Key result
Prestroke antiplatelets linked to ~21% higher sICH risk after thrombolysis without increasing mortality.
Why the study?
Does prestroke antiplatelet therapy increase the risk of symptomatic intracranial hemorrhage or affect functional outcomes and mortality in patients with acute ischemic stroke receiving intravenous thrombolysis?
Meta-Analysis (n=108,588)
Does prestroke antiplatelet therapy increase the risk of symptomatic intracranial hemorrhage or affect functional outcomes and mortality in patients with acute ischemic stroke receiving intravenous thrombolysis?
Odds Ratio: 1.21 (95% CI 1.02–1.44)
Prestroke antiplatelet therapy slightly increases the risk of symptomatic intracranial hemorrhage after IV thrombolysis for acute ischemic stroke, but does not independently worsen long-term functional outcomes or mortality.
No takes yet. Share an insight, caveat, or question.
May warrant caution with prestroke antiplatelet therapy before thrombolysis; leaves open net impact on functional recovery in broader populations.
Luo et al. (2016) conducted a meta-analysis in Acute ischemic stroke (n=108,588). Prestroke antiplatelet therapy vs. No prestroke antiplatelet therapy was evaluated on Symptomatic intracranial hemorrhage (sICH) (OR 1.21, 95% CI 1.02-1.44). Prestroke antiplatelet therapy was associated with a slightly increased risk of symptomatic intracranial hemorrhage after systemic thrombolysis (adjusted OR 1.21), but not with unfavorable functional outcomes or mortality.
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