Navigation Links
Timely treatment after stroke is crucial, UCLA researchers report
Date:6/19/2013

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 researchers' ability to determine whether the benefits could be generalized to a wider population. To address this need, the current study used a large national registry to determine more precisely the association of time-to-treatment and the resulting outcomes.

The team, which included UCLA's Dr. Gregg C. Fonarow, a professor of cardiovascular medicine and the director of the AhmansonUCLA Cardiomyopathy Center, analyzed data from the national stroke care quality-improvement database maintained by the American Heart Association/American Stroke Association's Get With the GuidelinesStroke program (GWTGStroke). They looked at the relationship between the time of treatment and in-hospital outcomes for 58,353 acute ischemic stroke patients treated with tPA within 4.5 hours of stroke onset.

The data was obtained from 1,395 hospitals between April 2003 and March 2012. The median age of patients, who were evenly divided between males and females, was 72. The average time from stroke onset to the beginning of treatment was 144 minutes, or roughly 2.5 hours. The extensive GWTGStroke database included information on each patient's medical history, stroke onset time, arrival time at a hospital, the time tPA treatment began, and other treatments and procedures.

Distilling this information, the researchers were able to confirm precisely how critical the time gap is between when a stroke occurs and when treatment begins.

"We know from brain-imaging studies that in humans, the volume of irreversibly injured tissue in the brain from an ischemic stroke expands rapidly over time, consuming 2 million additional neurons every minute until blood flow to the brain is restored," Saver said.

In examining the data from the GWTGStroke database, the researchers found that for every 15-minute faster interval of treatment, going home was 3 percent more likely, walking at the time of discharge was 4 percent more likely, having symptoms of hemorrhaging in the brain was 4 percent less likely to occur, and death was 4 percent less likely.

The findings underscore the important public health message that "time lost is brain lost in acute stroke," Saver said. "These results support the importance of the American Heart Association's "Target: Stroke" campaign, and the ongoing worldwide efforts to get stroke patients to a hospital and begin clot-busting treatment as soon as possible."

Please see the full JAMA paper for other authors and institutions that participated in the study, as well as for all author disclosures.


'/>"/>

Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles
Source:Eurekalert

Related medicine news :

1. First prospective trial shows molecular profiling timely for tailoring therapy
2. A shortcut to timely, cost-effective interventions for HIV
3. Lyme Disease Prevention Begins with Proper Tick Identification and Timely Removal.
4. Timely reminders boost childhood immunizations rates
5. New Evidence Based Information on Treatment for Over 8 Million People in the U.S. Affected With Disorders of the Vestibular System
6. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Announce A New Four Phase Program that Allows Patients to Lose Belly Fat, Thigh Fat and Underarm Fat Easily
7. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Offers New Fast Weight Loss Programs for Patients Suffering with Health Care Concerns
8. Involuntary Detention Proposal Dehumanizing, Says Holistic Mental Health Service Provider The Australian Addiction And Trauma Treatment Centre
9. Crystal Meth Addiction Treatment and Crystal Meth Drug Rehab Announced by Recovery Associates
10. Cancer Survivor Linda Christina Beauregard Writes New Tell-All Book About Her Alternative Treatment Method
11. Sexual minority youth need specialized treatment from therapists
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/9/2016)... ... December 09, 2016 , ... The ... Hotel in New York, NY, on December 3rd, to benefit Holy Name Medical ... the annual event, which raised over $1 million - the largest event in ...
(Date:12/8/2016)... Charleston, WV (PRWEB) , ... December 08, 2016 ... ... that it will become Quality Insights beginning January 1, 2017. The name ... emphasizes its commitment to measuring and improving health care quality. , “We are ...
(Date:12/8/2016)... ... December 08, 2016 , ... ZyDoc , ... Processing–Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A ... Results of the comparative usability study demonstrate that a dictation-based method (“NLP Entry”) ...
(Date:12/8/2016)... ... 2016 , ... With the increasing demand for dental implants, the National Association ... to inform dentists and patients about the safety issues related to dental restorations. According ... the U.S. is projected to reach $6.4 billion in 2018 with more than 30 ...
(Date:12/8/2016)... ... December 08, 2016 , ... ... continuity to its innovative Unified Instance Manager architecture, meeting the needs of ... new version optimizes the unattended auto-dialing system without agents, Presence Robodialer, provides ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... Dec. 8, 2016 Global Interventional Radiology ... the global interventional radiology market analyzes the current ... comprises an elaborate executive summary, including a market ... and sub-segments. The research is a combination ... the bulk of our research efforts along with ...
(Date:12/8/2016)... Dec. 8, 2016 Allergy Diagnostics Market: ... and tests that are used to determine the ... milk, or drugs etc. in the samples by ... immune system. The report on global allergy diagnostics ... the market. The report consists of an executive ...
(Date:12/8/2016)... NORWALK, Connecticut , 8 de dezembro de 2016  A Mederi ... a terapia Stretta, um tratamento não cirúrgico para a doença do refluxo gastroesofágico ... Reading ... Live Stretta procedure performed ... Director of Endoscopy at Wuhan Union Hospital ...
Breaking Medicine Technology: