Clot-Busters Safely Treated Wake-Up Stroke Patients

By: ALICIA AULT, Cardiology News Digital Network: NEW ORLEANS  – A review of a stroke registry shows that it may be safe to give clot-busting therapy to “wake-up” stroke patients who have the same clinical and imaging features as those of patients who are traditionally considered eligible for the therapies.

Clinicians have traditionally shied away from giving clot-busters to patients who have stroke symptoms upon awakening because the time of onset is generally unknown. But many of these patients likely have experienced the stroke within a few hours of arriving for treatment and could benefit from a clot-busting intervention, Dr. Dulka Manawadu said during a press briefing at the International Stroke Conference.

Determining how to identify which wake-up patients could benefit “is an area of growing importance because it may allow us to extend the indication for this effective treatment,” said Dr. Manawadu, a stroke and general medicine consultant at King’s College Hospital in London.

Dr. Manawadu and her colleagues at King’s College analyzed patients in the hospital’s stroke registry who received alteplase (Activase) between January 2009 and December 2010. The study analyzed data for 326 unselected and consecutive patients with a stroke onset of 0 to 4.5 hours with a National Institute of Health Stroke Scale (NIHSS) score of 5 or greater, and 68 unselected, consecutive patients who awoke with symptoms, had an NIHSS of 5 or greater, and had an unknown time of onset. Read Full Article