People with prior stroke or diabetes benefit from thrombolytic therapy

People with a history of stroke or diabetes who were given clot-busting drugs to break up blood clots after stroke fared better than those who did not receive the drugs, according to a study published in the November 16, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"The use of these drugs, called thrombolytic therapy, can limit damage and disability due to blood clots," said study author Kennedy R. Lees, MD, of the University of Glasgow in Scotland. "However, current guidelines can keep people from receiving the therapy if they have a history of stroke and diabetes."

For the study, scientists gathered data from 23,062 people who received clot-busting therapy along with 6,166 people who did not receive clot-busting therapy. Measurements of how well people were able to function 90 days after the stroke were taken from both groups. A total of 19 percent of the people had diabetes and 17 percent had a prior stroke.

Stroke outcomes were measured on a scale of zero to six using the modified Rankin Scale. Zero represented no symptoms, three represented moderate disability meaning a person requires some help but is able to walk unassisted and a six indicated death.

The study found that 43 percent of people with diabetes who received the clot-busting therapy had a disability score of two or less, compared with only 34 percent of diabetes patients who did not receive the therapy. Additionally, the study found 48 percent of patients with previous stroke who received clot-busting therapy scored a two or less, compared with 35 percent of patients with previous stroke who did not receive the therapy.

"Better outcomes with therapy show that people with prior stroke or diabetes should not be excluded from receiving thrombolytic therapy," said Lees.