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Intravenous tissue plasminogen activator (IV TPA) is the only FDA-approved medication for patients with acute ischemic stroke. Despite being approved for more than 15 years, with considerable clinical experience in numerous countries, some of the contraindications and warnings for IV TPA in acute stroke are still controversial. One area of uncertainty is whether IV TPA is safe to use in patients currently receiving warfarin who have an international normalized ratio (INR) ≤1.7. To examine this issue, these authors investigated a national database of 23,437 patients treated at more than 1200 hospitals from April 2009 through June 2011. Of this group, 1802 patients were being treated with warfarin at the time of IV TPA administration. The med…