American Heart Association rapid access journal report:
Acute stroke care and clinical outcomes have improved significantly at hospitals participating in the American Heart Association/American Stroke Association’s Get With The Guidelines–Stroke program, according to a large study in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.
To better characterize contemporary stroke patients and determine the impact of Get With The Guidelines–Stroke participation, researchers analyzed several aspects of the first 1 million stroke patients at 1,392 hospitals participating in the quality improvement initiative from 2003 to 2009.
Each year more than 795,000 Americans suffer a stroke and another 200,000 to 500,000 present with a transient ischemic attack (TIA), often called a “warning stroke.”
“We found that the opportunities to provide guideline-recommended care addressed by the performance measures were substantially met for stroke and TIA patients, with overall composite care improving substantially from 72 percent in 2003 to 93 percent in 2009,” said Gregg C. Fonarow, M.D., lead author of the study and professor of cardiovascular medicine at the University of California-Los Angeles. “Stroke and TIA patients receiving all of the care measures for which they were eligible increased from 44 percent in 2003 to 84 percent in 2009.”
Patients in the database were an average 70.1 years of age. Of all strokes analyzed, ischemic strokes (caused by a blood clot blocking a blood vessel in the brain) were the most common (60.2 percent), followed by TIAs (22.8 percent), intracerebral hemorrhages (10.9 percent), subarachnoid hemorrhages (3.5 percent) and unclassified strokes (2.7 percent).
In-hospital mortality was highest among patients suffering hemorrhagic strokes (caused by blood leaking into the brain tissue). Hospital participation in Get With The Guidelines–Stroke made the biggest impact on stroke death rates among the most common stroke types – ischemic stroke and TIA – reducing the risk-adjusted odds of in-hospital mortality rate after ischemic stroke by 10 percent.
“The study has shown what is of primary importance to those who rely on the nation’s hospitals for optimal stroke care: the implementation of Get With The Guidelines–Stroke has resulted in substantial improvement in care at a rapid pace in a variety of hospital types and in multiple hospitals, simultaneously,” said Lee H. Schwamm, M.D., study co-author, chair of the Get With The Guidelines National Steering Committee and director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston, Mass.
The initiative is making a landmark contribution to stroke patients of today and tomorrow, said Clyde W. Yancy, M.D., president of the American Heart Association.
“Not only has quality improved, but lives are being saved and subsequent strokes are being thwarted,” said Yancy, medical director at the Baylor Heart and Vascular Institute in Dallas. “These findings demonstrate the true potential of implementing best practices within a care delivery system and the approach taken by the Get With The Guidelines team is a template for the future.” To facilitate better treatment and outcomes for stroke patients, the American Heart Association/American Stroke Association has launched Target: Stroke. The program will arm healthcare providers with information and tools to improve the use of the intravenous thrombolysis recombinent tissue plasminogen activator (IV rt-PA), the only drug approved by the U.S. Food and Drug Administration for the urgent treatment of ischemic stroke.
“An earlier analysis of Get With The Guidelines–Stroke data found that despite clinical trial evidence of improved outcomes for stroke patients treated early with an intravenous clot buster, only 27.4 percent of patients treated with IV rt-PA had door-to-needle times within 60 minutes,” Yancy said. “The goal for Target: Stroke is to achieve a door-to-needle time within 60 minutes or less in at least 50 percent of ischemic stroke patients treated with a clot-busting drug.
“The new initiative builds on this robust database we have from Get With The Guidelines to help us identify best practices that enable hospitals to further improve quality of care and outcomes in acute stroke care.”
Additional co-authors are Mathew J. Reeves, Ph.D.; Eric E. Smith, M.D., M.P.H.; Jeffrey L. Saver, M.D.; Xin Zhao, M.S.; DaiWai Olson, Ph.D.; Adrian F Hernandez, M.D. M.H.S.; and Eric D. Peterson, M.D., M.P.H. Author disclosures are on the manuscript.
Get With The Guidelines–Stroke is supported in part by an unrestricted educational grant from Merck/Schering-Plough Pharmaceutical.
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 www.americanheart.org/corporatefunding.
NR10– 1041 (CircQO/Fonarow)
Cathy Lewis | EurekAlert!
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
27.03.2017 | Earth Sciences
27.03.2017 | Life Sciences
27.03.2017 | Life Sciences