From the Research
After TNK (tenecteplase) administration, aspirin should be held for 18 hours, as supported by the most recent study 1, which found that low-dose aspirin initiation 18 hours after thrombolytic therapy in acute ischemic stroke did not increase bleeding events. This recommendation is based on the need to minimize bleeding risk during the critical period following thrombolytic therapy. TNK is a potent fibrinolytic agent that dissolves blood clots but also temporarily disrupts normal clotting mechanisms, creating a heightened bleeding risk. Aspirin, being an antiplatelet medication that inhibits platelet aggregation, can further increase this bleeding risk when given immediately after thrombolysis. Some key points to consider:
- The study 1 investigated the safety of administering low-dose aspirin (81 mg) 18 hours after intravenous thrombolytic therapy and found no statistically significant differences in bleeding events.
- The findings of this study 1 are consistent with the goal of minimizing bleeding risk while ensuring patients receive appropriate antithrombotic therapy for long-term cardiovascular protection.
- It is essential to closely monitor patients for signs of bleeding, including at puncture sites, gastrointestinal tract, or intracranially, during the period after TNK administration and aspirin initiation.
- Aspirin therapy (typically 81-325 mg daily) should be initiated or resumed after the 18-hour period, as it provides important secondary prevention benefits for patients with cardiovascular conditions.