New results published in the prestigious New England Journal of Medicine show that later treatment is also efficacious in that it improves the patients' prospects of recovery.
Thrombolytic treatment with the clot-busting drug alteplase is the only available method of treating acute stroke caused by a blood clot in the brain. However, the treatment is only approved within three hours after onset of stroke, which means that relatively few patients manage to be in a position to receive treatment before this time threshold has been crossed.
Scientists at the Swedish medical university Karolinska Institutet and the international network SITS (Safe Implementation of Treatments in Stroke) recently presented novel findings that may question present recommendations. The study, which was published in the Lancet on 15 September, demonstrated that thrombolysis administered within three to four and a half hours after a stroke was just as safe as that given within the three-hour time window.
These results are now corroborated by a study published in the top-ranking journal New England Journal of Medicine and co-authored by scientists from Karolinska Institutet. The study in question was a randomised comparative analysis of thrombolysis administered in the 3 to 4.5-hour interval and a placebo control, and shows that thrombolysis is more effective than control treatment and that many patients had recovered after three months.
"Both studies support the idea that the time window for thrombolysis should be extended, and this from the perspective of both safety and efficacy," says Professor Nils Wahlgren, who co-led both studies.
In this present study, 52.4 per cent of the patients who received thrombolysis recovered within three months, compared to 45.2 per cent of the placebo group - a statistically significant difference. A total of 418 patients received thrombolysis and 403 a placebo. The proportion of symptomatic haemorrhages was higher in the experimental group than in the control group, but no higher than in the currently approved 0 to 3-hour interval.
The results of the two studies are to be discussed at Karolinska Stroke Update, an international expert conference to be held from 16 to 18 November in Stockholm, at which a decision is due to be taken on whether the European guidelines should be changed.
Publication: 'Alteplase Compared with Placebo within 3 to 4.5 Hours for Acute Ischemic Stroke' Werner Hacke, Markku Kaste, Erich Bluhmki, Miroslav Brozman, Antoni Dávalos, Donata Guidetti, Vincent Larrue, Kennedy R Lees, Zakaria Medeghri, Thomas Machnig, Dietmar Schneider, Rüdiger von Kummer, Nils Wahlgren, and Danilo Toni, for the European Cooperative Acute Stroke Study (ECASS) investigators, New England Journal of Medicine, 25 September 2008
Earlier publication: 'Thrombolysis with alteplase 3-4.5 h after acute ischaemic stroke: an observational study', Nils Wahlgren, Niaz Ahmed, Antoni Dávalos, Werner Hacke, Mónica Millán, Keith Muir, Risto O Roine, Danilo Toni, Kennedy R Lees, for the SITS investigators, Lancet 16 September 2006
For further information, please contact:Professor Nils Wahlgren
Katarina Sternudd | idw
New nanomedicine slips through the cracks
24.04.2019 | University of Tokyo
Sugar entering the brain during septic shock causes memory loss
23.04.2019 | Rensselaer Polytechnic Institute
For the first time, physicists at the University of Basel have succeeded in measuring the magnetic properties of atomically thin van der Waals materials on the nanoscale. They used diamond quantum sensors to determine the strength of the magnetization of individual atomic layers of the material chromium triiodide. In addition, they found a long-sought explanation for the unusual magnetic properties of the material. The journal Science has published the findings.
The use of atomically thin, two-dimensional van der Waals materials promises innovations in numerous fields in science and technology. Scientists around the...
Flexible, organic and printed electronics conquer everyday life. The forecasts for growth promise increasing markets and opportunities for the industry. In Europe, top institutions and companies are engaged in research and further development of these technologies for tomorrow's markets and applications. However, access by SMEs is difficult. The European project SmartEEs - Smart Emerging Electronics Servicing works on the establishment of a European innovation network, which supports both the access to competences as well as the support of the enterprises with the assumption of innovations and the progress up to the commercialization.
It surrounds us and almost unconsciously accompanies us through everyday life - printed electronics. It starts with smart labels or RFID tags in clothing, we...
The human eye is particularly sensitive to green, but less sensitive to blue and red. Chemists led by Hubert Huppertz at the University of Innsbruck have now developed a new red phosphor whose light is well perceived by the eye. This increases the light yield of white LEDs by around one sixth, which can significantly improve the energy efficiency of lighting systems.
Light emitting diodes or LEDs are only able to produce light of a certain colour. However, white light can be created using different colour mixing processes.
Researchers led by Francesca Ferlaino from the University of Innsbruck and the Austrian Academy of Sciences report in Physical Review X on the observation of supersolid behavior in dipolar quantum gases of erbium and dysprosium. In the dysprosium gas these properties are unprecedentedly long-lived. This sets the stage for future investigations into the nature of this exotic phase of matter.
Supersolidity is a paradoxical state where the matter is both crystallized and superfluid. Predicted 50 years ago, such a counter-intuitive phase, featuring...
A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter
17.04.2019 | Event News
15.04.2019 | Event News
09.04.2019 | Event News
26.04.2019 | Life Sciences
26.04.2019 | Physics and Astronomy
26.04.2019 | Physics and Astronomy