| Symptomatic intracerebral hemorrhage among eligible warfarin-treated patients receiving intravenous tissue plasminogen activator for acute ischemic stroke. | |
| | |
MedLine Citation:
|
PMID: 20212195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To determine whether warfarin-treated patients with an international normalized ratio less than 1.7 who receive intravenous tissue plasminogen activator for acute ischemic stroke are at increased risk for symptomatic intracerebral hemorrhage. DESIGN: Retrospective study. SETTING: Academic hospital. PATIENTS: Consecutive patients with acute ischemic stroke who are treated with intravenous tissue plasminogen activator. MAIN OUTCOME MEASURE: Symptomatic intracerebral hemorrhage. RESULTS: One hundred seven patients were included (mean age, 69.2 years; 43.9% men; median National Institutes of Health Stroke Scale score, 14; median onset-to-treatment time, 140 minutes; baseline warfarin use, 12.1%). The median international normalized ratio was 1.04 (range, 0.82-1.61). The overall rate of symptomatic intracerebral hemorrhage was 6.5%, but it was nearly 10-fold higher among patients taking warfarin compared with those not taking warfarin at baseline (30.8% vs 3.2%, respectively; P = .004). Baseline warfarin use remained strongly associated with symptomatic intracerebral hemorrhage (P = .004) after adjusting for relevant covariates, including age, atrial fibrillation, National Institutes of Health Stroke Scale score, and international normalized ratio. CONCLUSIONS: Despite an international normalized ratio less than 1.7, warfarin-treated patients are more likely than those not taking warfarin to experience symptomatic intracerebral hemorrhage following treatment with intravenous tissue plasminogen activator. Larger studies in this subgroup are warranted. |
| | |
Authors:
|
Shyam Prabhakaran; Juan Rivolta; Julio R Vieira; Fred Rincon; Joshua Stillman; Randolph S Marshall; Ji Y Chong |
Related Documents
:
|
1463805 - Transcranial doppler sonography in the acute cerebral ischemic disease. 19105765 - Neuroimaging of ischemic stroke with ct and mri: advancing towards physiology-based dia... 19342825 - Classification of stroke subtypes. 17309795 - Socially assistive robotics for post-stroke rehabilitation. 19692435 - Multiple sclerosis and neurofibromatosis type 1: report of seven patients from iran. 18827475 - Deferasirox treatment improved the hemoglobin level and decreased transfusion requireme... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-03-08 |
Journal Detail:
|
Title: Archives of neurology Volume: 67 ISSN: 1538-3687 ISO Abbreviation: Arch. Neurol. Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-05-11 Completed Date: 2010-07-01 Revised Date: 2011-01-27 |
Medline Journal Info:
|
Nlm Unique ID: 0372436 Medline TA: Arch Neurol Country: United States |
Other Details:
|
Languages: eng Pagination: 559-63 Citation Subset: AIM; IM |
Affiliation:
|
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA. shyam_prabhakaran@rush.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease
/
therapy Anticoagulants / adverse effects Brain Ischemia / drug therapy* Cerebral Arteries / drug effects, physiopathology Cerebral Hemorrhage / chemically induced*, physiopathology Drug Synergism Drug Therapy, Combination Fibrinolytic Agents / adverse effects Humans Iatrogenic Disease / prevention & control Retrospective Studies Risk Factors Stroke / drug therapy* Tissue Plasminogen Activator / adverse effects* Warfarin / adverse effects* |
| Grant Support | |
ID/Acronym/Agency:
|
5P50NS049060/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Fibrinolytic Agents; 81-81-2/Warfarin; EC 3.4.21.68/Tissue Plasminogen Activator |
| Comments/Corrections | |
Comment In:
|
Arch Neurol. 2010 Sep;67(9):1156; author reply 1156-7
[PMID:
20837869
]
Arch Neurol. 2010 Nov;67(11):1413-4; author reply 1414 [PMID: 21060022 ] Arch Neurol. 2010 Nov;67(11):1413; author reply 1414 [PMID: 21060023 ] Arch Neurol. 2011 Jan;68(1):135; author reply 135-6 [PMID: 21220688 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Iatrogenic hyperammonemia after anorexia.
Next Document: Delaying Treatment of Ocular Hypertension: The Ocular Hypertension Treatment Study.