Nav: Home

Clot buster treatment safe, effective for patients who required living assistance pre-stroke

January 21, 2016

DALLAS, Jan. 21, 2016 -- Intravenous clot busting may be safe and effective in patients who required daily living assistance prior to stroke, according to new research in the American Heart Association's journal Stroke.

A European multicenter study researched the effect of intravenous thrombolysis (IVT) - clot busting - among ischemic stroke patients with preexisting dependency - defined as unable to live alone without help from another person. Patients with prior dependency are often excluded from clinical trials of IVT, and because of a lack of information about this population, if they have a stroke, they may not be treated with clot busters due to the expected higher risk of bleeding complications and lower treatment response.

"These findings prove that randomized-controlled IVT trials should be considered for such patients," said Henrik Gensicke, M.D., lead author and neurologist in the Department of Neurology at the University Hospital Basel in Switzerland.

Among 7,430 IVT-treated patients in 12 European stroke centers, 6.6 percent were dependent prior to stroke. Researchers measured the degree of disability at 3 months after stroke onset. In this case, poor outcome included not reaching at least pre-stroke dependence among the dependent group.

Within three months after IVT treatment, dependent patients were twice as likely to die as independent patients. However, poor outcome and intracranial hemorrhages was equally frequent in both groups.

Among three-month survivors, the proportion of dependent patients with poor outcome did not differ from independent patients. After adjusting for age and stroke severity, dependent patients were at lower risk of poor outcomes than independent patients.

"Concerns of higher complication rates from IVT-treatment resulting in a less-than-favorable risk-benefit ratio for dependent patients might be unjustified and perhaps should be set aside to allow further study," Gensicke said.

In this study, prior stroke, dementia, heart and bone diseases were the most common causes of preexisting dependency and dependent patients were older, more often female, had more severe strokes and were more often prescribed antithrombotic medication than previously independent patients.
-end-
Co-authors are Daniel Strbian, M.D.; Sanne Zinkstok, M.D., Ph.D.; Jan Scheitz, M.D.; Olivier Bill, M.D.; Christian Hametner, M.D.; Solene Moulin, M.D., M.Sc.; Andrea Zini, M.D.; Georg Kagi, M.D.; Alessandro Pezzini, M.D.; Visnja Padjen, M.D.; Yannick Bejot, M.D.; Sydney Corbiere; Thomas Zonneveld, M.D.; David Seiffge, M.D.; Yvo Roos, M.D., Ph.D.; Christopher Traenka, M.D.; Jukka Putaala, M.D.; Nils Peters, M.D.; Leo Bonati, M.D.; Sami Curtze, M.D., Ph.D.; Hebun Erdur, M.D.; Gerti Sibolt, M.D.; Peter Koch, M.D.; Laura Vandelli, M.D.; Peter Ringleb, M.D.; Didier Leys, M.D.; Philippe Lyrer, M.D.; Charlotte Cordonnier, M.D.; Patrik Michel, M.D.; Christian Nolte, M.D.; Turgut Tatlisumak, M.D.; Paul Nederkoorn, M.D. and Stefan Engelter, M.D. Author disclosures are on the manuscript.

The Stroke-[Hirnschlag]-Fund Basel and Swiss National Foundation grants supported the study.

Additional Resources:

Stroke and brain images are located in the right column of this release link http://newsroom.heart.org/news/clot-buster-treatment-safe-effective-for-patients-who-required-living-assistance-pre-stroke?preview=95ad1e5804faa4ad3c5d66f70a108761

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.

American Heart Association

Related Stroke Articles:

Retraining the brain to see after stroke
A new study out today in Neurology, provides the first evidence that rigorous visual training restores rudimentary sight in patients who went partially blind after suffering a stroke, while patients who did not train continued to get progressively worse.
Catheter ablations reduce risks of stroke in heart patients with stroke history, study finds
Atrial fibrillation patients with a prior history of stroke who undergo catheter ablation to treat the abnormal heart rhythm lower their long-term risk of a recurrent stroke by 50 percent, according to new research from the Intermountain Medical Center Heart Institute.
Imaging stroke risk in 4-D
A new MRI technique developed at Northwestern University detects blood flow velocity to identify who is most at risk for stroke, so they can be treated accordingly.
Biomarkers may help better predict who will have a stroke
People with high levels of four biomarkers in the blood may be more likely to develop a stroke than people with low levels of the biomarkers, according to a study published in the Aug.
Pre-stroke risk factors influence long-term future stroke, dementia risk
If you had heart disease risk factors, such as high blood pressure, before your first stoke, your risk of suffering subsequent strokes and dementia long after your initial stroke may be higher.
More Stroke News and Stroke Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...