Influence of antiplatelet pre-treatment on the risk of intracranial haemorrhage in acute ischaemic stroke after intravenous thrombolysis

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
L DoradoA Dávalos

Abstract

Pre-treatment with antiplatelet agents (AP) is present amongst 30% of acute stroke patients. Previous studies have shown conflicting results on the effect of these drugs regarding haemorrhagic transformation after thrombolytic therapy. The hypothesis that pre-treatment with AP may increase the risk of cerebral haemorrhage (ICH) after intravenous tissue plasminogen activator (tPA) was assessed. Retrospective study of consecutive prospectively registered patients with acute ischaemic stroke treated with iv tPA (n = 235) in the last 5 years. Baseline characteristics and prior AP therapy were registered on admission. Computed tomography (CT) scan was performed on admission and 24-36 h after tPA. ICH was classified according to the ECASS II criteria into haemorrhagic infarction and parenchymal haematoma (PH). Symptomatic intracerebral haemorrhage (SICH) was defined as a worsening of > or = 4 points in the NIHSS score during the first 36 h in any haemorrhage subtype. Seventy-two (30.6%) patients were pre-treated with AP (55 aspirin, 14 clopidogrel, 2 aspirin + clopidogrel, 1 triflusal). PH was observed in 33 (14.1%) patients (PH1 13, PH2 12, PHr 8) of whom 16 were symptomatic. Male gender (78.8% vs. 21.2%, P = 0.036), prior AP therap...Continue Reading

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Citations

Jul 27, 2011·Der Nervenarzt·M EndresM Dichgans
Nov 20, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·M Uyttenboogaart, G J Luijckx
Feb 15, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·William J MeurerPhillip A Scott
Sep 22, 2017·Journal of Intensive Care Medicine·Mark M McDonaldTiffany R Chang
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Feb 9, 2010·Journal of Neurology·Eugenia Martínez-HernándezJoan Martí-Fàbregas
Jun 24, 2017·Plant, Cell & Environment·Birgit PiechullaMarco Kai

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