A 72-year-old woman with atrial fibrillation and hypertension is on warfarin with INR 2.5. She presents with ischaemic stroke symptoms that started 2 ...

Question

A 72-year-old woman with atrial fibrillation and hypertension is on warfarin with INR 2.5. She presents with ischaemic stroke symptoms that started 2 hours ago. CT head shows no haemorrhage. According to Canadian Stroke Best Practices, what is the most appropriate decision regarding IV alteplase?

Accepted Answer

Withhold IV alteplase because therapeutic warfarin is a contraindication

Answer

Administer IV alteplase because INR is therapeutic

Answer

Reduce alteplase dose by half

Answer

Reverse warfarin then give alteplase immediately

Answer

Warfarin status is irrelevant to alteplase eligibility

ca-mccqe1 MCQ (SBA): Ischaemic stroke thrombolysis in anticoagulated patient

A 72-year-old woman with atrial fibrillation and hypertension is on warfarin with INR 2.5. She presents with ischaemic stroke symptoms that started 2 hours ago. CT head shows no haemorrhage. According to Canadian Stroke Best Practices, what is the most appropriate decision regarding IV alteplase?