title: Preexisting dual antiplatelet treatment increases the risk of post-thrombolysis intracranial hemorrhage in Chinese stroke patients.
abstract: OBJECTIVE
  Previous studies have shown conflicting results on the use of antiplatelet (AP) agent and its risk of symptomatic intracerebral hemorrhage (sICH) following thrombolysis for acute ischemic stroke. Our study was to explore the safety of intravenous (IV) thrombolysis in Chinese stroke patients who were on AP prior to stroke.
  
  
  METHODS
  Data were collected from the thrombolysis implementation and monitor of acute ischemic stroke in China (TIMS-China) registry. Symptomatic ICH defined per SITS-MOST (safe implementation of treatments in stroke-monitoring study), ECASS II (second European-Australasian acute stroke study), and NINDS (National Institute of Neurological Disorders and Stroke) criteria, 90-day functional outcome, and 7-day and 90-day mortalities were compared between the stroke patients who were on mono and dual AP therapy.
  
  
  RESULTS
  A total of 157 (14.2%) patients received at least one AP drug within 24 hours before thrombolysis. Patients with preexisting dual AP treatment had higher rate of sICH (14.3% (2/14) per SITS-MOST, 21.4% (3/14) per ECASS II definitions) than those on no AP treatment. No significant difference was found in the rate of sICH or 7-day or 90-day mortalities between the groups on aspirin (ASA) alone and on no AP treatment.
  
  
  CONCLUSIONS
  The risk of developing sICH is low when thrombolysis is given to patients who are on ASA alone. However, there is potential increased risk of sICH if a patient is on dual AP treatment.
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.forename: Qidong
authors.initials: Q
authors.lastname: Chen
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Liao
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.forename: Chunjuan
authors.initials: C
authors.lastname: Wang
authors.forename: Gaifen
authors.initials: G
authors.lastname: Liu
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.forename: David
authors.initials: D
authors.lastname: Wang
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet,; Ischemic stroke,; Safety,; Symptomatic intracerebral hemorrhage,; Thrombolysis