Stroke Thrombolysis with Recent Direct Oral Anticoagulant Use

Recent direct oral anticoagulant use was not associated with increased brain hemorrhage after thrombolysis in a retrospective study.

Current guidelines recommend that intravenous thrombolysis (IVT) should not be administered in patients who have taken a direct oral anticoagulant (DOAC) medication in the preceding 48 hours. However, this recommendation is based on limited data, and large studies evaluating the safety of IVT in patients with recent DOAC use are lacking. These authors conducted a retrospective study from 2008 through 2021, comparing patients treated at 64 centers who received IVT after taking a DOAC in the preceding 48 hours to control patients with no DOAC use before IVT. The primary outcome was symptomatic intracerebral hemorrhage (sICH), defined as ICH with worsening on the NIH Stroke Scale of 4 or more points.

During the study period, the investigators i…

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 Thrombolysis with Recent Direct Oral Anticoagulant Use

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Reviewing Author