title: Safety of early initiation of rivaroxaban or dabigatran after thrombolysis in acute ischemic stroke.
abstract: The introduction of direct oral anticoagulants (DOA) in the early stage of cerebral infarction after thrombolysis may reduce the recurrence rate but raises safety concern. We sought to study the feasibility and safety of the introduction of rivaroxaban or dabigatran in this context. Thirty-four consecutive patients admitted for ischemic stroke related to non-valvular atrial fibrillation in whom DOA were given within the first two weeks following intravenous rt-PA were studied. A clinical and radiological monitoring protocol was established to ensure the safety of the prescription. None of the patients experienced symptomatic hemorrhagic transformation or a symptomatic recurrent ischemic event after early rivaroxaban or dabigatran introduction.
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France; CREATIS, université de Lyon, CNRS UMR 5220, Inserm U1044, INSA-Lyon, université Lyon 1, hospices civils de Lyon, 69500 Villeurbanne cedex, France. Electronic address: norbert.nighoghossian@chu-lyon.fr.
authors: T
authors: T
authors: Ritzenthaler
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
authors: L
authors: L
authors: Derex
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
authors: C
authors: C
authors: Davenas
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
authors: W
authors: W
authors: Bnouhanna
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
authors: A
authors: A
authors: Farghali
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France.
authors: L
authors: L
authors: Mechtouff
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France; CREATIS, université de Lyon, CNRS UMR 5220, Inserm U1044, INSA-Lyon, université Lyon 1, hospices civils de Lyon, 69500 Villeurbanne cedex, France.
authors: T-H
authors: TH
authors: Cho
authors: Service d'urgences neuro-vasculaires, hôpital neurologique Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 59677 Bron cedex, France; CREATIS, université de Lyon, CNRS UMR 5220, Inserm U1044, INSA-Lyon, université Lyon 1, hospices civils de Lyon, 69500 Villeurbanne cedex, France.
authors: N
authors: N
authors: Nighoghossian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications; D002545:Brain Ischemia / Q000188:drug therapy*; D000069604:Dabigatran / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007902:Length of Stay; D008297:Male; D010865:Pilot Projects; D011859:Radiography; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000991:Antithrombins; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D000069552:Rivaroxaban; D010959:Tissue Plasminogen Activator; D000069604:Dabigatran
keywords: Accident ischémique cérébral; Acute stroke; Anticoagulant direct; Anticoagulants; Atrial fibrillation; Dabigatran; Dabigatran etexilate; Fibrillation atriale; Rivaroxaban; Thrombolysis