Diabetes and prior stroke should not preclude use of IV thrombolysis for stroke.
In Europe, health authorities have restricted the use of intravenous tissue plasminogen activator (IV TPA) in patients with both diabetes mellitus (DM) and prior stroke (PS) on the basis of an unfavorable risk/benefit ratio. To clarify the validity behind the restriction of IV thrombolysis in these patients, researchers compared clinical outcomes of more than 23,000 patients who had received IV TPA in the Safe Implementation of Thrombolysis Stroke-International Stroke Thrombolysis Register (SITS-ISTR) and of more than 6000 patients registered in the Virtual International Stroke Trials Archive (VISTA) who had not received IV TPA. They examined the influence of DM, PS, or both on patient outcomes: 5411 patients (18.5%) had DM, 5019 (17.1%) ha…