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:3/27/2017)... ... March 27, 2017 , ... The Anaheim Hills office ... First National Capital has added 10 new sales professionals over the past 6 months ... by 15 additional new hires over the course of 2017. , “This new ...
(Date:3/27/2017)... Orange, Texas (PRWEB) , ... March 27, 2017 ... ... celebration at the GTEC Orange facility from 8:00am-10:00am on Monday, April 3rd to ... giveaways and will be an opportunity for area-residents to celebrate two great years ...
(Date:3/26/2017)... ... March 26, 2017 , ... Local physician Dr. Justin ... a prestigious award honoring the top influencers on RealSelf—the most trusted online destination ... doctors and clinics. , In 2016, more than 82 million people visited RealSelf ...
(Date:3/24/2017)... ... March 24, 2017 , ... Vighter ... the same time by providing Prehospital Trauma Life Support (PHTLS) course scholarships to ... premier prehospital trauma education developed in cooperation with the American College of Surgeons ...
(Date:3/24/2017)... ... ... The Radiology Business Management Association (RBMA) has named the nine winners ... year, are among the most prestigious in radiology marketing because a panel of radiology ... recognize achievements in both large budget (over $5,000) and small budget (under $5,000) campaigns. ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... BOSTON , March 27, 2017 ... pharmaceutical company and Paratek Pharmaceuticals, Inc. (Nasdaq: PRTK), ... commercialization of innovative therapies based upon tetracycline chemistry, ... sarecycline for the treatment of moderate to severe ... Sarecycline is a once-daily, oral, narrow spectrum tetracycline-derived ...
(Date:3/27/2017)... 2017  Impax Laboratories, Inc. (NASDAQ: IPXL)today announced that ... Bisaro as Impax,s President and Chief Executive Officer ... 27, 2017. Mr. Bisaro will succeed J. Kevin ... Chief Executive Officer since December of 2016. ... experience, Mr. Bisaro, 56, is an accomplished global business ...
(Date:3/27/2017)... 27, 2017  PhaseRx, Inc. (NASDAQ: PZRX), a ... liver diseases in children, today reported financial results ... December 31, 2016 and provided an update on ... to make progress during the fourth quarter of ... our non-human primate safety study, and with our lead ...
Breaking Medicine Technology: