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VNA of Care New England

tPA Use in Ischemic Stroke Nearly Doubled 2003 to 2011

Increased use of IV tissue plasminogen activator in oldest old, nonwhites, and milder strokes
FRIDAY, Aug. 23 (HealthDay News) -- The use of intravenous tissue plasminogen activator (IV tPA) in acute ischemic stroke (AIS) patients nearly doubled from 2003 to 2011, according to research published online Aug. 20 in Circulation: Cardiovascular Quality and Outcomes.
Lee H. Schwamm, M.D., of the Massachusetts General Hospital in Boston, and colleagues analyzed data for 1,093,895 patients with AIS to assess changes in patient characteristics and rates of tPA use from 2003 to 2011 at U.S. hospitals enrolled in the Get With the Guidelines (GWTG)-Stroke program.
The researchers found that 50,798 patients with AIS arrived two hours or sooner after onset and were treated with IV tPA three hours or earlier after onset. Use of IV tPA within three hours of stroke onset increased from 4.0 to 7.0 percent in all AIS admissions, and from 42.6 to 77.0 percent in AIS patients who arrived within two hours of onset and were fully eligible for IV thrombolysis. Univariate analysis showed that tPA use increased over time, particularly in AIS patients who were older than 85 years, were nonwhite, or who had milder strokes.
"Nevertheless, there is still substantial undertreatment of acute stroke patients with intravenous tPA, and major improvements may require increased public awareness, regionalization of stroke care, and increased use of telemedicine," the authors write.
The GWTG-Stroke program is funded by various pharmaceutical companies. One study author disclosed financial ties to the pharmaceutical industry.
Abstract (http://circoutcomes.ahajournals.org/content/early/2013/08/20/CIRCOUTCOMES.111.000095.abstract )Full Text (subscription or payment may be required) (http://circoutcomes.ahajournals.org/content/early/2013/08/20/CIRCOUTCOMES.111.000095.full.pdf+html )
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