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| Minority of stroke patients receive t-PA, often due to treatment delay |
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13 February 2006
In a study of more than 2000 patients with non-haemorrhagic strokes, just 2.1% received tissue plasminogen activator (t-PA), an agent known to improve stroke morbidity and mortality, according to a report in the February 14th issue of Neurology.
In many cases, t-PA was not given simply because the patient did not arrive at the hospital within 3 hours of stroke onset, the recommended therapeutic window, Dr Mathew J. Reeves, from Michigan State University in East Lansing, USA, and colleagues note.
The findings are based on a study of 2566 stroke admissions recorded in Michigan from May to November 2002. Of these, 330 were considered eligible for t-PA therapy and 2236 were not. Reasons for not being eligible for t-PA therapy included evidence of haemorrhage in 21% of cases, unknown stroke onset time in 35%, onset to arrival time >3 hours in 38%, and a physician-documented contraindication in 6%. Among the patients considered eligible for t-PA, only 13% actually received it. Factors predictive of receiving the drug included male gender, use of emergency medical services, and rapid presentation. As a result, out of 2097 patients with non-haemorrhagic strokes, only 43 patients (2.1%) received t-PA.
"People need to learn the warning signs of stroke and call 911 immediately if they think someone might be having a stroke," Dr Reeves said in a statement. "It's very important to be able to tell the medical staff when the symptoms started," he added. "It could mean the difference between receiving treatment and not receiving treatment."
Reference:
Neurology 2006; 66 (3): 306-312.
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