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Mild strokes may be a target for clot-busting drug

Mild strokes can cause disability, but people who have them usually don’t receive the clot-busting medication that is recommended for people with severe strokes. A new study, however, suggests that giving more people the medication might prevent a lot of disability and reduce healthcare costs.

Researchers at the University of Cincinnati looked at the hospital records of 437 people who had a mild ischemic stroke, the kind of stroke that is caused by a blood clot. All of these patients arrived within 4.5 hours of the stroke, which is necessary for the medication -- tissue plasminogen activator -- to be effective. But tPA is usually given only to people with severe strokes and, true to form, fewer than 1% of the people in the study received the drug.

However, the researchers identified 150 other patients who could have been candidates for the drug if it was used for mild stroke.

Previous studies suggest that about one-third of patients with mild strokes remain disabled three months after the event. Thus, if tPA was as effective in mild strokes as it is for severe strokes, it could prevent disability in many people and save as much as $200 million a year in disability expenditures nationwide, the authors said.

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The effectiveness of tissue plasminogen activator is still unproven in mild stroke, however.

“The pivotal randomized trials that proved tPA’s usefulness excluded mild stroke patients because it was thought that they generally did well and the risk of tPA treatment, which includes a slight but significant risk of life-threatening bleeding in the brain, would not be worth the benefit,” Dr. Pooja Khatri, the lead author of the study, said in a news release.

Seems it’s time to find out if tPA is effective for preventing damage from mild strokes.

The study was presented at the American Stroke Assn.'s International Stroke Conference in Los Angeles.

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Related: Stroke centers have better rates of patient survival, researchers say

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