@entity1003 rarely prevents IV thrombolysis in acute XXXX .

@entity1 @entity64 @entity548 @entity1456 @entity1003 @entity4461 @entity385
BACKGROUND: American Heart Association/American @entity64 Association guidelines recommend initiating treatment with IV @entity1456 (tPA) in acute @entity385 @entity1 without suspected @entity1003 prior to availability of clotting results; however, little or no data support this practice. We sought to identify how often @entity4461 were responsible for withholding IV tPA at our institution. METHODS: We conducted a retrospective review of our prospectively acquired Get With the Guidelines @entity64 database from January 2003 to April 2008. All @entity1 underwent clinical evaluation by a neurologist, diagnostic neuroimaging, and laboratory testing on admission. We classified @entity1 with absolute contraindications to IV tPA as ineligible, and those with warnings/relative contraindications or potentially treatable factors as potentially eligible. RESULTS: Of 2,335 considered for analysis, 470 (20.1%) @entity1 presented to our emergency department (ED) within 3 hours. Among these, 147 (31.3%) received IV tPA in our ED, 102 (21.7%) had an absolute contraindication, and 221 (47%) had a reason to consider withholding tPA. Only 30/470 (6.4%) of potential thrombolysis @entity1 were discovered to have international normalized ratio > or =1.7 or platelets < or =100,000/microL, and of these, 28 were suspected a priori due to known @entity1003 from medication or illness. Only 2/470 (0.4%) @entity1 had an unsuspected @entity1003 that ultimately prevented thrombolysis. CONCLUSIONS: Based on the experience of a large thrombolysis referral center, @entity64 @entity1 without suspected clotting abnormality can safely begin thrombolytic therapy before clotting results are available. These data support the current practice guidelines, and may reassure clinicians that the benefits of early administration greatly outweigh the risks due to an unsuspected @entity548 diathesis.
