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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
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