New Guidelines for Treating Stroke

The clot-busting drug tPA (tissue plasminogen activator) is still the most effective early treatment for ischemic stroke, according to new guidelines from a special panel of the American Stroke Association, a division of the American Heart Association. The guidelines were published in the April 4, 2003, issue of Stroke.

The panelists investigated a number of promising new treatments for ischemic stroke, including neuroprotective agents to prevent stroke damage, methods to induce hypothermia to reduce fever and stroke damage, clot-busting drugs and techniques, imaging techniques to diagnose ischemic stroke, and surgical interventions. However, they found that the administration of tPA within three hours of stroke onset is still the best early treatment for stroke. It is the only treatment for ischemic stroke approved by the US Food and Drug Administration (FDA).

A number of other recommendations were contained in the new guidelines. Because time is so critical in acute stroke care, institutions should have diagnostic equipment and staff available 24 hours a day, seven days a week to treat stroke patients or transfer them to another facility. Aspirin may be given within 48 hours of stroke onset for most patients but not within 24 hours of tPA treatment. Stroke units with comprehensive rehabilitation services and stroke treatment centers should be developed. Anticoagulants, such as heparin, are not indicated for most ischemic stroke patients. Several trials of these have shown negative results. While intra-arterial thrombolytic therapy holds promise for some strokes, its effectiveness has not been sufficiently established.

"One of the key messages in the new guidelines is the importance of early treatment of stroke,” said panel chairman Harold P. Adams, Jr., M.D., professor of neurology at the University of Iowa Carver College of Medicine (Iowa City, USA). "Public awareness of the symptoms of stroke and seeking medical attention immediately are critical to early treatment.”





Related Links:
American Heart Ass'n
U. Iowa Carver College of Med.