Clot-Busters Improve Outcomes Even With Prior Stroke

By Michael Smith, North American Correspondent, MedPage Today
Published: November 16, 2011
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Clot-busting drugs improve outcomes after stroke even in people with a history of stroke or diabetes, researchers reported.

And outcomes were comparable to those seen among patients with neither condition, according to Kennedy Lees, MD, of the University of Glasgow, in Scotland, and colleagues.

On the basis of the analysis, there is “no statistical justification” for denying thrombolytic drugs to patients with previous stroke or concomitant diabetes, or both, Lees and colleagues concluded in the Nov. 22 issue ofNeurology.

The issue has been controversial, largely because of restrictions in the European approval for intravenous alteplase (Activase), Lees and colleagues noted, although in clinical practice the restriction is often ignored.

Thrombolytic therapy “can limit damage and disability due to blood clots,” Lees said in a statement, but, “current guidelines can keep people from receiving the therapy if they have a history of stroke and diabetes.”

To clarify the issue, he and colleagues used data from two large stroke registries. The T group included 23,334 patients in the Safe Implementation of Thrombolysis in Stroke–International Stroke Thrombolysis Register. Read Full Article