![]() ![]() Therapeutic yield is maximal in the first minutes after symptom onset and declines rapidly during the next 4.5 hours. The benefit of intravenous (IV) thrombolytic therapy in acute brain ischemia is strongly time dependent. These findings support public health initiates to increase early presentation and shorten door-to-needle times in patients arriving within the golden hour. A door-to-needle time of ≤60 minutes was achieved in 18.3% of golden hour patients.Ĭonclusions- At Get With the Guidelines-Stroke hospital Emergency Departments, more than one quarter of patients with documented onset time and at least one eighth of all ischemic stroke patients arrived within 1 hour of onset, where they received thrombolytic therapy more frequently but more slowly than late arrivers. Compared with patients arriving at 61 to 180 minute, “golden hour” patients received intravenous thrombolytic therapy more frequently (27.1% vs 12.9% odds ratio=2.51 95% CI, 2.41–2.61 P<0.0001), but door-to-needle time was longer (mean, 90.6 vs 76.7 minutes, P<0.0001). Features most strongly distinguishing the patients arriving at ≤60, 61 to 180, and >180 minutes were greater stroke severity (median National Institutes of Health Stroke Scale score, 8.0 vs 6.0 vs 4.0, P<0.0001) and more frequent arrival by ambulance (79.0%. Results- During the 4.75-year study period, among 253 148 ischemic stroke patients arriving directly by ambulance or private vehicle at 905 hospital Emergency Departments, 106 924 (42.2%) had documented, exact last known well times. Methods- The Get With the Guidelines–Stroke database was analyzed to characterize ischemic stroke patients arriving at hospital Emergency Departments within 60 minutes of the last known well time from April 1, 2003, to December 30, 2007. Customer Service and Ordering Informationīackground and Purpose- The benefit of intravenous thrombolytic therapy in acute brain ischemia is strongly time dependent.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes. ![]() Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB). ![]()
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