In Reply Dr Radecki raises the interesting question of whether inclusion in the GWTG-Stroke registry cohort of a small proportion of patients who actually had stroke mimicking conditions or TIAs might have inflated the study’s estimates of the relationship of onset to lytic treatment time and clinical outcome. The available evidence indicates it did not.
First, patients whose final diagnosis was a stroke mimicking condition were not included in the GWTG-Stroke registry during the study period, even if they had received thrombolysis, so their contribution to the data was negligible.
Saver JL, Fonarow GC, Schwamm LH. Acute Ischemic Stroke and Timing of Treatment—Reply. JAMA. 2013;310(17):1856-1857. doi:10.1001/jama.2013.278898