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ASH has repeatedly urged members who think they (or someone else) -- smoker or nonsmoker - is having a stroke to get the person to an emergency room quickly so that new "stroke busting" drugs can be administered in a timely manner.

New evidence now strengthens the belief that such drugs can help if they administered within THREE (3) HOURS of the onset of the stroke.

But new studies also suggest that the drugs could be ineffective or dangerous if administered later, or if the proper medical tests (like a brain scan) and other procedures are not followed carefully by emergency room physicians and other personnel.

Therefore, as a public service, ASH reprints below a copy of an article about these new studies, and provides a link to a medical journal with even more detailed information.

PLEASE MAKE CAREFUL NOTE OF THIS NEW INFORMATION. FOR MORE INFORMATION, CLICK: 
Thrombolytic Therapy for Ischemic Stroke: From Clinical Trials to Clinical Practice 

By Lindsey Tanner, Associated Press [02/29/00]

Two new studies underscore just how tricky it is to use TPA, the revolutionary clot-busting drug that can save stroke victims but can do more harm than good in less-than-expert hands.

For TPA to be effective, it must be administered within three hours of the onset of a stroke. After that, it's ineffective and may be dangerous.

Doctors must also perform a brain scan first to rule out bleeding in the brain. TPA can cause bleeding or worsen a hemorrhage, with sometimes fatal results.

The new studies, which appear in Wednesday's Journal of the American Medical Association, found that the guidelines are frequently violated and that the lapses may be causing deaths and dangerous bleeding.

Strokes are the nation's third-leading cause of death, killing an estimated 159,000 people each year and leaving many survivors disabled.

The Cleveland researchers examined 3,948 stroke patients. Only 70 - just 1.8 percent - were given TPA, suggesting that eligible patients were being overlooked.

But in half of those who did get the drug, treatment guidelines were violated. Some patients got TPA as much as six hours after the three-hour deadline.

Those violations contributed to a slightly higher death rate than in Albers' study and significantly more cases of bleeding in the brain, said Dr. Irene L. Katzan, a neurologist at the Cleveland Clinic Foundation.