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June 27, 2012

Cerebral Hemorrhage, Warfarin, and Intravenous tPA: The Real Risk Is Not Treating

Author Affiliations

Author Affiliation: Stroke Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

JAMA. 2012;307(24):2637-2639. doi:10.1001/jama.2012.7265

Intravenous tissue plasminogen activator (tPA) was approved by the US Food and Drug Administration in 1996 for the treatment of patients with acute ischemic stroke. Although tPA is the only acute medical therapy proven to reduce disability and improve outcomes in ischemic stroke, more than 15 years after its approval it remains vastly underutilized: of patients with acute ischemic stroke in the United States, only 2% to 8% receive this therapy.1,2 Although the percentage of eligible patients (those presenting within 2 hours of stroke onset) receiving intravenous tPA is higher, there is still substantial room and need for improvement.