Clot-busting drug tissue plasminogen activator (tPA) safely treats acute ischemic stroke patients even if they take the prescribed anticoagulant.
"Seek immediate treatment for stroke symptoms."
Ying Xian, MD, PhD, the study’s lead author and a research fellow at Duke Clinical Research Institute, noted that even though tPA is the only U.S. Food and Drug Administration approved drug for treating acute ischemic strokes, it remains underused among patients taking warfarin because of fear it will cause bleeding.
Researchers used data from the American Heart Association's Get With The Guidelines Stroke registry to evaluate the safety of tPA in ischemic stroke patients who were taking warfarin prior to arriving at the hospital.
They reviewed data from 23,437 ischemic stroke patients who received tPA at more than 1,200 hospitals participating in Get With The Guidelines, a program designed to improve stroke care, between 2009 and 2011. Of the patients receiving tPA, 8 percent were taking warfarin prior to hospital admission.
Patients taking warfarin tended to be older at an average age of 77 compared to 71 among those not taking the drug, had more medical conditions at the time of the stroke and tended to have more severe strokes.
However the risk of severe bleeding from brain hemorrhage was similar among other stroke patients receiving tPA, regardless of whether they were taking warfarin.
Patients receiving tPA also had similar rates of complications and in-hospital deaths, with no distinguishable difference among those taking the blood thinner. The study did not examine long-term results, or functional or neurological outcomes following treatment.
“Our study suggests tPA is not associated with excessive bleeding or death among warfarin patients, when used according to American Heart Association/American Stroke Association guidelines,” Dr. Xian said.
“tPA has been shown to minimize brain damage and disability from stroke and should not be withheld from these patients.”
The study was presented Thursday at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2012 in Atlanta, Georgia.