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BLOOD CLOTS
page 61
Dr. Levine explains it like this.
If absolutely nothing were done
for ischemic stroke victims, 20
percent would bounce back with
few or no disabilities. The t-PA
increased these positive outcomes
to 31 percent.
In other words, patients who
received t-PA did 1.7 times bet-
ter than those who got the place-
bo, he says.
A
t Henry Ford Hospital in
Detroit, Dr. Levine super-
vised one of eight trials at
centers across the country.
Of 62 local patient participants,
30 got t-PA. Thirty-two did not.
Twenty-four hours after the
drug was administered, Dr.
Levine didn't see the results he
had hoped for. But, three months
later, people in the t-PA group
were doing well, much better
than those in the placebo group.
Many were walking, talking,
speaking clearly, even dressing
themselves.
"We didn't change death rate
from stroke," Dr. Levine explains.
"What we did was decrease the
severe-to-moderate damage or
disability from stroke."
And, there's something else.
For years, ambulance dispatch-
ers did not consider stroke an
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emergency condition. Before t-
PA, there was nothing much any-
one could do for victims.
Consequently, rescue vehicles
would rush to sites of more press-
ing circumstances.
However, the recent NIH
study makes time of the essence.
That three-hour window is key.
"Stroke is now a valid 9-1-1
emergency that requires lights
and sirens," says Dr. Levine. "It
is as valid an emergency as a
heart attack or gunshot wound,
but the opportunity for effective
intervention might be shorter for
stroke than for (the latter)."
There are cost benefits to t-PA,
researchers believe. Government
agencies and insurance compa-
nies estimate that, nationally,
strokes incur $30 billion a year
in health-care expenses, nursing-
home care and lost wages. Each
incident of stroke can carry a
price tag of $15,000 to $70,000.
The drug t-PA, on the other
hand, costs $2,000. It was first
successfully used on heart-attack
patients. Now, doctors are re-
lieved to know they can use it,
with acceptable risk, on victims
of stroke. E
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