Key result
Rapid plasma DOAC testing identified low DOAC levels (<50 ng/mL) in 40% of ischaemic stroke patients taking DOACs, expanding eligibility for thrombolysis.
Why the study?
DOACs prevent stroke in atrial fibrillation, but their presence can limit thrombolysis eligibility in acute stroke, prompting evaluation of whether rapid plasma DOAC testing expands eligibility.
Does rapid plasma DOAC testing expand eligibility for thrombolysis in ischaemic stroke patients taking DOACs?
Observational
Does rapid plasma DOAC testing expand eligibility for thrombolysis in ischaemic stroke patients taking DOACs?
Rapid plasma DOAC testing identifies a significant proportion (40%) of ischaemic stroke patients on DOACs who have low drug levels and can therefore receive potentially life-saving thrombolysis.
May expand thrombolysis eligibility in DOAC-treated stroke; hypothesis-generating pending prospective validation.
Direct oral anticoagulants (DOACs) are used for stroke prevention in atrial fibrillation, but their presence can limit thrombolysis eligibility in acute stroke. This retrospective study examined whether rapid plasma DOAC testing expanded eligibility for thrombolysis. Among ischaemic stroke patients taking DOACs who were otherwise eligible for thrombolysis, 40% had low DOAC levels (<50 ng/mL). This led to the use of potentially life- and disability-saving thrombolysis in patients who would otherwise have been ineligible.
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Callaly et al. (2025) conducted an observational in Ischaemic stroke. Rapid plasma DOAC testing was evaluated on Low DOAC levels (<50 ng/mL). Rapid plasma DOAC testing identified low DOAC levels (<50 ng/mL) in 40% of ischaemic stroke patients taking DOACs, expanding eligibility for thrombolysis.
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