• Susanne Schmülling, Jobst Rudolf, Timm Strotmann-Tack, Martin Grond, Susanne Schneweis, Jan Sobesky, Alexander Thiel, and Wolf-Dieter Heiss.
• Department of Neurology, University of Cologne, Cologne, Germany.
• Cerebrovasc. Dis. 2003 Jan 1;16(3):183-90.

BackgroundThe risk of intracerebral hemorrhage in systemic thrombolysis for acute ischemic stroke after acetylsalicylic acid (ASA) pretreatment or with subsequent heparin is controversially discussed.Methods300 consecutive stroke patients were treated with recombinant tissue-type plasminogen activator (rt-PA) in a prospective open study (92 pretreated with ASA, 202 ASA nonusers) with 3 months of follow-up. After thrombolysis, 122 patients received low-dose, 153 patients high-dose heparin.ResultsLogistic regression analysis showed no relationship of hemorrhagic complications within the first 48 h to ASA pretreatment (p = 0.15), or heparin application (p = 0.38), but dependency on stroke severity (NIHSS) at baseline (p = 0.01).ConclusionASA pretreatment does not increase the risk of symptomatic bleeding after systemic thrombolysis with rt-PA, even if thrombolysis is followed by anticoagulation.Copyright 2003 S. Karger AG, Basel

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