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Early stroke treatment with t-PA has long-lasting benefit, according to NEJM report

One year after experiencing a stroke, patients who received a clot-buster early on were significantly less likely to be disabled than patients who did not receive treatment, reports the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator (rt-PA) Stroke Study Group in this week's issue of the New England Journal of Medicine.

"These findings are particularly significant in light of the staggering toll stroke can take on those who survive it," says third author Michael Frankel, M.D., associate professor of neurology at the Emory University School of Medicine and chief of neurology at Grady Memorial Hospital. "Since stroke is the leading cause of adult disability in the United States, any means to reduce its disabling effects translates into enormous cost-savings and improvements in quality of life."

Patients treated with tissue plasminogen activator (t-PA) within three hours of experiencing symptoms of acute ischemic stroke, "?were at least 30 percent more likely to have minimal or no disability at 12 months than were the placebo-treated patients?" the group reports.

The current study extends to one year the group?s 1995 findings of a sustained three-month benefit from early t-PA treatment. The study population was comprised of 624 ischemic stroke patients randomly assigned to receive either t-PA or placebo intravenously in the emergency department within three hours of stroke symptom onset.

According to Dr. Frankel, 39 stroke patients at Grady and Emory Affiliated Hospitals were entered into the Emory component of the multicenter trial.

"Other large studies of thrombolysis for the treatment of acute ischemic stroke have shown either no benefit or equivocal benefit from intravenous t-PA or streptokinase and high rates of early mortality and intracerebral hemorrhage," the group says. "Reasons for the disparity between the results of these studies
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Contact: Sarah Goodwin
sgoodwi@emory.edu
404-727-5686
Emory University Health Sciences Center
9-Jun-1999


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