Are many persons in Colorado receiving t-PA for treatment for acute stroke? If so, what have been the results to date in reducing the impact of stroke?
Urgent treatment of an acute stroke with t-PA, a clot-dissolving medication, has the potential to completely prevent the permanent brain damage that a stroke might otherwise cause. Unfortunately, it also has the potential to cause serious, even fatal bleeding within the brain. In a large clinical trial at leading stroke centers around the country, t-PA’s benefit/risk ratio seemed favorable. For treated patients, the absolute increase in no-disability outcomes was about 12%, while the absolute increase in significant brain hemorrhage was about 6%. Even allowing for the greater number of hemorrhages, treated patients were less likely to die or have a disabling stroke than those not treated with t-PA. Whether these good results can be generalized to hospitals with less experience and expertise is a matter of concern, however. T-PA is a two-edged sword, with potential for both good and for harm. Patient selection and rapid treatment are the keys to its successful use. With this concern in
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