4. Million person milestone, emerging research shows quality initiatives improve outcomes

In an analysis of the first one million stroke patients enrolled in the national Get With the Guidelines® – Stroke quality improvement program at nearly 1400 hospitals across the country, quality of care on 10 performance measures improved substantially from 2003 to 2009. More than 80 percent of patients were receiving defect-free care by 2009, up from less than half in 2003. The Get With The Guidelines database is an invaluable resource in furthering development of tools and outcomes results that are making marked improvement in stroke patient care.

·  Fonarow, et al – Circulation: Cardiovascular Quality and Outcomes, Feb. 22, 2010; http://circoutcomes.ahajournals.org; Circ Cardiovasc Qual Outcomes 2010; 3;291-302.

·  Smith, et al - Circulation, Sept. 27, 2010; http://circ.ahajournals.org; Circulation. 2010;122:1496-1504.

·  Saver, et al – Stroke, June 3, 2010; http://stroke.ahajournals.org; Stroke 2010;41: 1431-1439.

·  Reeves, et al – Stroke, May 20, 2010; http://stroke.ahajournals.org; Stroke 2010;41(7):1573-8.

Funding: Get With The Guidelines®–Stroke (GWTG-Stroke) is provided by the American Heart Association/American Stroke Association. The program is currently supported in part by a charitable contribution from Bristol-Myers Squib/Sanofi Pharmaceutical Partnership and the American Heart Association Pharmaceutical Roundtable. GWTG-Stroke has been funded in the past through support from Boeringher-Ingelheim and Merck.

5. International study identifies the ten major risk factors for stroke

In the worldwide INTERSTROKE study, 10 simple risk factors were found to be associated with 90 percent of the risk of stroke. Targeted interventions that reduce blood pressure and smoking, and promote physical activity and a healthy diet, could substantially reduce the worldwide burden of stroke.

·  INTERSTROKE Investigators – Lancet, June 18, 2010; http://www.thelancet.org; Lancet 2010;376,112-123; Funding: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Pfizer Cardiovascular Award, Merck, AstraZeneca, Boehringer Ingelheim.

6. Ultrasound detection of silent emboli identifies patients at high risk of stroke

This international, multicenter, prospective study confirms that detection of silent, microclots traveling to the brain on transcranial Doppler ultrasound identifies a subgroup of patients with asymptomatic narrowing of the carotid artery who are at high risk for stroke and might benefit from surgery or stenting.

·  ACES – Lancet Neurology, July 2010; http://www.thelancet.com; Lancet Neurol;9(7):663-71; Funding: British Heart Foundation.