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Related Experiment Videos

Anticoagulants for acute ischaemic stroke.

G Gubitz1, C Counsell, P Sandercock

  • 1Department of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh, UK, EH4 2XU. pags@skull.dcn.ed.ac.uk

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Early anticoagulant therapy for acute ischaemic stroke does not show net benefits. This review found no evidence to support routine use of anticoagulants in acute stroke patients.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Ischaemic stroke is primarily caused by cerebral artery blockages from blood clots.
  • Anticoagulant therapy is a potential strategy for preventing clot formation, impacting patient survival and reducing disability.

Purpose of the Study:

  • To evaluate the efficacy of early anticoagulant therapy in managing acute ischaemic stroke patients.

Main Methods:

  • Systematic review of randomized controlled trials comparing early anticoagulant therapy (initiated within two weeks of stroke onset) with control groups.
  • Searched Cochrane Stroke Group trials register and MedStrategy, also contacted pharmaceutical companies.
  • Data extraction and quality assessment performed independently by two reviewers.

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Main Results:

  • Twenty-one trials with 23,427 patients were analyzed, showing variable quality.
  • No significant reduction in all-cause mortality (OR 1.05) or death/dependency (OR 0.99) was observed with anticoagulant therapy.
  • While anticoagulants reduced recurrent strokes and pulmonary emboli, they increased symptomatic intracranial and major extracranial haemorrhages, resulting in no net benefit.

Conclusions:

  • Early anticoagulant therapy in acute ischaemic stroke offers no discernible short- or long-term net benefit.
  • Current evidence does not support the routine administration of any anticoagulant type for acute ischaemic stroke.