Warfarin therapy does not increase risk of symptomatic intracerebral hemorrhage in eligible patients after intravenous thrombolysis.

摘要

Prabhakaran and colleagues1 reported that warfarin-treated patients with an international normalized ratio (INR) of 1.7 or less had a markedly increased risk of symptomatic intracerebral hemorrhage (SICH) after treatment with intravenous tissue plasmino-gen activator (IV tPA) for ischemic stroke at a single institution. We examined this issue by analyzing data from the Colorado Stroke Alliance registry, a shared database of 35 Colorado hospitals. Of the 6614 ischemic strokes in the database with complete records, 580 (8.7%) had received IV tPA. Warfarin dierapy in patients with an INR of 1.7 or less was reported in 26 of the 580 patients (4.4%), of whom 18 (3.1%) were receiving warfarin alone and 8 (1.4%) were receiving warfarin and an antiplatelet drag.