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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.
AuthorsT Ritzenthaler, L Derex, C Davenas, W Bnouhanna, A Farghali, L Mechtouff, T-H Cho, N Nighoghossian
JournalRevue neurologique (Rev Neurol (Paris)) Vol. 171 Issue 8-9 Pg. 613-5 (Sep 2015) ISSN: 0035-3787 [Print] France
PMID25857461 (Publication Type: Journal Article, Observational Study)
CopyrightCopyright © 2015 Elsevier Masson SAS. All rights reserved.
Chemical References
  • Antithrombins
  • Factor Xa Inhibitors
  • Fibrinolytic Agents
  • Recombinant Proteins
  • Rivaroxaban
  • Tissue Plasminogen Activator
  • Dabigatran
Topics
  • Aged
  • Aged, 80 and over
  • Antithrombins (administration & dosage, adverse effects, therapeutic use)
  • Atrial Fibrillation (blood, complications)
  • Brain Ischemia (drug therapy)
  • Dabigatran (administration & dosage, adverse effects, therapeutic use)
  • Drug Administration Schedule
  • Factor Xa Inhibitors (administration & dosage, adverse effects, therapeutic use)
  • Female
  • Fibrinolytic Agents (administration & dosage, therapeutic use)
  • Humans
  • Intracranial Hemorrhages (chemically induced, diagnostic imaging)
  • Length of Stay
  • Male
  • Pilot Projects
  • Radiography
  • Recombinant Proteins (administration & dosage, therapeutic use)
  • Recurrence
  • Retrospective Studies
  • Rivaroxaban (administration & dosage, adverse effects, therapeutic use)
  • Severity of Illness Index
  • Thrombolytic Therapy
  • Thrombophilia (drug therapy, etiology)
  • Tissue Plasminogen Activator (administration & dosage, therapeutic use)

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