The risk of a stroke resulting in death diminishes the sooner a clot-reducing drug is administered, according to a UCLA study released yesterday.
In the study, researchers reported the frequency, patient and hospital characteristics, trends, and outcomes of ischemic strokes (those which occur as a result of an obstruction within a blood vessel supplying blood to the brain) with door-to-needle times of an hour or less. What they found was a 5% lower risk of death for every 15-minute reduction in the administration of intravenous tissue plasminogen activator – tPA.
“Early tPA treatment is key to effectively treating stroke and lowering mortality for the majority of patients,” said study author Dr. Jeffrey L. Saver, a professor of neurology at the David Geffen School of Medicine at UCLA and director of the UCLA Stroke Center.
“Once the patient arrives at the hospital, it is critical for the facility to perform rapid diagnostic evaluation and imaging, and in eligible patients promptly initiate tPA,” he said.
The more time that elapses before a patient receives the drug to help break up the clot blocking a blood vessel in the brain, the slimmer the chances of a positive outcome, according to the research, which was also published in the American Heart Association journal Circulation.
The tPA drug is a proven intervention for acute ischemic stroke patients but can only be given within four-and-a-half hours after the onset of a stroke – it has the greatest benefits when given earlier in that time frame, the study found.
“Despite proven benefits, national guidelines recommendations and explicit goals for administering tPA within 60 minutes of hospital arrival, the vast majority of U.S. hospitals are not meeting this critical goal for timely administration of tPA in stroke patients,” said study author Dr. Gregg C. Fonarow, the Eliot Corday Professor of Cardiovascular Medicine and Sciences at the UCLA medical school.