Patient use of any anticoagulation during an acute stroke is a contraindication for the use of thrombolytics or clot busters. Recent meta-analyses and animal studies raise the question of this contraindication. Join guest, Geoff Wall, as he examines the data on Direct Oral Anticoagulants (DOACs) and thrombolytics.

The GameChanger
DOACs have a significantly smaller intracranial hemorrhage (ICH) risk compared to warfarin and this benefit may translate to risk of bleed with thrombolytics. A new study found a numerically decreased risk of ICH in patients with DOACs compared to controls.

Show Segments
00:00 - Introductions
01:07 - Current Practices with Thrombolytics
05:05 - Looking at the Study
19:45 - The GameChanger: Decreased ICH Risk?
23:30 - Study Limitations
26:11 - Connecting to Practice
27:01 - Closing Remarks

Host
Geoff Wall, PharmD, BCPS, FCCP, CGP
Professor of Pharmacy Practice, Drake University
Internal Medicine/Critical Care, UnityPoint Health

References and Resources
Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants

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CE Information

Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:

1. Discuss the theory about why DOACs may not increase risk of intracranial bleed in stroke patients receiving thrombolytics
2. Describe the limitations of the Meinel et al study

0.05 CEU/0.5 Hr
UAN: 0107-0000-23-064-H01-P
Initial release date: 02/13/2023
Expiration date: 02/13/2024
Additional CPE and CME details can be found here.

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