Clot-busting drugs may be safe for patients who wake up experiencing stroke symptoms, according to preliminary research presented Wednesday at the American Stroke Association's International Stroke Conference 2012 in New Orleans.
In "wakeup 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 wakeup 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, MD, lead researcher of the study and a stroke medical consultant at King's College Hospital in London.
"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 wakeup stroke patients with unknown onset.
All the patients were treated in the same London medical center, where 20% suffered wakeup stroke. A limiting factor, however, was that the researchers did not randomly assign patients to receive different treatments for comparison.
"Our study shows that administering clot-busting drugs to patients with wakeup 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. Wakeup 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, a standardized method used by healthcare professionals to measure the level of impairment caused by a stroke.
After three months, the researchers found the wakeup stroke patients' death rates and risk of bleeding inside the brain, and the proportion who made a good recovery, were similar to those patients treated within a known 4.5 hours of stroke onset.
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 when clot-busting treatments are known to be effective, Manawadu said. Advanced imaging techniques likely can help identify patients with wakeup stroke who have the potential to benefit from clot-busting drugs.
In "wakeup 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 wakeup 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, MD, lead researcher of the study and a stroke medical consultant at King's College Hospital in London.
"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 wakeup stroke patients with unknown onset.
All the patients were treated in the same London medical center, where 20% suffered wakeup stroke. A limiting factor, however, was that the researchers did not randomly assign patients to receive different treatments for comparison.
"Our study shows that administering clot-busting drugs to patients with wakeup 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. Wakeup 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, a standardized method used by healthcare professionals to measure the level of impairment caused by a stroke.
After three months, the researchers found the wakeup stroke patients' death rates and risk of bleeding inside the brain, and the proportion who made a good recovery, were similar to those patients treated within a known 4.5 hours of stroke onset.
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 when clot-busting treatments are known to be effective, Manawadu said. Advanced imaging techniques likely can help identify patients with wakeup stroke who have the potential to benefit from clot-busting drugs.
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