Author Contributions: Drs Xian, Liang, and Peterson had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Xian, Peterson.
Acquisition of data: Xian, Peterson.
Analysis and interpretation of data: Xian, Liang, Smith, Schwamm, Reeves, Olson, Hernandez, Fonarow, Peterson.
Drafting of the manuscript: Xian, Peterson.
Critical revision of the manuscript for important intellectual content: Xian, Liang, Smith, Schwamm, Reeves, Olson, Hernandez, Fonarow, Peterson.
Statistical analysis: Liang.
Administrative, technical, or material support: Xian, Peterson.
Study supervision: Peterson.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Smith reported serving as a volunteer for the American Heart Association (AHA) Get With The Guidelines (GWTG) Steering Committee and serving on the advisory board for Genentech. Dr Schwamm reported serving as the chair of the AHA GWTG Steering Committee; serving as a consultant to the Massachusetts Department of Public Health; providing expert review of medical records for malpractice claims against neurologists regarding care of acute stroke; and serving as principal investigator of a phase 2 multicenter study of extended-window intravenous thrombolysis (alteplase provided at no cost to Massachusetts General Hospital). Dr Olson reported receiving a grant from the American Heart Association (Duke Clinical Research Institute serves as the statistical coordinating center for AHA GWTG). Dr Hernandez reported serving as a consultant for Johnson & Johnson, AstraZeneca, sanofi, and Corthera; receiving research grants or grants pending from Johnson & Johnson, Amylin, Portola, and Preventis; and serving as a consultant to Corthera. Dr Fonarow reported serving as a consultant to Pfizer, Merck, Schering-Plough, Bristol-Myers Squibb, and sanofi-aventis; receiving research grants or grants pending from the National Institutes of Health; receiving speakers honoraria from Pfizer, Merck, Schering-Plough, Bristol-Myers Squibb, and sanofi-aventis; and that he is an employee of the University of California, which holds a patent on retriever devices for stroke. Dr Peterson reported receiving research grants from Johnson & Johnson, Eli Lilly, and Janssen Pharmaceuticals and serving as a consultant to Boehringer Ingelheim, Johnson & Johnson, Medscape, Merck, Novartis, Ortho-McNeil-Janssen, Pfizer, Westat, the Cardiovascular Research Foundation, WebMD, and United Healthcare. No other authors reported disclosures.
Funding/Support: This study received an award from the American Heart Association–Pharmaceutical Roundtable and from David and Stevie Spina. The Get With The Guidelines–Stroke (GWTG-Stroke) program is provided by the American Heart Association/American Stroke Association. The GWTG-Stroke Program is currently supported in part by a charitable contribution from Janssen Pharmaceutical Companies of Johnson & Johnson. GWTG-Stroke has been funded in the past through support from Boehringer Ingelheim, Merck, Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership, and the AHA Pharmaceutical Roundtable.
Role of the Sponsor: The funding organizations had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation of the manuscript. Representatives from the AHA reviewed and approved a draft of the manuscript.
Disclaimer: This study used the GWTG-Stroke database. The interpretation and reporting of these data are the sole responsibility of the authors and do not necessarily represent the official views of the AHA. Dr Peterson, Contributing Editor for JAMA, was not involved in the editorial review of or the decision to publish this article.
Previous Presentation: Presented in part at the Quality of Care and Outcomes Research 2012 Scientific Sessions, Atlanta, Georgia, May 10, 2012.
Additional Contributions: We thank Erin Lofrese, MS, Duke Clinical Research Institute, for editorial assistance and manuscript preparation. Ms Lofrese did not receive compensation for her assistance apart from her employment at the institution where the study was conducted.