Aspirin is taken by millions of Americans who want to reduce the risk of heart
attack. For patients with stroke, it has been thought that clot-busting drugs such
as tPA could react adversely with certain blood thinners and cause serious brain
bleeding.
“Does Preexisting Antiplatelet Treatment Influence Postthrombolysis Intracranial
Hemorrhage in Community-treated Ischemic Stroke Patients? An Observational Study,”
published in Academic Emergency Medicine, finds this belief is unfounded in many cases.
The University of Michigan Stroke Program, Ann Arbor, organized the study,
analyzing data from 830 patients with stroke who received tPA while at 28 Michigan-area hospitals. Nearly half
the patients were taking aspirin or clopidogrel (Plavix) before having a stroke.
The study found no significant difference in the rate of brain bleeding — including low-level bleeding that did
not cause symptoms — among those who were taking aspirin compared to those who were not. However, the
findings did show there was a small increase in risk of non-symptomatic brain bleeding in patients older than 81.
The study didn’t include patients taking more potent blood thinners such as warfarin, heparin, dabigatran
(Pradaxa) or rivaroxaban (Xarelto), and it cautions that the potential use of tPA in patients taking these drugs
needs more research.