Potential hazards of thrombolysis for mild stroke

17 Aug 2023 • This study aimed to assess the potential benefits of intravenous thrombolysis (IVT) versus dual antiplatelet therapy (DAPT) in patients with mild ischemic strokes. Researchers analyzed data from an Austrian registry, identifying 1616 patients with mild stroke (NIH Stroke Scale score of 3 or less) and excluding certain subgroups. After adjusting for factors through propensity score adjustment, they found that IVT was associated with higher rates of symptomatic intracerebral hemorrhage (sICH) and early neurologic deterioration (END) compared to DAPT. The modified Rankin Scale (mRS) scores at 3 months were similar in both groups. These findings align with recent trials that have evaluated IVT in mild, nondisabling strokes. The study suggests that DAPT is preferable for patients with very low NIHSS scores, while IVT might be considered for those with certain disabling deficits, such as isolated hemianopia, with shared decision making. Source: NEJM | Read full story

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