Abstract Details

Title Incidence of Stroke and Intracranial Hemorrhage Based on Timing of Antiplatelet Initiation following Intravenous tPA for Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 118

Objective The goal of this study is to further evaluate the risk of recurrent ischemic stroke, or intracerebral hemorrhage (ICH), in patients of varying antiplatelet (AP) start times who received tPA and developed hemorrhagic transformation (HT).

Background Antiplatelets have become a mainstay of stroke-risk reduction in those patients who have experienced either ischemic stroke or TIA. Typically AP are deferred in the first 24 hours but minimal data focuses on AP initiation times following tPA and HT.

Design/Methods The patient population was from the Rhode Island Hospital stroke database and included all patients who received tPA for ischemic stroke from March 1st, 2015 until March 1st, 2017. We then identified those patients who were started on AP medication(s) prior to discharge and determined their 90-day stroke/ICH incidence. Ultimately these patients were divided into two groups which compared risk of ischemic stroke and ICH following AP initiation in those patient who were HT+ vs HT-.

Results 34 subjects were identified. The average time from TPA to AP start was 47.15 hours. Only 1 subject (2.9%) had a stroke or MI within 90 days of discharge and 2 subjects (5.88%) had ICH within 90 days of discharge. All patients were separated into 4 groups, based on AP start timing, and these included:≤24 hours;>24-≤36hours;>36-≤48; >48 hours. There were no statistically significant differences in discharge MRS, 90 day MRS or 90 day stroke/ICH incidence between time from TPA to AP start groups nor between the HT+ and HT- groups.

Conclusions Though the total patient number is low, no significant differences in 90-day mRS and 90-day stroke/ICH incidence was seen when the patients were separated into categories based on tPA to AP start time as well as when comparing between the HT+ and HT- groups. With increasing patient numbers, potentially significant differences may be revealed.

Authors/Disclosures
Brandon James, MD PRESENTER	Dr. James has nothing to disclose.
Shawna M. Cutting, MD, F�鶹��ýӳ��	The institution of Dr. Cutting has received research support from Genentech.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ)	The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Tina M. Burton, MD	Dr. Burton has nothing to disclose.
Christoph Stretz, MD, F�鶹��ýӳ�� (Brown University)	The institution of Dr. Stretz has received research support from American Heart Association. The institution of Dr. Stretz has received research support from Duke University Medical Center/NIH. The institution of Dr. Stretz has received research support from University of Cincinnati/NINDS. The institution of Dr. Stretz has received research support from Biogen, Inc.. The institution of Dr. Stretz has received research support from Brown Physicians, Inc.. Dr. Stretz has a non-compensated relationship as a Editorial Board Member with Neurology: Clinical Practice that is relevant to �鶹��ýӳ�� interests or activities.
Sleiman El Jamal, MD	Dr. El Jamal has nothing to disclose.
Daniel Sacchetti, DO, F�鶹��ýӳ��	Dr. Sacchetti has nothing to disclose.

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