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Post-stroke clot-busting therapy beneficial
for patients on Aspirin
Newswise — Patients given a clot-busting drug following stroke
appear to have better outcomes if they were
already taking anti-platelet medications,
despite an apparent increased risk for
bleeding in the brain, according to an
article posted online today that will appear
in the May 2008 print issue of Archives of
Neurology, one of the JAMA/Archives
journals.
Dissolving blood clots by administering the drug tissue
plasminogen activator (tPA) appears to
improve outcomes in some patients with
stroke, according to background information
in the article.
However, the medication is associated with a 10-fold increased
risk of symptomatic brain hemorrhage
(bleeding).
Antiplatelet medications, such as aspirin, might further increase
the risk for bleeding because these drugs
impair the function of cells critical in
forming blood clots.
Maarten Uyttenboogaart, M.D., and colleagues at the University of
Groningen, Groningen, the Netherlands,
studied 301 patients who received tPA
following stroke between 2002 and 2006. Of
those, 89 had used antiplatelet drugs prior
to receiving tPA.
Symptomatic brain hemorrhages occurred in 12 patients who had
received antiplatelet therapy (13.5 percent)
and six patients who had not (2.8 percent).
Patients who had been taking antiplatelet therapy had a higher
risk for symptomatic brain hemorrhages.
“Despite this increased risk, prior antiplatelet therapy
increased the odds of a favorable outcome,”
defined as the ability to independently
carry out activities of daily living after
three months, the authors write.
“Therefore, our study suggests that tPA treatment should not be
withheld from patients receiving
antiplatelet therapy.”
Aspirin remains active for four to six days and might prevent an
additional blood vessel blockage from
occurring following tPA therapy, leading to
the observed improved outcomes, the authors
note.
“Larger prospective studies are warranted to further investigate
the influence of antiplatelet therapy on
outcome after thrombolytic therapy for acute
ischemic stroke,” they conclude.
Editor’s Note: This study was supported by a
grant from the Catharina Heerdt Foundation.
Please see the article for additional
information, including other authors, author
contributions and affiliations, financial
disclosures, funding and support, etc.
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