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

Emergency drug is underused in stroke patients on blood thinners, researchers say

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THURSDAY, May 10, 2012 (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.

SOURCE: American Heart Association, news release, May 10, 2012


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