For years, the mantra of neurologists treating stroke victims has been "time equals brain." That's because getting a patient to the emergency room quickly to receive a drug that dissolves the stroke-causing blood clot can make a significant difference in how much brain tissue is saved or lost.
But specific information has been limited on just how the timing of giving the intravenous drug known as a tissue plasminogen activator, or tPA influences outcomes for victims of ischemic (clot-caused), stroke, the most common type of stroke.
Now, a team led by UCLA researchers has conducted a major study on the importance of the speed of treatment when using tPA, analyzing outcomes for more than 50,000 stroke patients and determining just how critical the time between the onset of stroke and the administering of treatment is.
"We found that treatment time has a profound influence on outcome," said the study's first author, Dr. Jeffrey Saver, a professor of neurology and director of the UCLA Stroke Center. "The sooner treatment is started, the better. Beginning treatment earlier resulted in an improved ability to walk, the ability to remain living independently, less bleeding in the brain and reduced mortality."
The team's findings are reported in the June 19 issue of the JAMA, The Journal of the American Medical Association.
Previous research had demonstrated that administering tPA intravenously up to 4.5 hours after a stroke occurs benefits patients with moderate to severe acute ischemic stroke. Data pooled from a number of small, randomized clinical trials showed that the benefit of tPA was greatest when given very early after stroke, and that the benefit declined throughout the first 4.5 hours.
But the available data from these clinical trials was small just 1,850 tPA-treated patients from eight trials limiting precision in delineating the influence of time-to-treatment, as well as res
|Contact: Mark Wheeler|
University of California - Los Angeles