Stroke Outcomes with Alteplase and Recent Novel Oral Anticoagulant Use

Analysis of a large database shows no difference in symptomatic intracerebral hemorrhage risk with recent NOAC use before alteplase administration.

Although thrombolytic therapy is standard treatment for acute ischemic stroke in appropriately selected patients, current guidelines recommend avoiding thrombolytics such as alteplase in patients who have used novel oral anticoagulants (NOACs) in the previous 48 hours. However, this recommendation is somewhat arbitrary. In this study from the well-known American Heart Association Get With The Guidelines–Stroke registry, data were compiled from more than 1700 hospitals from 2015 to 2020, comparing outcomes after alteplase administration in patients with NOAC use within the past 7 days and in those not using NOACs. The primary outcome was symptomatic intracranial hemorrhage (sICH) within 36 hours after alteplase administration. Additional ana…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Stroke Outcomes with Alteplase and Recent Novel Oral Anticoagulant Use

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Reviewing Author