Clot-Buster Doesn’t Raise Bleeding Risk in Warfarin Patients: Study

THURSDAY, May 10 (HealthDay News) — Tissue plasminogen activator
(tPA), a drug used to combat clots in stroke patients, does not increase
the risk of dangerous bleeding in patients also taking the blood thinner
warfarin, new research found.

The study included information on more than 23,000 ischemic stroke
patients treated with tPA at more than 1,200 U.S. hospitals. Ischemic
stroke, the most common type of brain attack, is caused by a blocked blood
vessel to the brain. The clot-busting drug tPA is sold under the brand
name Activase and the generic name alteplase.

In the study, about 8 percent of the stroke patients were taking the
anticoagulant warfarin (Coumadin) before hospital admission.

The researchers found little difference in the risk of severe bleeding
due to a brain hemorrhage in patients who received tPA while on warfarin
versus those not taking the blood-thinning drug. The study also found no
major differences in the patients’ risks of tPA-related complications or
in-hospital death after tPA.

The research was scheduled to be presented on Thursday at the American
Heart Association’s Quality of Care and Outcomes Research meeting in
Atlanta.

“Although it’s the only drug approved by the U.S. Food and Drug
Administration to treat acute ischemic stroke, tPA is underused among
patients on home warfarin therapy mainly because of the fear that it will
cause bleeding,” study lead author Dr. Ying Xian, a research fellow at
Duke Clinical Research Institute in Durham, N.C., said in a heart
association news release.

The researchers noted that the patients taking warfarin were usually
older, had more illnesses and had more severe strokes than those not on
warfarin.

“Our study suggests tPA is not associated with excessive bleeding or
death among warfarin patients when used according to American Heart
Association/American Stroke Association guidelines,” Xian said.

And, the researcher added, tPA “has been shown to minimize brain damage
and disability from stroke and should not be withheld from these
patients.”

The study authors pointed out that they didn’t measure functional,
neurological or long-term results of tPA treatment.

The data and conclusions of research presented at medical meetings
should be viewed as preliminary until published in a peer-reviewed
journal.

More information

The U.S. National Stroke Association has more about treatments for stroke.

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