OK to Give tPA to Stroke Patients on NOACs

Intravenous administration of tissue plasminogen activator (tPA) appears safe in selected patients who were already on novel oral anticoagulants (NOACs) a team reported at the American Heart Association Annual Scientific Session in Orlando, FL.

Ying Jian and colleagues at Duke Clinical Research Institute, Duke University, Durham NC and at other institutions analyzed data from 42,887 ischemic stroke patients treated with IV tPA within 4.5 hours of onset of symptoms. The patients were all at hospitals complying with the "Get with the Guidelines-Stroke" protocols.

Of of the patients treated 1,751 were taking NOACs prior to admission.

These patients had more comorbidities, more severe stroke and tended to be older than other patients studied.

The patients on NOACs prior to admission "appeared to have higher likelihood of discharge home and of being able to ambulate independently at discharge," the researchers noted.

The also said that "the number of patients taking NOACs who received tPA is small and may reflect potential treatment selection."