In Mild Strokes, Ultra-Early Treatment May Eliminate Risk Of Disability

Source : American Heart Association

DALLAS, August 22, 2013 — In the case of mild or moderate strokes, getting treatment ultra-fast – within 90 minutes of experiencing symptoms – greatly reduces the risk of suffering disability, according to a new study reported in the American Heart Association's journal Stoke.

The American Heart Association/American Stroke Association recommends getting to a hospital within three hours of the onset of stroke symptoms. According to guidelines, clot-busting drugs may be given to treat stroke up to 4.5 hours after the onset of symptoms.

The study found that survivors with mild to moderate strokes who were given the clot-busting drugs in the first 90 minutes of the recommended time window had little or no disability three months later compared to those who were treated between 90 and 270 minutes.

"Ultra-early treatment increases the likelihood of excellent outcome in patients with moderately severe symptoms, and in secondary analysis also in those with mild symptoms," said Daniel Strbian, M.D., Ph.D., from the Department of Neurology at Helsinki University Central Hospital in Helsinki, Finland. "All measures must be taken to reduce onset-to-treatment time as much as possible."

The study included more than 6,800 stroke patients at 10 stroke centers in Europe over 14 years. They were treated intravenously with Alteplase, a clot-busting drug that is given through an IV in the vein. Patients were separated into three groups based on stroke severity – minor (NIH stroke score 0-6), mild/moderate (NIH score 7-12), or moderate/severe (NIH score higher than 12). Those with mild to moderate stroke seemed to benefit most from the ultra-early care. Early treatment also helped those with minor strokes, but the likelihood of disability is already very low in these patients.

Those with severe stroke did not benefit as much from the ultra-early treatment because they had severe artery blockage.

"We need more research to offer something more for people with severe strokes," Strbian said.

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Co-authors are Peter Ringleb, M.D., Ph.D., and Patrik Michel, M,D. Author disclosures are on the manuscript.

The American Heart Association/American Stroke Association's Target: Stroke program aims to help hospital teams quickly get clot busting drugs to stroke patients who need them.

F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you'll know that you need to call 9-1-1 for help right away. F.A.S.T. is:

F-Face drooping. Does one side of the face droop or is it numb?

A-Arm weakness. Is one arm weak or numb?

S-Speech difficulty. Is the speech slurred or incoherent?

T-Time to call 9-1-1 when someone is experiencing these symptoms.

A F.A.S.T. infographic and additional resources/multimedia are available on the right column of this link: http://newsroom.heart.org/news/in-mild-strokes-ultra-early-treatment-may-eliminate-risk-of-disability?preview=c0a672412ed87148bf743270b05652b7

Follow @HeartNews on Twitter for the latest heart and stroke news.

For stroke science, follow the Stroke journal at @StrokeAHA_ASA

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.

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