{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:24:39Z","timestamp":1792009479595,"version":"4.4.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To emphasize treatment speed for time-sensitive conditions, emergency medicine has developed not only the concept of the golden hour, but also the platinum half-hour. Patients with acute stroke treated within the first half-hour of onset have not been previously characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this cohort study, we analyzed patients enrolled in the FAST-MAG (Field Administration of Stroke Therapy\u2013Magnesium) trial, testing paramedic prehospital start of neuroprotective agent \u22642 hours of onset. The features of all acute cerebral ischemia, and intracranial hemorrhage patients with treatment starting at \u226430 m of last known well were compared with later-treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 1680 patients, 203 (12.1%) received study agents within 30 minutes of last known well. Among platinum half-hour patients, median onset-to-treatment time was 28 minutes (interquartile range, 25\u201330), and final diagnoses were acute cerebral ischemia in 71.8% (ischemic stroke, 61.5%, TIA 10.3%); intracranial hemorrhage in 26.1%; and mimic in 2.5%. Clinical features among platinum half-hour patients were largely similar to later-treated patients and included age 69 (interquartile range, 57\u201379), 44.8% women, prehospital Los Angeles Motor Scale median 4 (3\u20135), and early-postarrival National Institutes of Health Stroke Scale deficit 8 (interquartile range, 3\u201318). Platinum half-hour acute cerebral ischemia patients did have more severe prehospital motor deficits and younger age; platinum half-hour intracranial hemorrhage patients had more severe motor deficits, were more often female, and less often of Hispanic ethnicity. Outcomes at 3 m in platinum half-hour patients were comparable to later-treated patients and included freedom-from-disability (modified Rankin Scale score, 0\u20131) in 35.5%, functional independence (modified Rankin Scale score, 0\u20132) in 53.2%, and mortality in 17.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Prehospital initiation permits treatment start within the platinum half-hour after last known well in a substantial proportion of acute ischemic and hemorrhagic stroke patients, accounting for more than 1 in 10 enrolled in a multicenter trial. Hyperacute platinum half-hour patients were largely similar to later-treated patients and are an attainable target for treatment in prehospital stroke trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.121.036993","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T05:00:33Z","timestamp":1652331633000},"page":"2426-2434","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Beyond the Golden Hour: Treating Acute Stroke in the Platinum 30 Minutes"],"prefix":"10.1161","volume":"53","author":[{"given":"Anantbir S.","family":"Randhawa","sequence":"first","affiliation":[{"name":"California University of Science and Medicine, School of Medicine, Colton (A.S.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1274-2015","authenticated-orcid":true,"given":"Fatima","family":"Pariona-Vargas","sequence":"additional","affiliation":[{"name":"National University of Cajamarca, School of Medicine, Cajamarca, Peru (F.P.-V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4074-1076","authenticated-orcid":true,"given":"Sidney","family":"Starkman","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Neurology (S.S., S.S.), University of California Los Angeles David Geffen School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-9518","authenticated-orcid":true,"given":"Nerses","family":"Sanossian","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Southern California, Los Angeles (N.S., 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