Safety of IV thrombolysis for ischemic stroke in patients treated with warfarin

Stroke Reports Sunday, June 16th, 2013

Background: Controversy surrounds the safety of intravenous (IV) tissue plasminogen activator (tPA) in ischemic stroke patients treated with warfarin. The European tPA license precludes its use in anticoagulated patients altogether. American guidelines accept IV tPA use with an international normalized ratio (INR) ≤1.7. The influence of warfarin on symptomatic intracerebral hemorrhage (SICH), arterial recanalization and long-term functional outcome in stroke thrombolysis remains unclear.

Methods: We analysed data from 45074 patients treated with IV tPA enrolled in the SITS International Stroke Thrombolysis Register. 768 patients had baseline warfarin treatment with INR≤1.7. Outcome measures were SICH, arterial recanalization, mortality and functional independence at 3 months. Read more

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