Thrombolytic Use in Persons with Stroke and Direct Oral Anticoagulants

Patient use of any anticoagulation during an acute stroke is a contraindication for the use of thrombolytics or clot busters. Recent meta-analyses and animal studies raise the question of this contraindication. Join guest, Geoff Wall, as he examines the data on Direct Oral Anticoagulants (DOACs) and thrombolytics.The GameChangerDOACs have a significantly smaller intracranial hemorrhage (ICH) risk compared to warfarin and this benefit may translate to risk of bleed with thrombolytics. A new study found a numerically decreased risk of ICH in patients with DOACs compared to controls.Show Segments00:00 - Introductions01:07 - Current Practices with Thrombolytics05:05 - Looking at the Study19:45 - The GameChanger: Decreased ICH Risk?23:30 - Study Limitations26:11 - Connecting to Practice 27:01 - Closing RemarksHostGeoff Wall, PharmD, BCPS, FCCP, CGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthReferences and ResourcesIntravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral AnticoagulantsRedeem your CPE hereCPE (Pharmacist)Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode)Pharmacists: Get a membershipCE InformationLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the theory about why DOACs may not increase risk of intracranial bleed in stroke patients receiving thrombolytics2. Describe the limitations of the Meinel et al study0.05 CEU/0.5 HrUAN: 0107-0000-23-064-H01-PInitial release date: 02/13/2023Expiration date: 02/13/2024Additional CPE and CME details can be found here.Follow CEimpact on Social Media:LinkedInInstagram