* . *
  • About
  • Advertise
  • Privacy & Policy
  • Contact
Thursday, September 18, 2025
Earth-News
  • Home
  • Business
  • Entertainment
    REO to return for UI homecoming – The News-Gazette

    REO Gears Up to Ignite the Stage at UI Homecoming Celebration!

    Gen V Season 2: What is The Odessa Project? – yahoo.com

    Gen V Season 2: Unlocking the Secrets of The Odessa Project

    PENN Entertainment stock rating reiterated at Market Outperform by JMP – Investing.com

    PENN Entertainment Stock Rated a Market Outperformer by Experts

    Here’s how NJ’s once-vibrant nightclub scene was born and why it died – Bergen Record

    The Rise and Fall of New Jersey’s Once-Vibrant Nightclub Scene: What Happened?

    The Emmys are back: Viewership soars to highest numbers in 4 years – yahoo.com

    The Emmys Return with a Bang: Viewership Hits a 4-Year High

    From Spinal Tap II to Ed Sheeran : your complete entertainment guide to the week ahead – The Guardian

  • General
  • Health
  • News

    Cracking the Code: Why China’s Economic Challenges Aren’t Shaking Markets, Unlike America’s” – Bloomberg

    Trump’s Narrow Window to Spread the Truth About Harris

    Trump’s Narrow Window to Spread the Truth About Harris

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Trending Tags

    • Trump Inauguration
    • United Stated
    • White House
    • Market Stories
    • Election Results
  • Science
  • Sports
  • Technology
    Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

    Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

    City IT presented Best of North Carolina Technology Award – RaleighNC.gov

    City IT Honored with Best of North Carolina Technology Award

    LELO Releases 2025 Futurist Report: Intergenerational Views on Relationships, Sex, and Technology – PR Newswire

    Exploring the Future: How Different Generations View Relationships, Sex, and Technology in 2025

    Will New Big Technology Engagements Reshape Innodata’s Growth Path? – Yahoo Finance

    Could New Major Tech Partnerships Propel Innodata to Unprecedented Growth?

    Unlocking AI Success: How People, Process, and Technology Form the Ultimate Triangle

    Billion-dollar coffins? New technology could make oceans transparent and Aukus submarines vulnerable – The Guardian

    Billion-Dollar Coffins? How New Technology Could Make Oceans Transparent and Expose Submarines

    Trending Tags

    • Nintendo Switch
    • CES 2017
    • Playstation 4 Pro
    • Mark Zuckerberg
No Result
View All Result
  • Home
  • Business
  • Entertainment
    REO to return for UI homecoming – The News-Gazette

    REO Gears Up to Ignite the Stage at UI Homecoming Celebration!

    Gen V Season 2: What is The Odessa Project? – yahoo.com

    Gen V Season 2: Unlocking the Secrets of The Odessa Project

    PENN Entertainment stock rating reiterated at Market Outperform by JMP – Investing.com

    PENN Entertainment Stock Rated a Market Outperformer by Experts

    Here’s how NJ’s once-vibrant nightclub scene was born and why it died – Bergen Record

    The Rise and Fall of New Jersey’s Once-Vibrant Nightclub Scene: What Happened?

    The Emmys are back: Viewership soars to highest numbers in 4 years – yahoo.com

    The Emmys Return with a Bang: Viewership Hits a 4-Year High

    From Spinal Tap II to Ed Sheeran : your complete entertainment guide to the week ahead – The Guardian

  • General
  • Health
  • News

    Cracking the Code: Why China’s Economic Challenges Aren’t Shaking Markets, Unlike America’s” – Bloomberg

    Trump’s Narrow Window to Spread the Truth About Harris

    Trump’s Narrow Window to Spread the Truth About Harris

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Trending Tags

    • Trump Inauguration
    • United Stated
    • White House
    • Market Stories
    • Election Results
  • Science
  • Sports
  • Technology
    Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

    Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

    City IT presented Best of North Carolina Technology Award – RaleighNC.gov

    City IT Honored with Best of North Carolina Technology Award

    LELO Releases 2025 Futurist Report: Intergenerational Views on Relationships, Sex, and Technology – PR Newswire

    Exploring the Future: How Different Generations View Relationships, Sex, and Technology in 2025

    Will New Big Technology Engagements Reshape Innodata’s Growth Path? – Yahoo Finance

    Could New Major Tech Partnerships Propel Innodata to Unprecedented Growth?

    Unlocking AI Success: How People, Process, and Technology Form the Ultimate Triangle

    Billion-dollar coffins? New technology could make oceans transparent and Aukus submarines vulnerable – The Guardian

    Billion-Dollar Coffins? How New Technology Could Make Oceans Transparent and Expose Submarines

    Trending Tags

    • Nintendo Switch
    • CES 2017
    • Playstation 4 Pro
    • Mark Zuckerberg
No Result
View All Result
Earth-News
No Result
View All Result
Home Health

Alteplase Not Harmful in NOAC Users, Even in a More Bleeding-Prone Cohort

November 21, 2023
in Health
Alteplase Not Harmful in NOAC Users, Even in a More Bleeding-Prone Cohort
Share on FacebookShare on Twitter

Stroke patients treated with intravenous alteplase (Activase) did not have more intracranial hemorrhages if they had recently taken non-vitamin K antagonist oral anticoagulants (NOACs), according to an Asian cohort study that adds to the growing evidence for this off-label practice.

Between groups with recent NOAC therapy versus no treatment with anticoagulants, small differences in bleeding and mortality events after alteplase administration did not reach statistical significance in a propensity score-matched analysis:

Intracranial hemorrhage during hospitalization after alteplase administration: 9.9% with NOACs vs 7.4% with no anticoagulants (OR 1.37, 95% CI 0.62-3.03)Major bleeding during the index hospitalization: 13.2% vs 8.2% (OR 1.69, 95% CI 0.83-3.45)All-cause 30-day mortality: 8.8% vs 11.0% (OR 0.78, 95% CI 0.35-1.73)In-hospital mortality: 4.4% vs 9.3% (OR 0.45, 95% CI 0.15-1.29)

Similarly, outcomes were no different between NOAC and warfarin groups. Results remained consistent in a meta-analysis pooling this Taiwanese analysis with prior studies, reported Huei-Kai Huang, MD, of Hualien Tzu Chi Hospital in Taiwan, and colleagues in JAMA Internal Medicine.

“Our meta-analysis synthesized the latest evidence, consistently demonstrating that pretreatment with NOACs was not associated with excess harm in patients receiving intravenous thrombolysis for acute ischemic stroke,” they wrote. “These findings provide robust evidence with potential implications for future research and guideline updates.”

Current stroke guidelines do not strongly endorse alteplase for these patients, giving thrombolysis a class III recommendation within 48 hours of last direct oral anticoagulant (DOAC) intake for fear of bleeding. This exclusion of DOAC users from stroke thrombolytics has been contested, however, as reports have suggested that carefully selected DOAC users do not have excess bleeding risks.

One large U.S. study found that intravenous thrombolysis could be safely given to ischemic stroke patients who had taken these medications in the preceding 7 days, while a Japanese analysis showed the same for thrombolysis within a day of DOAC administration. Furthermore, another group reported that off-label IV thrombolysis in DOAC users was in fact associated with a lower incidence of symptomatic intracranial hemorrhage compared with controls not on anticoagulant therapy.

In the present study, Huang and colleagues considered those who had prescriptions for dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), or edoxaban (Savaysa) within 2 days before the index hospitalization as being pretreated with DOACs before receiving alteplase.

The setting of this cohort is notable, as Asian individuals are thought to have inherently higher bleeding risks during thrombolytic therapy.

“Furthermore, our study specifically involved patients who neither had their NOAC plasma levels measured nor received any antidote. While European guidelines recommend the measurement of NOAC plasma levels before administering intravenous alteplase, practical limitations in performing these measurements are a reality faced by many hospitals worldwide, including those in Taiwan,” the authors noted.

Their nationwide, population-based cohort study relied on Taiwan’s National Health Insurance Research Database that covers claims data for the entire country. They included 7,483 adults (mean age 67.4 years, 38.9% women) who had been treated with alteplase for acute ischemic stroke from 2011 to 2020.

The vast majority of participants were not on anticoagulants prior to their stroke, with only 1.2% on NOACs and another 2.4% on warfarin. The primary indication for oral anticoagulant therapy was atrial fibrillation.

The NOAC group was of disproportionately older age and comprised more women. This group also had a higher prevalence of prior stroke and coronary artery disease.

For the comparison of NOACs versus no anticoagulation, propensity score matching was performed 1:4 and yielded 91 and 364 patients, respectively, with balanced baseline differences. For the analysis comparing NOACs versus warfarin, 1:1 matching yielded comparator groups including 77 patients each in the NOAC and warfarin groups.

Huang’s group cautioned that each patient’s medication history was derived from drug dispensing records in the database, based on expiration dates of prescriptions. They were therefore unable to estimate exactly if or when patients were taking their prescribed oral anticoagulants.

Additionally, despite propensity score matching to balance baseline differences, the retrospective study left room for residual confounding.

author['full_name']

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by a grant from Hualien Tzu Chi Hospital.

Huang and colleagues had no disclosures.

Primary Source

JAMA Internal Medicine

Source Reference: Tsai T, et al “Risk of bleeding following non-vitamin K antagonist oral anticoagulant use in patients with acute ischemic stroke treated with alteplase” JAMA Intern Med 2023; DOI: 10.1001/jamainternmed.2023.6160.

>>> Read full article>>>
Copyright for syndicated content belongs to the linked Source : MedPageToday – https://www.medpagetoday.com/cardiology/strokes/107464

Tags: AlteplaseHarmfulhealth
Previous Post

What to Know About Ongoing Eye Drop Recalls

Next Post

Proteins Predict Signs of Alzheimer’s Disease

Trump Designates Antifa ‘Terror Organisation’ Days After Charlie Kirk Murder – NDTV

Trump Designates Antifa ‘Terror Organisation’ Days After Charlie Kirk Murder – NDTV

September 18, 2025
Study: UIS contributes nearly $1 billion to the Illinois economy – NPR Illinois

Study: UIS contributes nearly $1 billion to the Illinois economy – NPR Illinois

September 18, 2025
REO to return for UI homecoming – The News-Gazette

REO Gears Up to Ignite the Stage at UI Homecoming Celebration!

September 18, 2025
WATCH: Former CDC doctor says U.S. is on track to see uptick in preventable diseases under Kennedy – PBS

WATCH: Former CDC Doctor Warns of Rising Preventable Diseases in the U.S

September 18, 2025
Local politicians, judges, officials face increased threats, new data shows – WDSU

Local politicians, judges, officials face increased threats, new data shows – WDSU

September 18, 2025
Washington State Honors Hanford Team for Protecting Native Habitat – Department of Energy (.gov)

Washington State Celebrates Hanford Team’s Success in Protecting Native Habitat

September 17, 2025
Kent State University unveils poetry inspired by science despite federal funding cut – Ideastream

Kent State University Unveils Science-Inspired Poetry Amid Federal Funding Cuts

September 17, 2025
Fired CDC director warns of backslide in US vaccine science under RFK Jr – Al Jazeera

Fired CDC director warns of backslide in US vaccine science under RFK Jr – Al Jazeera

September 17, 2025
Melting Pot Brings Back Its Most ‘Luxurious’ Fondue for a Limited Time – yahoo.com

Melting Pot Brings Back Its Most ‘Luxurious’ Fondue for a Limited Time – yahoo.com

September 17, 2025
Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

Bucking the Odds: Why Technology Companies Should Embrace Software Patents Today – Crowell & Moring LLP

September 17, 2025

Categories

Archives

September 2025
MTWTFSS
1234567
891011121314
15161718192021
22232425262728
2930 
« Aug    
Earth-News.info

The Earth News is an independent English-language daily published Website from all around the World News

Browse by Category

  • Business (20,132)
  • Ecology (824)
  • Economy (844)
  • Entertainment (21,723)
  • General (17,097)
  • Health (9,889)
  • Lifestyle (858)
  • News (22,149)
  • People (848)
  • Politics (854)
  • Science (16,055)
  • Sports (21,344)
  • Technology (15,826)
  • World (828)

Recent News

Trump Designates Antifa ‘Terror Organisation’ Days After Charlie Kirk Murder – NDTV

Trump Designates Antifa ‘Terror Organisation’ Days After Charlie Kirk Murder – NDTV

September 18, 2025
Study: UIS contributes nearly $1 billion to the Illinois economy – NPR Illinois

Study: UIS contributes nearly $1 billion to the Illinois economy – NPR Illinois

September 18, 2025
  • About
  • Advertise
  • Privacy & Policy
  • Contact

© 2023 earth-news.info

No Result
View All Result

© 2023 earth-news.info

No Result
View All Result

© 2023 earth-news.info

Go to mobile version