Jazmin Hampton, Purity Mugambi, Emily Caggiano, Reynalde Eugene, Alycia Valente, Melissa Taylor, Stephanie Carreiro
Closing the Digital Divide in Interventions for Substance Use Disorder
Journal of psychiatry and brain science
alteplase tpa initial treatment acute ischemic stroke current tpa guidelines exclude patients took direct oral anticoagulants doac within prior 48 hours propensitymatched retrospective study compared acute ischemic stroke patients treated tpa received doacs within 48 hours thrombolysis previously treated doacs regarding three outcomes mortality intracranial hemorrhage ich need acute blood transfusions marker significant blood loss using united states cohort 54 healthcare organizations trinetx database identified 8582 stroke patients treated tpa doacs within 48 hours thrombolysis 46703 stroke patients treated tpa doacs since january 1 2012 performed propensity score matching demographic information seven prior clinical diagnostic groups resulting total 17164 acute stroke patients evenly matched groups recorded mortality rates frequency ich need blood transfusions group ensuing 7 30day periods patients treated tpa doacs reduced mortality 33 vs 73 risk ratio rr 0456 p 0001 fewer ichs 68 vs 101 rr 0678 p 0001 less risk major bleeding measured frequency blood transfusions 05 vs 15 rr 0317 p 0001 7 days post thrombolytic tpa patients doacs findings 30 days postthrombolytics similarstatistically significant lower mortality rate 72 vs 131 rr 0550 p 0001 fewer ichs 76 vs 108 rr 0705 p 0001 fewer blood transfusions 09 vs 20 rr 0448 p 0001 acute ischemic stroke patients treated tpa received doacs within 48 hours thrombolysis lower mortality rates reduced incidence ich less blood loss doacs study suggests prior use doacs contraindication thrombolysis ischemic stroke