Current anticoagulation with INR 2-3 is considered what in the decision to use thrombolysis?

Current anticoagulation with INR 2-3 is considered what in the decision to use thrombolysis?

• A. Absolute contraindication
• B. Relative contraindication
• C. Required therapy
• D. No contraindication

Answer: (B)

The key idea is how anticoagulation changes the risk–benefit balance of thrombolysis. An INR in the 2–3 range shows the blood’s clotting ability is reduced, so giving a thrombolytic markedly raises the risk of serious bleeding, especially intracranial hemorrhage. Because this bleeding risk is real but not an automatic disqualification, the scenario is categorized as a relative contraindication. In practice, clinicians weigh the potential benefit of reperfusion against the increased bleeding risk, and may take steps to reverse anticoagulation (when feasible) or delay therapy if possible. This is different from an absolute contraindication, where thrombolysis would not be considered under any circumstances.

The key idea is how anticoagulation changes the risk–benefit balance of thrombolysis. An INR in the 2–3 range shows the blood’s clotting ability is reduced, so giving a thrombolytic markedly raises the risk of serious bleeding, especially intracranial hemorrhage. Because this bleeding risk is real but not an automatic disqualification, the scenario is categorized as a relative contraindication. In practice, clinicians weigh the potential benefit of reperfusion against the increased bleeding risk, and may take steps to reverse anticoagulation (when feasible) or delay therapy if possible. This is different from an absolute contraindication, where thrombolysis would not be considered under any circumstances.