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Updated: Aug 12, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Antithrombotic therapy in the acute phase: new approaches
1Department of Medicine (Neurology), University of Texas Health Science Center, San Antonio, TX 78299-3900, USA. sherman@uthscsa.edu
Cerebrovascular Diseases (Basel, Switzerland)
|March 13, 2001
Summary
Anticoagulants and antiplatelet agents show mixed results for acute ischemic stroke treatment. While aspirin offers modest benefits, other agents like ancrod and abciximab require further investigation for efficacy and safety.
Area of Science:
- Neurology
- Pharmacology
Background:
- Anticoagulants and antiplatelet agents are explored for acute ischemic stroke.
- Previous trials with unfractionated heparin, low-molecular-weight heparin, and heparinoids showed no overall benefit due to bleeding risks.
- Aspirin demonstrates modest benefit within 48 hours of stroke onset.
Purpose of the Study:
- To evaluate the efficacy and safety of anticoagulants and antiplatelet agents in acute ischemic stroke.
- To assess the role of ancrod, a fibrinogen-lowering agent, and abciximab, a platelet GPIIb/IIIa receptor blocker.
Main Methods:
- Review of randomized trials for heparinoids, aspirin, ancrod, and abciximab.
- Analysis of patient outcomes, focusing on thromboembolic events and bleeding complications.
- Assessment of functional outcomes at 90 days for ancrod-treated patients.
Main Results:
- Heparin-based anticoagulants did not show overall benefit due to increased bleeding.
- Ancrod treatment within 3 hours improved functional outcomes but carried bleeding risks.
- Abciximab showed no increased intracerebral bleeding risk and potential neurological benefits.
Conclusions:
- Anticoagulation generally lacks overall benefit in acute ischemic stroke due to bleeding complications.
- Ancrod and abciximab show potential but require further research for optimal use in acute stroke.
- Aspirin remains a beneficial agent for acute ischemic stroke treatment within a specific timeframe.
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