ...
Breaking Medicine News(10 mins):
(Date:4/29/2016)... , April 29, 2016 ... Life Sciences, Product Development Capabilities in ... Customer Base . Indegene ( ... announced the acquisition of Skura Corporation,s life science ... in adaptive sales enablement technology for life science ...
(Date:4/29/2016)... April 29, 2016 Automation is ... laboratory due to the growing demands for productivity in ... contemporary automated systems are already adept of a wide ... tedious and manual labor. Instrumentation continues to evolve, and ... conceivable just a few years ago. Originally used mostly ...
(Date:4/28/2016)... 2016 Research and Markets has ... Products Market 2016-2020" report to their offering. ... The global plastic surgery products market is expected ... period 2016-2020. , ,The growing adoption of laser in ... of the market. Lasers are used to treat a ...
Breaking Medicine Technology: