Key result
Prior treatment with aspirin and clopidogrel increased the risk of symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke (OR 2.11; 95% CI 1.29-3.45; P=0.003).
Why the study?
Does prior antiplatelet therapy increase the risk of symptomatic intracerebral hemorrhage in acute ischemic stroke patients receiving intravenous thrombolysis compared to antiplatelet-naïve patients?
Population
11,865 patients with acute ischemic stroke compliant with European license criteria for intravenous…
Comparison
Intravenous thrombolysis in patients receiving… vs Intravenous thrombolysis in antiplatelet-naïve…
Design
Cohort
Follow-up
3 months
Authors
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Prior dual antiplatelet use was associated with higher sICH risk after IVT; leaves open net clinical benefit and eligibility decisions.
Cohort (n=11,865)
Yes
Does prior antiplatelet therapy increase the risk of symptomatic intracerebral hemorrhage in acute ischemic stroke patients receiving intravenous thrombolysis compared to antiplatelet-naïve patients?
Odds Ratio: 2.11 (95% CI 1.29–3.45)
Absolute Event Rate: 13.4% vs 4.1%
p-value: p=0.003
Prior antiplatelet therapy, including dual therapy, increases the risk of symptomatic intracerebral hemorrhage after IV thrombolysis for acute ischemic stroke but does not worsen mortality or functional outcomes, suggesting it should not be an absolute contraindication.
Diedler et al. (2010) conducted a cohort in Acute Ischemic Stroke (n=11,865). Antiplatelet therapy (specifically aspirin and clopidogrel) vs. Antiplatelet naïve was evaluated on Symptomatic intracerebral hemorrhage (SICH) per ECASS II (OR 2.11, 95% CI 1.29 to 3.45, p=0.003). Prior treatment with aspirin and clopidogrel increased the risk of symptomatic intracerebral hemorrhage after intravenous thrombolysis for acute ischemic stroke (OR 2.11; 95% CI 1.29-3.45; P=0.003).
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