Thrombolytic therapy for stroke patients on blood thinners

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This study investigates the safety and efficacy of intravenous thrombolytic therapy (IVT) in patients experiencing acute ischemic stroke while on direct oral anticoagulants (DOACs). It aims to recruit patients who have taken DOACs within 12-48 hours prior to their stroke and assess their neurological outcomes after receiving IVT. The study will compare these patients to a matched cohort who did not receive IVT to determine if IVT can be safely administered without increasing the risk of intracerebral bleeding. The research is being conducted at the Chinese University of Hong Kong and several collaborating hospitals.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Acute ischemic stroke patients with a last-known-well to presentation time within 4.5 hours
2. Patients who took any doses of apixaban (2.5mg or 5mg twice daily), dabigatran (110mg or 150mg twice daily), edoxaban (30mg or 60mg daily) or rivaroxaban (15mg or 20mg daily) 12-48 hours before presentation
3. National Institute of Health Stroke Scale (NIHSS) ≥ 3
4. Alberta Stroke Programme Early CT (ASPECT) score ≥ 6
5. Pre-morbid modified Rankin Scale (mRS) ≤ 3
6. Patients aged ≥ 18 years old

Exclusion Criteria:

1. Initial CT brain showing intracranial haemorrhage
2. Contraindications to IVT according to current guideline recommendations \[5\], except for the use of DOAC within 12-48 hours
3. Patients with an estimated glomerular filtration rate of ≤ 30ml/min/1.73m2
4. Patients with bleeding propensities apart from the use of DOAC, e.g. platelet count of \< 100x109/L
5. Patients with significant head injury immediately prior to presentation

Where it's running

• Chinese University of Hong Kong
  Hong Kong, Hong Kong Recruiting

Study contacts

• Principal investigator: Bonaventure Yiu Ming Ip, MB ChB — Chinese University of Hong Kong
• Study coordinator: Yiu Ming Bonaventure Ip, MB ChB
• Email: bonaventureip@cuhk.edu.hk
• Phone: +852-26352152

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.