SynthesisJournal of the American Heart Association2023
Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Endovascular thrombectomy for acute stroke in anticoagulated patients: systematic review and Meta-Analysis.Journal of thrombosis and thrombolysis · 2026Pooled it
- The efficacy of different doses of citicoline in improving the prognosis of patients with acute ischemic stroke based on network meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Serum sCD40L and galectin-3 in the prognosis prediction of patients with acute ischemic stroke.Journal of medical biochemistry · 2026Article
- Intracranial hemorrhage after ischemic stroke in patients on direct oral anticoagulants: results from a prospective observational study.Neurological research and practice · 2026Article
- Intravenous Thrombolysis in Patients on Direct Oral Anticoagulants: Analysis of the Get With The Guidelines Stroke Registry.Journal of the American Heart Association · 2026Article
- Distinct macrophage and microglia function in ischemic stroke.Journal of biosciences · 2026Article
- Impacts of neurointerventional therapy combined with intravenous thrombolysis on neurological function, oxidative stress, and immune function in patients with acute ischemic stroke.Frontiers in medicine · 2026Article
- Establishment and validation of a short-term prognostic model for AIS patients receiving intravenous thrombolysis based on multimodal CT.BMC neurology · 2025Article
- Post-Ablation Stroke Despite NOAC Use: Successful Reperfusion Therapy After Dabigatran Reversal with Incidental Discovery of a Large MCA Aneurysm-A Case Report.Neurology international · 2025Article
- Safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke patients with direct oral anticoagulation: experience from a German stroke center.Neurological research and practice · 2025Article
- Recent intake of direct oral anticoagulants and acute ischemic stroke: real world data from a comprehensive stroke center.Neurological research and practice · 2025Article
- Viscoelastic Point-of-Care Testing (ClotProNeurology international · 2025Article
- Observational
- Explainable AI in medicine: challenges of integrating XAI into the future clinical routine.Frontiers in radiology · 2025Review
- Cerebrolysin, hemorrhagic transformation, and anticoagulation timing after reperfusion therapy in stroke:Frontiers in pharmacology · 2025Article
- Intravenous thrombolysis and mechanical thrombectomy in acute stroke patients on direct oral anticoagulants.Journal of neurology · 2024Review
- Detection of factor Xa activity using giant magnetoresistive biosensors.Analytica chimica acta · 2024Article
- Before, during, and after: An Argument for Safety and Improved Outcome of Thrombolysis in Acute Ischemic Stroke with Direct Oral Anticoagulant Treatment.Annals of neurology · 2024Review
- Idarucizumab in dabigatran-treated patients with acute stroke: a review and clinical update.Frontiers in neurology · 2024Review
- Hemorrhagic complications after stroke treatment with intravenous thrombolysis despite use of direct oral anticoagulants: an observational study.Therapeutic advances in neurological disorders · 2024Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntravenous thrombolysis (IVT) is an effective stroke therapy that remains underused. Currently, the use of IVT in patients with recent direct oral anticoagulant (DOAC) intake is not recommended. In this study we aim to investigate the safety and efficacy of IVT in patients with acute ischemic stroke and recent DOAC use. METHODS AND
resultsA systematic review and meta-analysis of proportions evaluating IVT with recent DOAC use was conducted. Outcomes included symptomatic intracranial hemorrhage, any intracranial hemorrhage, serious systemic bleeding, and 90-day functional independence (modified Rankin scale score 0-2). Additionally, rates were compared between patients receiving IVT using DOAC and non-DOAC by a random effect meta-analysis to calculate pooled odds ratios (OR) for each outcome. Finally, sensitivity analysis for idarucizumab, National Institutes of Health Stroke Scale, and timing of DOAC administration was completed. Fourteen studies with 247 079 patients were included (3610 in DOAC and 243 469 in non-DOAC). The rates of IVT complications in the DOAC group were 3% (95% CI, 3-4) symptomatic intracranial hemorrhage, 12% (95% CI, 7-19) any ICH, and 0.7% (95%CI, 0-1) serious systemic bleeding, and 90-day functional independence was achieved in 57% (95% CI, 43-70). The rates of symptomatic intracranial hemorrhage (3.4 versus 3.5%; OR, 0.95 [95% CI, 0.67-1.36]), any intracranial hemorrhage (17.7 versus 17.3%; OR, 1.23 [95% CI, 0.61-2.48]), serious systemic bleeding (0.7 versus 0.6%; OR, 1.27 [95% CI, 0.79-2.02]), and 90-day modified Rankin scale score 0-2 (46.4 versus 56.8%; OR, 1.21 [95% CI, 0.400-3.67]) did not differ between DOAC and non-DOAC groups. There was no difference in symptomatic intracranial hemorrhage rate based on idarucizumab administration.
conclusionsPatients with acute ischemic stroke treated with IVT in recent DOAC versus non-DOAC use have similar rates of hemorrhagic complications and functional independence. Further prospective randomized trials are warranted.
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