11 May 2012

Clot-busting Drug Tissue Plasminogen Activator (tPA) For Stroke Patients Safe To Use With Blood Thinner Warfarin

A stroke is a brain condition where it doesn’t get enough oxygen because of a blood clot in the blood vessel. Because the brain does not get the oxygen it needs, brain function is impaired and permanent brain damage can occur. This is called an ischemic stroke.

The most common stroke is the ischemic stroke. This happens when there is an obstruction in the blood vessel supplying blood to the brain. This is called a blood clot. Sometimes the blood clot is temporary and cuts off blood for only minutes. This is called a Transient Ischemic Attack or TIA. These are relatively harmless as they cause no permanent injury but are a serious warning about the risk of another stroke and one should immediately seek medical advice after a TIA

Ischemic strokes, on the other hand, are harmful. The obstruction is much more pronounced and sometimes literally cuts off the blood circulation in a region of the brain . People who suffer an Ischemic stroke will suffer physical impairment, mood and behavioral swings, and bouts of depression afterwards. Rehabilitation is a long journey for stroke victims

Clot-busting drug safe for stroke patients taking blood thinner

Acute ischemic stroke patients taking the blood thinner warfarin can be treated safely with the clot-busting drug tissue plasminogen activator (tPA), according to research presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2012.

"Although it's the only drug approved by the 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," said Ying Xian, M.D., Ph.D., the study's lead author and a research fellow at Duke Clinical Research Institute, in Durham, N.C.

Video: How it feels like to have a stroke

Xian and colleagues used data from the American Heart Association/American Stroke Association's Get With The Guidelines®-Stroke registry to evaluate tPA safety in warfarin-treated patients who had an ischemic stroke, which occurs when a blood vessel to the brain becomes blocked.

The data was from 23,437 ischemic stroke patients treated with tPA in 1,203 Get With The Guidelines-Stroke hospitals between April 2009 and June 2011. Almost 8 percent (1,802) of patients were taking warfarin prior to admission.

Patients on warfarin prior to hospitalization for an ischemic stroke tended to be older (77 years vs. 71 years), had more illnesses at the time of their strokes and had more severe strokes than patients not on warfarin.

Nevertheless, the risk of severe bleeding from brain hemorrhage was similar among stroke patients who received tPA after stroke, regardless of whether they were on warfarin.

The researchers also didn't find notable differences between warfarin and non-warfarin patients when they compared risks of tPA-related complications or in-hospital death after tPA.

"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. "tPA has been shown to minimize brain damage and disability from stroke and should not be withheld from these patients."

The study is the largest on the safety of tPA in warfarin-treated patients who meet clinical guideline criteria. However, Xian said they didn't measure functional, neurological or long-term results of tPA treatment.


American Heart Association
Food and Drug Administration
American Heart Association
American Stroke Association
Quality of Care and Outcomes Research Scientific Sessions 2012
New Drug Discovery May Lead to Faster Stroke Recovery
Long Term Diabetes Increases Risk of Stroke
Aspirin Lowers Risk in Trans Fat Related Strokes
Flavonoids in Citrus Fruits Lowers Stroke Risk
Relationship Found Between Body Mass Index (BMI) and risk for Ischemic Heart Disease (IHD)
Popular Flavonoid, Rutin, As Preventive Therapy Against Blood Clots, Strokes and Heart Attacks
Nonsteroidal Anti Inflammatory Drugs (NSAIDs) and Cardiovascular Risk Explained
New Research on Resveratrol Enhances Claim That The Compound Prolongs Lifespan and Healthspan