SHELBY — The first time Dr. Ambrose Wu administered tenecteplase was at OhioHealth Shelby Hospital.
An attending physician, Wu is also the EMS medical director for OhioHealth Shelby and Mansfield hospitals, as well as several local fire departments.
He said the OhioHealth Research Institute began a study about four years ago to see if TNKase — commonly used to break up coronary blood clots for patients experiencing a heart attack — could also be used to treat strokes.
Earlier this year, the United States Food and Drug Administration approved TNKase for the treatment of acute ischemic stroke for adults.
Wu said he’s been using the treatment in clinical practice since about 2021.
The first time he administered TNKase to a patient was at the Shelby Hospital. Wu said the drug attacks and “dissolves” the clot that is formed. Alteplase (tPA) was previously the common drug used for treatment.
“Not everybody that receives either of these medications is going to necessarily get better from a stroke,” he said. “But a higher percentage of people that get TNKase get better versus the old medication.”
Wu said the recently FDA-approved treatment is also easier to administer and has a better side effect profile.
Level of care
The first patient Wu treated with TNKase in Shelby showed improvements within the period of time a helicopter was en route to transfer them to OhioHealth Riverside Hospital.
“The main thing is improvement of cognition and improvement of speech,” he said. “The motor deficits, facial droop and arm drift, those sorts of things require rehab.
“But to see improved cognition and speech in that short amount of time was quite phenomenal.”
Wu said small community hospitals like Shelby benefit from leveraging the power of OhioHealth’s network of larger facilities.
Patients who enter OhioHealth Shelby with stroke symptoms can be treated just like they would at Riverside — with the exception of being admitted to the ICU or receiving a thrombectomy, he said.
As the EMS medical director, Wu said they encourage squads to bring in patients experiencing a stroke to Shelby if its a closer distance than Mansfield.
“The sooner that you can get this medication on board and break up that clot, you can save brain cells from dying,” he said. “The first few hours (of care) don’t look that different.
“Whether you’re in Shelby’s, Mansfield’s or Riverside’s emergency room, you get the same high-quality physician and nursing care.”
Benefits of FDA approval
Anytime a procedure is going to be performed or a medication is about to be administered, informed consent is a required ethical responsibility, Wu said.
Prior to TNKase’s approval in March, patients also had to be informed the drug wasn’t FDA-approved. The approval has made communication with patients smoother, he said.
“It’s a lot to explain to a patient in the heat of the moment when everything is geared toward trying to get this medication into their arm as fast as possible,” Wu said.
Having spent time at OhioHealth Grant Medical Center, he said the ability to practice modern, cutting-edge medicine at a smaller hospital like Shelby is remarkable.
“I think it’s an exciting time and I think it validates our practice at OhioHealth. As we know something is working, we can make changes and give our patients the best,” Wu said.