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October 3, 2012

Bleeding Risk With Ischemic Stroke Therapy

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Neurology, University Medical Center Groningen, Groningen, the Netherlands (i.miedema@umcg.nl).

JAMA. 2012;308(13):1318. doi:10.1001/2012.jama.11664

To the Editor: Dr Xian and coauthors1 reported no increased risk of sICH among patients with acute ischemic stroke treated with tPA and warfarin before treatment with thrombolysis. This finding is in contrast with the results from 2 meta-analyses on this subject, which both found a more than 2-fold increased risk for developing sICH in patients with warfarin pretreatment.2,3 The difference in results could be caused by several factors.