Document Detail

Thrombolysis for acute stroke under antiplatelet therapy: safe enough to be beneficial?
MedLine Citation:
PMID:  18665145     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Controversy exists over whether chronic antiplatelet therapy in patients with acute ischemic stroke is a contraindication to treatment with tissue plasminogen activator (tPA). Antiplatelets impair thrombocyte function and might, therefore, increase the risk of symptomatic intracerebral hemorrhage (SICH) after intravenous thrombolysis. This Practice Point commentary discusses a recent study by Uyttenboogaart et al. that aimed to further explore the interactions between antiplatelet and tPA therapies. The single-center study, which included 301 consecutive patients with ischemic stroke, found that the incidence of SICH was indeed increased among patients who were pretreated with antiplatelets, but that these patients nevertheless had a greater net benefit of thrombolysis than did those who had not received previous antiplatelet therapy. The commentary authors consider the study's shortcomings, but conclude that the widespread practice of using tPA in the presence of antiplatelet therapy is justified.
Werner Hacke; Christoph Lichy
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Publication Detail:
Type:  Comment; Journal Article     Date:  2008-07-29
Journal Detail:
Title:  Nature clinical practice. Neurology     Volume:  4     ISSN:  1745-8358     ISO Abbreviation:  -     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-04     Completed Date:  2009-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101261799     Medline TA:  Nat Clin Pract Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  474-5     Citation Subset:  -    
Department of Neurology, University of Heidelberg, Heidelberg, Germany.
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Comment On:
Arch Neurol. 2008 May;65(5):607-11   [PMID:  18332238 ]

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