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• W3136955099 abstract "Background: Alteplase (tPA) is the standard of care in acute ischemic stroke (AIS) treatment, but it is associated with increased risk of symptomatic intracranial hemorrhage (sICH). Cryoprecipitate (Cryo) is recommended for tPA-associated sICH reversal. Tranexamic acid (TXA), an antifibrinolytic, is of interest as an adjunct therapy, but data in AIS is limited. We aim to assess the relationship of TXA and sICH reversal. Methods: We conducted a multicenter retrospective cohort study of AIS patients admitted between April 2015 and July 2020 who were treated for tPA-associated sICH. Patients with extracranial bleeds, who were not reversed, or who died within 24 hours were excluded. Demographics, clinical characteristics, imaging, and outcome data were collected from electronic health records. Outcomes included hematoma expansion, a poor functional outcome at 90 days (modified Rankin Score 3-6), and thrombotic events. We used Pearson chi-square, Fisher’s exact, and Wilcoxon rank-sum tests to compare outcomes between adjunct TXA treatment (TXA+Cryo) vs. Cryo only groups. Results: The study cohort included 30 patients with tPA-related sICH (mean age 80 ±12.4 years; 60% female). Overall median (IQR) hematoma size was 4.4 ml (1.1-20). Multifocal bleeds were present in 39% of patients. TXA+Cryo was administered in 16 (53%) patients. Initial hematoma size was smaller in the TXA+Cryo group than the Cryo only group, median (IQR) of 2.4 ml (0.5-14.3) vs 24.1 ml (2.5-56.5), p=0.043. However, there were no marked differences between TXA+Cryo and the Cryo only groups for hematoma expansion (5 [33%] vs. 6 [50%] patients, p=0.38), poor functional outcome (15 [94%] vs. 11 [79%] patients, p=0.32), or thrombotic events (1 [6%] vs. 0, p=1.00). Conclusion: Among patients treated for tPA-related sICH, there was no difference in hematoma expansion, poor functional outcome, or thrombotic events in patients treated with adjunct TXA compared to Cryo alone." @default.
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• W3136955099 date "2021-03-01" @default.
• W3136955099 modified "2023-10-18" @default.
• W3136955099 title "Abstract P26: Association of Tranexamic Acid Use With Outcomes in Alteplase-Associated Intracranial Hemorrhage" @default.
• W3136955099 doi "https://doi.org/10.1161/str.52.suppl_1.p26" @default.
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