title: Postthrombolytic Antiplatelet Use for Patients with Intercerebral Hemorrhage without Extensive Parenchymal Involvement Does Not Worsen Outcome.
abstract: OBJECTIVE
  It is unclear whether postthrombolytic antiplatelet (AP) therapy after thrombolytic-related hemorrhage without extensive parenchymal involvement (THEPI) affects the clinical outcome. This study explored whether AP administration in patients with THEPI affects short- and long-term outcomes.
  
  
  METHODS
  All of the data for this study were collected from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China) registry. Patients with THEPI were assigned to either the AP (AP therapy should be commenced 24 h after intravenous thrombolysis) or AP-naïve groups. THEPI was defined according to European-Australasian Acute Stroke Study II criteria. The 90-day functional outcome, 7-day National Institutes of Health Stroke Scale (NIHSS) score, and 7-day and 90-day mortalities were compared between the AP and AP-naïve groups. Logistic regression analysis wy on the short- and long-term clinical outcomes.
  
  
  RESULTS
  Of the 928 patients enrolled from those in the TIMS-China registry (n=1,440), 89 (9.6%) had nonsymptomatic intracerebral hemorrhage (ICH) within 24-36 h after thrombolysis; 33 (37%) of these patients were given AP therapy (AP group) and 56 (63%) were not (AP-naïve group). No significant differences were found for the risk of 7-day aggravated ICH (p=0.998), 7-day NIHSS score (p=0.5491), 7-day mortality [odds ratio (OR)=3.427; 95% confidence interval (95% CI)=0.344-34.160; p=0.294], 90-day mortality (OR=0.788, 95% CI=0.154-4.040, p=0.775), or modified Rankin score 5 or 6 at 90-days (OR=1.108, 95% CI=0.249-4.928, p=0.893) between the AP and AP-naïve groups after THEPI.
  
  
  CONCLUSIONS
  Early administration of postthrombolytic AP therapy after THEPI does not worsen either the short- or long-term outcome. AP therapy may be a reasonable treatment option for patients with THEPI to reduce the risk of ischemic stroke recurrence.
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Jia
authors.affiliation: Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Lichun
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Liao
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. yongjunwang1962@gmail.com.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
keywords: antiplatelet therapy; ischemic stroke; outcome; thrombolytic-related hemorrhage