Subtherapeutic warfarin therapy entails an increased bleeding risk after stroke thrombolysis

Neurology

Volumn 79, Issue 1, 2012, Pages 31-38

  Ruecker, Michael ^a   Matosevic, Benjamin ^a   Willeit, Peter ^a,b   Kirchmayr, Matthias ^a   Zangerle, Alexandra ^a   Knoflach, Michael ^a   Willeit, Johann ^a   Kiechl, Stefan ^a  

^a INNSBRUCK MEDICAL UNIVERSITY   (Austria)

^b UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ALTEPLASE; PROTHROMBIN; WARFARIN;

ADULT; AGED; ANTICOAGULANT THERAPY; ARTICLE; BLEEDING; BRAIN ISCHEMIA; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; DIABETES MELLITUS; DRUG INDUCED DISEASE; FEMALE; HUMAN; INTERNATIONAL NORMALIZED RATIO; MAJOR CLINICAL STUDY; MALE; NATIONAL INSTITUTES OF HEALTH STROKE SCALE; OUTCOME ASSESSMENT; PREMEDICATION; PRIORITY JOURNAL; PROSPECTIVE STUDY; PROTHROMBIN TIME; RISK ASSESSMENT;

EID: 84863603095     PISSN: 00283878     EISSN: 1526632X     Source Type: Journal    
DOI: 10.1212/WNL.0b013e31825dcdf0     Document Type: Article

References (29)

1. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333: 1581-1587.
2. Hacke W, Kaste M, Fieschi C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: The European Cooperative Acute Stroke Study (ECASS). JAMA 1995;274:1017-1025.
3. Hacke W, Kaste M, Fieschi C, et al. Randomised doubleblind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II): Second European-Australasian Acute Stroke Study Investigators. Lancet 1998;352:1245-1251.
4. Hacke W, Kaste M, Bluhmki E, et al, ECASS Investigators. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-1329.
5. Marler JR, Tilley BC, Lu M, et al. Early stroke treatment associated with better outcome: the NINDS rt-PA stroke study. Neurology 2000;55:1649-1655.
6. Wahlgren N, Ahmed N, Dávalos A, et al, SITS-MOST investigators. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet 2007;369:275-282.
7. Wahlgren N, Ahmed N, Dávalos A, et al, SITS investigators. Thrombolysis with alteplase 3-45 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet 2008;372:1303-1309.
8. Clark WM, Wissman S, Albers GW, Jhamandas JH, Madden KP, Hamilton S. Recombinant tissue-type plasminogen activator (Alteplase) for ischemic stroke 3 to 5 hours after symptom onset: the ATLANTIS Study: a randomized controlled trial: Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke. JAMA 1999;282:2019-2026.
9. Albers GW, Bates VE, Clark WM, Bell R, Verro P, Hamilton SA. Intravenous tissue-type plasminogen activator for treatment of acute stroke: the Standard Treatment with Alteplase to Reverse Stroke (STARS) study. JAMA 2000; 283:1145-1150.
10. Prabhakaran S, Rivolta J, Vieira JR, et al. Symptomatic intracerebral hemorrhage among eligible warfarintreated patients receiving intravenous tissue plasminogen activator for acute ischemic stroke. Arch Neurol 2010;67:559-563.
11. Rueckert CM, Staudacher T, Bengel D. Symptomatic intracerebral hemorrhage in warfarin treated patients receiving thrombolytic therapy for acute ischemic stroke. Cerebrovasc Dis 2011;31:abstract.
12. Seet RC, Zhang Y, Moore SA, Wijdicks EF, Rabinstein AA. Subtherapeutic international normalized ratio in warfarin-treated patients increases the risk for symptomatic intracerebral hemorrhage after intravenous thrombolysis. Stroke 2011;42:2333-2335.
13. Vergouwen MD, Casaubon LK, Swartz RH, et al, Investigators of the Registry of the Canadian Stroke Network. Subtherapeutic warfarin is not associated with increased hemorrhage rates in ischemic strokes treated with tissue plasminogen activator. Stroke 2011;42:1041-1045.
14. Kim YD, Lee JH, Jung YH, et al. Safety and outcome after thrombolytic treatment in ischemic stroke patients with high-risk cardioembolic sources and prior subtherapeutic warfarin use. J Neurol Sci 2010;298:101-105.
15. Meretoja A, Putaala J, Tatlisumak T, et al. Off-label thrombolysis is not associated with poor outcome in patients with stroke. Stroke 2010;41:1450-1458.
16. Levin D, Smith DB, Cumbler E, Carter J, Glasheen JJ, Jones W. Warfarin therapy does not increase risk of symptomatic intracerebral hemorrhage in eligible patients after intravenous thrombolysis. Arch Neurol 2011;68:135; author reply 135-136.
17. Ibrahim MM, Sebastian J, Hussain M, et al, CLOTBUST Investigators. Does current oral antiplatelet agent or subtherapeutic anticoagulation use have an effect on tissueplasminogen-activator-mediated recanalization rate in patients with acute ischemic stroke? Cerebrovasc Dis 2010; 30:508-513.
18. Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial. Circulation 2011;123: 2363-2372.
19. Vandenbroucke JP, von Elm E, Altman DG, et al. STROBE Initiative: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007;18:805-835.
20. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327: 557-560.
21. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-634.
22. The NINDS t-PA Stroke Study Group. Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. Stroke 1997;28:2109-2118.
23. Graham GD. Tissue plasminogen activator for acute ischemic stroke in clinical practice: a meta-analysis of safety data. Stroke 2003;34:2847-2850.
24. Lansberg MG, Thijs VN, Bammer R, et al, DEFUSE Investigators. Risk factors of symptomatic intracerebral hemorrhage after tPA therapy for acute stroke. Stroke 2007;38: 2275-2278.
25. Singer OC, Humpich MC, Fiehler J, et al, MR Stroke Study Group Investigators. Risk for symptomatic intracerebral hemorrhage after thrombolysis assessed by diffusionweighted magnetic resonance imaging. Ann Neurol 2008; 63:52-60.
26. Hacke W, Donnan G, Fieschi C, et al, ATLANTIS Trials Investigators, ECASS Trials Investigators, NINDS rt-PA Study Group Investigators. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004;363:768-774.
27. Larrue V, von Kummer RR, Müller A, Bluhmki E. Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European-Australasian Acute Stroke Study (ECASS II). Stroke 2001; 32:438-441.
28. Illoh OC, Illoh K. Thrombolytic-associated coagulopathy and management dilemmas: a review of two cases. Blood Coagul Fibrinolysis 2008;19:605-607.
29. Stangl K, Laule M, Tenckhoff B, et al. Fibrinogen breakdown, long-lasting systemic fibrinolysis, and procoagulant activation during alteplase double-bolus regimen in acute myocardial infarction. Am J Cardiol 1998; 81:841-847.