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Study overcomes stroke care's biggest travesty

ANN ARBOR, MI Only a tiny percentage of stroke victims who could be saved from death or lifelong disability by the quick delivery of emergency therapy actually get the right treatment in time. But a new study shows there might be a way to fight what stroke experts call one of the biggest travesties in the treatment of the nation's third biggest killer.

The study finds that a focused educational campaign aimed at the public and health professionals nearly quintupled the use of an emergency clot-busting drug in stroke patients in three Texas counties, so that 69 percent of eligible patients got it. And the three-year community campaign produced a sustained increase that wasn't seen at all in two comparable nearby counties where the campaign wasn't carried out.

In the October 13 Archives of Internal Medicine, researchers from the University of Michigan Cardiovascular Center and the University of Texas at Houston report results from the $1.5 million project, funded by the TLL Temple Foundation.

"The campaign had high-impact results in a short time, which clearly shows that we can make dramatic improvements in acute stroke treatment through education," says lead author and U-M Stroke Program director Lewis Morgenstern, M.D., who began the study when he was a stroke neurologist at the U-T Medical School. "The results are especially promising because the same quick deployment needed for the acute therapy drug in this study, tPA, will be essential in any future acute stroke treatments."

Now, Morgenstern and his colleagues hope to see if they can replicate their results in other communities, with further randomized, controlled, prospective studies.

Since its introduction in 1996, tPA (short for tissue plasminogen activator) has helped tens of thousands of stroke victims who received it within three hours of the onset of their symptoms. By breaking up the blood clots that cause 80 percent of strokes by clogging the brain's blood vess
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
13-Oct-2003


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