Impact of Tranexamic Acid on Clinical Outcomes in Patients with Hemorrhagic Stroke: A Comprehensive Review
Abstract
Pinky and Rimpi Arora
Background: Hemorrhagic stroke, characterized by the rupture of blood vessels within the brain, leads to significant morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent, has been explored for its potential to stabilize clots and reduce hemorrhage expansion. This review aims to critically assess the impact of TXA on clinical outcomes in patients with hemorrhagic stroke.
Methods: A systematic literature search was conducted across major databases including PubMed, Cochrane Library, and Google Scholar, focusing on studies published in the past two decades. Keywords included “tranexamic acid,” “hemorrhagic stroke,” “intracerebral hemorrhage,” and “clinical outcomes.” Both randomized controlled trials (RCTs) and observational studies were included. The primary outcomes assessed were mortality, functional recovery, and adverse events.
Results: The review identified and analyzed 15 RCTs and 10 observational studies. Overall, the administration of TXA was associated with a modest reduction in hematoma expansion and early mortality. However, the evidence on long-term functional outcomes remained inconclusive. Adverse events, particularly thromboembolic complications, were reported in a minority of cases but were not significantly higher than in control groups.
Conclusions: TXA shows the potential to improve early survival rates in patients with hemorrhagic stroke by limiting hematoma growth. However, the benefits of long-term functional recovery and quality of life are less clear, necessitating further large- scale, high-quality studies. Careful patient selection and monitoring for adverse events are crucial for optimizing outcomes with TXA therapy in hemorrhagic stroke.