Patients suffering from a stroke who were taking the anticoagulant medication, warfarin, were not found to have a higher risk of experiencing a brain bleed during a procedure to remove a blood clot than those, not on the medication.
The new study from UT Southwestern Medical Center, published in JAMA, could help clinicians better assess the risks of endovascular thrombectomy (EVT), potentially making more patients eligible for this standard stroke treatment.
The Role of Warfarin and the Risk of Brain Bleeds
Warfarin is a common blood thinner used to prevent strokes in patients with heart conditions like atrial fibrillation.
Although patients taking warfarin can still suffer a stroke, some physicians may avoid performing an EVT due to the prior warfarin treatment.
This research could lead to an increased number of patients being eligible for the life-saving EVT surgery, according to study leader Dr. Ying Xian, Associate Professor of Neurology at UT Southwestern.
Ischemic Stroke and the Role of EVT
Approximately 800,000 people experience a stroke each year in the U.S., with most of these being ischemic strokes, caused by a clot blocking blood flow to the brain.
EVT is the most common treatment for acute ischemic stroke. However, EVT can sometimes cause a symptomatic intracranial hemorrhage (sICH), a severe brain bleed that can be fatal.
It was previously unknown whether the risk of sICH post-EVT was higher for patients on warfarin.
Study Findings and Future Research
The researchers gathered data on 32,715 stroke patients who underwent EVT within six hours of stroke symptom onset between 2015 and 2020.
They compared outcomes for patients who were taking warfarin prior to their stroke and those who were not taking any blood thinners.
After adjusting for differences in these groups, they found no overall difference in the risk of sICH or other adverse outcomes.
Patients with an international normalized ratio (INR) greater than 1.7—a measure of blood clotting tendency—were found to have an increased risk of experiencing sICH by about 4%.
However, these patients were not more likely to die or have worse functional outcomes at discharge, except for a higher risk of bleeding.
The researchers are now planning to investigate whether other anticoagulants commonly taken by stroke patients might increase the risk of sICH or other severe complications after EVT for ischemic stroke.
If you care about stroke, please read studies about a breakfast linked to better blood vessel health, and olive oil could help lower risks of heart disease and stroke.
For more information about health, please see recent studies about how the Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
The study was published in JAMA.
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