FRIDAY, Aug. 23 (HealthDay News) -- The use of a potentially
lifesaving, clot-busting drug -- called tissue plasminogen
activator (tPA) -- to treat patients with ischemic stroke nearly
doubled between 2003 and 2011, according to a large new study.
An ischemic stroke occurs when a clot blocks blood flow to the
brain. Guidelines recommend giving tPA within 4.5 hours of stroke
Researchers analyzed data from over 1 million ischemic stroke
patients treated at nearly 1,700 U.S. hospitals between 2003 and
2011. All of the hospitals in the study were part of an American
Heart Association quality improvement program to increase adherence
to stroke guidelines.
At these hospitals, use of tPA increased from 4 percent to 7
percent during the nine-year study period. Among patients who were
quickly brought to hospital and did not have any medical conditions
that would prevent safe use of the drug, tPA administration
increased from 43 percent to 77 percent.
There was also increased use of tPA to treat patients with less
serious stroke symptoms, those aged 80 and over, and black,
Hispanic and other nonwhite patients, according to the study
published online Aug. 20 in the journal
Circulation: Cardiovascular Quality and Outcomes.
"Hospitals have put tremendous efforts in the past decade into
increasing the number of patients who can be treated with
intravenous tPA, and this paper suggests those efforts are paying
off," study corresponding author Dr. Lee Schwamm, executive vice
chair of neurology and director of stroke services at Massachusetts
General Hospital, and a professor of neurology at Harvard Medical
School, said in a hospital news release.
"Today, more than three-quarters of stroke patients who are
eligible for IV tPA are getting this treatment at the more than
1,600 U.S. hospitals we studied," he added.
It's likely that the increased use of tPA "happened because, as
providers get comfortable using this drug and seeing good patient
outcomes, they become more willing to treat all eligible patients
and not just those they feel are the 'cream of the crop' for
treatment," Schwamm said.
Despite these findings, tPA is still underutilized, he
"We should be providing intravenous tPA to all eligible
patients, which means that nearly a quarter of them are still
missing that opportunity. Patients and their loved ones need to
recognize the signs of a stroke and get to the hospital quickly by
calling 911, and hospitals need to be ready to provide rapid
diagnosis and treatment," Schwamm said.
The American Heart Association has more about