| Hemorrhagic complications after systemic thrombolysis in acute stroke patients with abnormal baseline coagulation. | |
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MedLine Citation:
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PMID: 21672089 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background and purpose: As patients with abnormal baseline coagulation were excluded from the large randomized trials, the safety of intravenous thrombolysis after ischaemic stroke in this patient population remains controversial. Methods: We assessed the risk of symptomatic intracerebral hemorrhage (SICH) after systemic thrombolysis in patients with elevated baseline international normalized ratios (INRs) (≥1.3) or activated partial thromboplastin times (aPTT) (>37 s) using a prospectively recorded database from 2006 to 2010. An intracerebral hemorrhage leading to a deterioration of ≥4 points on the National Institutes of Health Stroke scale (NIHSS) was classified as symptomatic. Results: Amongst 688 patients (mean age, 72 years; median NIHSS, 11, median onset-to-treatment time, 135 min), 36 patients (5%) had an abnormal baseline coagulation. Twenty-nine of these patients had taken oral anticoagulants leading to elevated baseline INRs (median INR: 1.5; IQR 1.4-1.9), whereas seven patients had elevated aPTTs because of heparin therapy (n = 2), a coagulation disorder (n = 2), or for unknown reasons (n = 3). The rate of SICH did not differ significantly between patients with abnormal and normal baseline coagulation (4.4% vs. 0%; P = 0.6). Moreover, the in-hospital mortality was not significantly different between both treatment groups (8.3% in patients with abnormal baseline coagulation vs. 8.7% in patients with normal baseline coagulation, P = 1.0). Conclusions: The risk of SICH following intravenous thrombolysis after ischaemic stroke does not appear to be increased in patients with abnormal baseline coagulation. |
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Authors:
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F Brunner; B Tomandl; A Schröter; C Mellinghoff; A Haldenwanger; H Hildebrandt; A Kastrup |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-14 |
Journal Detail:
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Title: European journal of neurology : the official journal of the European Federation of Neurological Societies Volume: - ISSN: 1468-1331 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9506311 Medline TA: Eur J Neurol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Author(s). European Journal of Neurology © 2011 EFNS. |
Affiliation:
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Departments of Neurology Neuroradiology, Klinikum Bremen-Mitte, Bremen, Germany. |
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