RT Journal
A1 Kiechl S, Knoflach M, Willeit J
T1 BLeeding risk with ischemic stroke therapy
JF JAMA
JO JAMA
YR 2012
FD October 3
VO 308
IS 13
SP 1318
OP 1318
DO 10.1001/2012.jama.11661
UL http://dx.doi.org/10.1001/2012.jama.11661
AB 
To the Editor: Within a period of only 2 months, 3 articles1- 3 have been published on bleeding risk among patients with stroke who were treated with warfarin and intravenous thrombolysis, highlighting the scientific controversies and clinical uncertainties related to this issue. A heightened risk of symptomatic intracerebral hemorrhage (sICH) was demonstrated in a single-center patient series with high-quality ascertainment of warfarin intake1 and in 2 meta-analyses,1- 2 whereas Dr Xian and colleagues3 reported a null association. The latter evaluation3 represents the largest experience on the safety of thrombolysis in patients with acute stroke treated with warfarin, but difference in sample size is unlikely to fully explain the discrepancy among the studies. Differences in methods and patient enrollment deserve consideration.