Researchers from the
International Stroke Trial 3; have released results from the worlds largest
ever trial of the clot busting drug rt-PA. Published today concurrently in the
Lancet, and presented at the European Stroke Conference in Lisbon.
The IST-3 trial found patients
receiving clot-busting drugs have a better chance of survival and avoiding
disability. In patients over 80, a previously untreated group in the European
Union, the use of rt-PA will dramatically increase their survival rates post
stroke.
Research has found patients under
80 benefit from rt-PA when treated within four and a half hours of stroke. Co
investigator Richard Lindley, Professor of Geriatric Medicine from the
University of Sydney’s Medical School is adamant ‘Please don’t ignore the over
80s – they benefit hugely’.
 |
| Richard Lindley, Joanna Wardlaw and Michael Hennerici at todays ESC announcement |
The trial found fatal bleeding
was a risk factor associated with rt-PA use within the first week of treatment,
although the researchers insist that the early hazard is greatly outweighed by the
late substantial benefit. Dr Lindley insists that in his practical experience
patients over 80 have an extremely high risk of death after stoke within the
six month period indicated and that the risk of rt-PA bleed is minimal compared
to the risk of no treatment at all.
This latest study sought to
establish rt-PA treatment as effective in patients over 80, and it has done
exactly that. As the population ages and age becomes a primary risk factor in
Australia these treatments will be able to alleviate the extreme costs of
stroke on the community and increase quality of life for stroke patients.
IST-3 Imaging Lead Professor
Joanna Wardlaw for the University of Edinburgh Centre for Clinical Brain
Sciences, is also pushing for better managed clinical windows so that patients
can access rt-PA within the required time, ‘the faster you treat the better the
outcome’ she said ‘ and faster treatment will result from better communication
(among health workers)’.
Carmen Lahiff-Jenkins
Managing Editor the International
Journal of Stroke
Attending the European Stroke
Conference, Lisbon, Portugal
