| Racial disparities in tissue plasminogen activator treatment rate for stroke: a population-based study. | |
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MedLine Citation:
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PMID: 21719765 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Some prior studies have shown that racial disparities exist in intravenous tissue plasminogen activator (tPA) use for acute ischemic stroke. We sought to determine whether race was associated with tPA treatment for stroke in a predominantly black urban population. METHODS: Systematic chart abstraction was performed on consecutive hospitalized patients with ischemic stroke from all 7 acute care hospitals in the District of Columbia from February 1, 2008, to January 31, 2009. RESULTS: Of 1044 patients with ischemic stroke, 74% were black, 19% non-Hispanic white, and 5% received intravenous tPA. Blacks were one third less likely than whites to receive intravenous tPA (3% versus 10%, P<0.001). However, blacks were also less likely than whites to present within 3 hours of symptom onset (13% versus 21%, P=0.004) and also less likely to be tPA-eligible (5% versus 13%, P<0.001). Of those who presented within 3 hours, blacks were almost half as likely to be treated with intravenous tPA than whites (27% versus 46%, P=0.023). The treatment rate for tPA-eligible patients was similar for blacks and whites (70% versus 76%, P=0.62). CONCLUSIONS: In this predominantly black urban population hospitalized for acute ischemic stroke, blacks were significantly less likely to be treated with intravenous tPA due to contraindications to treatment, delayed presentation, and stroke severity. Effective interventions designed to increase treatment in this population need to focus on culturally relevant education programs designed to address barriers specific to this population. |
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Authors:
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Amie W Hsia; Dorothy F Edwards; Lewis B Morgenstern; Jeffrey J Wing; Nina C Brown; Regina Coles; Sarah Loftin; Andrea Wein; Sara S Koslosky; Sabiha Fatima; Brisa N Sánchez; Ali Fokar; M Chris Gibbons; Nawar Shara; Annapurni Jayam-Trouth; Chelsea S Kidwell |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2011-06-30 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 42 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-07-26 Completed Date: 2012-08-10 Revised Date: 2012-09-25 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 2217-21 Citation Subset: IM |
Affiliation:
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Washington Hospital Center, Washington, DC 20010, USA. hsiaa@ninds.nih.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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African Americans Aged Aged, 80 and over Brain Ischemia / drug therapy* European Continental Ancestry Group Female Fibrinolytic Agents / therapeutic use* Healthcare Disparities* Humans Male Middle Aged Stroke / drug therapy* Thrombolytic Therapy Time Factors Tissue Plasminogen Activator / therapeutic use* |
| Grant Support | |
ID/Acronym/Agency:
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U54 NS057405-01A1/NS/NINDS NIH HHS; U54NS057405/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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