Featured Research

from universities, journals, and other organizations

Warfarin users appear more likely to develop brain bleeding following stroke treatment

Date:
March 11, 2010
Source:
JAMA and Archives Journals
Summary:
Patients already taking warfarin who develop an acute stroke appear more likely to experience a brain hemorrhage following treatment with an intravenous clot-dissolving medication, even if their blood clotting function appears normal, according to a new study.

Patients already taking warfarin who develop an acute stroke appear more likely to experience a brain hemorrhage following treatment with an intravenous clot-dissolving medication, even if their blood clotting function appears normal, according to a report posted online that will appear in the May print issue of Archives of Neurology, one of the JAMA/Archives journals.

Related Articles


Intravenous tissue plasminogen activator (tPA), a clot-dissolving medication, is effective for acute ischemic stroke and generally results in improved clinical outcomes despite a slightly higher risk of brain hemorrhage, the authors write as background information in the article. Risk of hemorrhage is increased in some populations, including older adults and those with more severe strokes, high blood glucose levels, lower platelet counts and high blood pressure.

Use of anti-clotting medications, such as aspirin or warfarin, before having a stroke has raised further concerns about risk of hemorrhage. However, current American Heart Association/American Stroke Association guidelines permit the use of tPA in these patients as long as their results on blood clotting tests meet an international standard (described as an international normalized ratio of less than 1.7). Shyam Prabhakaran, M.D., M.S., of Rush University Medical Center, Chicago, and colleagues studied 107 patients (average age 69.2) with acute ischemic stroke who were treated with tPA between 2002 and 2009.

Of the patients, 13 (12.1 percent) were taking warfarin; all had an international normalized ratio of less than 1.7. "The overall rate of symptomatic intracerebral hemorrhage was 6.5 percent, but it was nearly 10-fold higher among patients taking warfarin compared with those not taking warfarin at baseline (30.8 percent vs. 3.2 percent, respectively)," the authors write. "Baseline warfarin use remained strongly associated with symptomatic intracerebral hemorrhage after adjusting for relevant co-variates, including age, atrial fibrillation, National Institutes of Health Stroke Scale score and international normalized ratio."

Several mechanisms may explain this association, the authors note. The clot-dissolving effects of tPA may be enhanced by the clot-preventing effects of warfarin, even at low levels. In addition, the effects of warfarin last for an average of three days after the last dose, so the international normalized ratio may continue to increase following treatment with tPA.

Given the small size and other limitations of the study, it should "serve as a hypothesis-generating report that requires confirmation in larger cohorts," the authors conclude. "Further analysis including more extensive adjustment for confounding variables in larger data sets may prove useful."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Shyam Prabhakaran; Juan Rivolta; Julio R. Vieira; Fred Rincon; Joshua Stillman; Randolph S. Marshall; Ji Y. Chong. Symptomatic Intracerebral Hemorrhage Among Eligible Warfarin-Treated Patients Receiving Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke. Arch Neurol, 2010; 0 (2010): 2010. 25 [link]

Cite This Page:

JAMA and Archives Journals. "Warfarin users appear more likely to develop brain bleeding following stroke treatment." ScienceDaily. ScienceDaily, 11 March 2010. <www.sciencedaily.com/releases/2010/03/100308171141.htm>.
JAMA and Archives Journals. (2010, March 11). Warfarin users appear more likely to develop brain bleeding following stroke treatment. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2010/03/100308171141.htm
JAMA and Archives Journals. "Warfarin users appear more likely to develop brain bleeding following stroke treatment." ScienceDaily. www.sciencedaily.com/releases/2010/03/100308171141.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Reuters - Innovations Video Online (Dec. 21, 2014) A team of scientists led by Danish chemist Jorn Christensen says they have isolated two chemical compounds within an existing antipsychotic medication that could be used to help a range of failing antibiotics work against killer bacterial infections, such as Tuberculosis. Jim Drury went to meet him. Video provided by Reuters
Powered by NewsLook.com
Hugging It Out Could Help You Ward Off A Cold

Hugging It Out Could Help You Ward Off A Cold

Newsy (Dec. 21, 2014) Carnegie Mellon researchers found frequent hugs can help people avoid stress-related illnesses. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins