Abstract Details

Title Is There an Increased Risk of Intracranial Hemorrhage When Treating Patients Who Are Currently on Dual Anti-Platelets with IV tPA?

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 233

Objective

Background BACKGROUND: IVtPA is the standard of care for treatment of acute ischemic stroke within 4.5 hours of stroke symptoms. Previous studies have shown an increased risk of hemorrhagic complications in patients on dual anti-platelet therapy who receive IVtPA.

Design/Methods DESIGN/METHODS: We performed a retrospective review of 73 patients who were admitted to the Stroke service at University of Toledo Medical Center (UTMC) after receiving IVtPA between October 2009 and September 2012. Medical records were reviewed to identify demographics, stroke risk factors, baseline NIHSS, time to treatment and radiographic and clinical outcomes.

Results RESULTS: 73 patients were treated with IVtPA within 4.5 hours from the onset of symptoms and were admitted to our center. The mean age was 65.7 years old and the mean NIH stroke scale was 10.5. Seventeen patients were only on aspirin, 2 only on clopidogrel, 1 only on prasugrel, 1 on aspirin and aspirin-dipyridamole, 1 on aspirin and ticlodipine, 1 on aspirin and warfarin, and 4 on aspirin and clopidogrel. Six patients (8.2%) had a symptomatic parenchymal hemorrhage (PH) and 1(1.4%) had asymptomatic hemorrhagic transformation (HT). Among those on aspirin, only 1 patient (5.9%) suffered a symptomatic PH and 1(5.9%) had an asymptomatic HT. Among those on both aspirin and clopidogrel, 1 patient (25%) suffered an asymptomatic HT. There was no PH in the aspirin and clopidogrel group. No significant difference in PH/HT was noted when aspirin vs. clopidogrel vs. aspirin + clopidogrel groups were compared ([chi]2=3.68, p=0.159).

Conclusions CONCLUSIONS: In our cohort, there was no additional risk of hemorrhagic complications in patients on dual antiplatelet therapy who received IVtPA, prospective studies are needed to confirm this finding.

Authors/Disclosures
Vieh M. Kung, MD (University of Toledo Medical Center) PRESENTER	Dr. Kung has nothing to disclose.
	No disclosure on file
	No disclosure on file
Syed F. Zaidi, MD (ProMedica Stroke Network)	Dr. Zaidi has nothing to disclose.
Mouhammad A. Jumaa, MD (ProMedica Stroke Network)	Dr. Jumaa has nothing to disclose.

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