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“Realistically achievable small reductions” in the time between the start of symptoms and tissue-type plasminogen activator (tPA) therapy can produce “significant and robust” improvements in outcomes, says a report in Stroke.

For example, a 15-minute decrease in onset-to-treatment time translated into, on average, an additional month of disability-free life.

Researchers applied evidence from major tPA trials to 2,258 consecutive stroke patients from Australia and Finland. Each minute of onset-to-treatment time saved translated into, on average, 1.8 days of “extra healthy life”. The benefit of reducing onset-to-treatment time emerged in all groups assessed.

For example, each minute reduction provided:

• 0.6 days in old people (80 years) with severe strokes
• 0.9 days in old people with mild strokes
• 2.7 days in young people (50 years) with mild stokes
• 3.5 days in young people with severe strokes.

“‘Save a minute, save a day’ is the message from our study,” says lead author Atte Meretoja associate professor of neurology, University of Melbourne, Australia. Each reduction of a minute between symptom onset and treatment may save around two million neurones.

Dr Meretoja hopes that the “concrete easy-to-relate-to figures will inspire medical services to measure and improve their game for the benefit of our stroke patients. Patients should never wait a single minute for stroke signs, such as face droop, arm weakness or speech disturbance, to go away. They should call for help immediately.”

Intravenous thrombolysis with tissue-type plasminogen activator (tPA) is described as “the only medical therapy shown to improve patient outcomes in acute ischaemic stroke”. (Stroke)