Thrombolysis Improved Ischemic Stroke Outcome In People Taking Blood Thinners With No Increased Risk of Bleeding

A study from UT Southwestern Medical Center showed that prior long-term use of blood thinners led to better recovery from stroke in those treated with the thrombolytic alteplase without increased risk of bleeding. 

The results run counter to the common practice of withholding alteplase from individuals who had been taking blood thinners and had ischemic stroke. The practice of withholding thrombolytic alteplase is related to concerns that could cause excess bleeding, such as a brain hemorrhage.

“The real risk is in not treating patients—they would otherwise be left with lifelong disability from their stroke,” said Ying Xian, MD, PhD, associate professor of neurology and population and data sciences, UT Southwestern Medical Center.

The study examined data from 163,083 patients across the US in the American Heart Association Stroke Registry. The data showed that 2,207 patients were taking non-vitamin K antagonist oral anticoagulants (NOACs) prior to having a stroke and were treated with alteplase. 

The study found no evidence that the patients were at risk of excess bleeding. Instead, they were able to return home free of disabilities and able to ambulate and function independently.

The results of the study are published in the Journal of the American Medical Association (JAMA).