Clot-busting drugs appear safe for treating 'wake-up' stroke patients
Clot-busting drugs may be safe for patients who wake up experiencing stroke symptoms, according to preliminary research presented at the American Stroke Association's International Stroke Conference 2012.
In "wake-up" stroke, the person wakes up with symptoms after going to sleep with none. Not knowing when the stroke began excludes these patients from anti-clotting drugs that must be given within 4.5 hours of the beginning of the stroke.
"Because wake-up strokes are common, occurring in up to a quarter of stroke sufferers, more research is needed on how to treat these patients," said Dulka Manawadu, M.D., lead researcher and a stroke medical consultant at King's College Hospital in London, U.K. "Patients who experience stroke symptoms should call Emergency Medical Services urgently and get to the hospital fast, regardless of the time of onset. This will help specialists decide if novel interventions are appropriate and feasible."
In the study, researchers used a stroke registry to compare clot busting treatments received by 326 patients within 4.5 hours of symptom onset to 68 wake-up stroke patients, with unknown onset.
All the patients were treated in the same London medical center, where 20 percent suffered wake-up stroke. Researchers didn't randomly assign patients to receive different treatments for comparison, which is the gold standard and, thus, a limitation of the study.
"Our study shows that administering clot-busting drugs to patients with wake-up stroke who have the same clinical and imaging features as those treated within current guidelines is feasible and safe," Manawadu said.
Researchers analyzed information on patients who received the clot-buster alteplase, sold under the name Activase, between January 2009 and December 2010. Wake-up stroke patients received clot-busting treatments if their clinical presentation and early stroke changes on CT scan images were comparable to those treated with a known time of onset. Both groups had similar blood pressure, blood sugar levels and scores on the National Institutes of Health Stroke Scale, which is a standardized method used by healthcare professionals to measure the level of impairment caused by a stroke.
After three months, the researchers found the wake-up stroke patients' death rates, risk of bleeding inside the brain, and the proportion that made a good recovery were similar to those patients treated within a known 4.5 hours of stroke onset.
Sometimes, doctors are reluctant to give clot-busting drugs to patients in whom the time of stroke onset is not known, because the risks of bleeding are not known, Manawadu said. However, a significant proportion of patients who have stroke symptoms on waking may have suffered stroke in the early hours of the morning and may still be within the window of time where clot-busting treatments are known to be effective. It is also likely that advanced imaging techniques may help to identify patients with wake-up stroke who have the potential to benefit from clot-busting drugs.
"This is an area of growing importance because it may allow us to extend the indication for this effective treatment," Manawadu said. "Research has been limited to date but the time is ripe to investigate effective treatments in this group of patients."
Provided by American Heart Association
- Use of clot busters for stroke increased from 2005 to 2009, but still low Jun 02, 2011 | not rated yet | 0
- Clot-busting drugs improve diabetic stroke patients' prospects, study reveals Nov 16, 2011 | not rated yet | 0
- Study opens way for later treatment of acute stroke Sep 15, 2008 | not rated yet | 0
- MRI may help determine time of stroke onset Nov 02, 2010 | not rated yet | 0
- MRI can help decide therapy in patients with unclear-onset stroke Feb 10, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
1 hour ago So energy can only be converted... So when you squeeze the bulb on a blood pressure cuff, you are applying kinetic energy. Then the cuff fills with...
How does momentum, inertia and drag affect the motion of an object?
4 hours ago How does momentum and inertia affect changes in speed, when considering acceleration from thrust, or from decelleration from drag? Say, for a...
What is Time-Varying Voltage?
5 hours ago In circuits, we have no problem saying that the voltage difference between two point is [itex]\cos(\omega t)[/itex], but what does that actually...
Contextual Relationships Between Momentum, Energy, and Force.
7 hours ago *I apologize in advance for the length of this post, if you wish to reduce reading skip to paragraph 5. Or if you are super lazy, the final...
Barometric pressure and the math behind it. Very interesting, I think.
8 hours ago Hey guys, I was actually researching the life of Edmond Halley and discovered that he discovered the relationship between barometric pressure and the...
Doubts in electrostatics
14 hours ago I have a few questions pertaining to some concepts in electrostatics, I'd be grateful if someone would help me out. 1) When we place a positive...
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 ...
Cardiology 14 hours ago | not rated yet | 0 |
An experimental, inexpensive iPhone application transmitted diagnostic heart images faster and more reliably than emailing photo images, according to a research study presented at the American Heart Association's Quality ...
Cardiology 15 hours ago | not rated yet | 0
Extracorporeal membrane oxygenation (ECMO), a procedure traditionally used during cardiac surgeries and in the ICU that functions as an artificial replacement for a patient's heart and lungs, has also been used to resuscitate ...
Cardiology 17 hours ago | not rated yet | 0
Age has little to do with how patients should be treated after suffering a stroke, according to new research from the University of Georgia.
Cardiology 18 hours ago | not rated yet | 0 |
Depressed middle-aged women have almost double the risk of having a stroke, according to research published in Stroke: Journal of the American Heart Association.
Cardiology May 16, 2013 | not rated yet | 0
Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.
23 minutes ago | not rated yet | 0
For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...
1 hour ago | not rated yet | 0 |
The neural machinery underlying our olfactory sense continues to be an enigma for neuroscience. A recent review in Neuron seeks to expand traditional ideas about how neurons in the olfactory bulb might encode information about ...
12 hours ago | not rated yet | 0 |
(Medical Xpress)—What if the quality of your work depends more on your focus on the piano keys or canvas or laptop than your musical or painting or computing skills? If target users can be convinced, they ...
13 hours ago | 3.7 / 5 (3) | 0 |
(AP)—A woman who lost both hands, her left leg and right foot after contracting a flesh-eating disease has been fitted with prosthetic hands.
1 hour ago | not rated yet | 0
In 2008 researchers from the University of Southern Denmark showed that the drug thioridazine, which has previously been used to treat schizophrenia, is also a powerful weapon against antibiotic-resistant bacteria such as ...
10 hours ago | 3.7 / 5 (3) | 0 |