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Aspirin versus low-dose low-molecular-weight heparin: antithrombotic therapy in pediatric ischemic stroke patients: a

R Sträter1, K Kurnik, C Heller

  • 1Department of Pediatrics, University of Münster, University of Munich, Germany.

Stroke
|November 3, 2001
PubMed

Insights

Low-dose low-molecular-weight heparin (LMWH) and aspirin show similar efficacy in preventing recurrent ischemic stroke in children. Further research is needed to confirm safety and effectiveness of these antithrombotic treatments.

Area of Science:

  • Pediatric Neurology
  • Cardiovascular Research
  • Hematology

Background:

  • Pediatric ischemic stroke is a significant cause of morbidity.
  • Secondary prevention strategies are crucial to reduce stroke recurrence.
  • Understanding the comparative efficacy of antithrombotic agents is vital.

Purpose of the Study:

  • To compare medium-dose aspirin with low-dose low-molecular-weight heparin (LMWH) for secondary stroke prevention in children.
  • To assess the risk of recurrent ischemic stroke in pediatric patients receiving different antithrombotic treatments.

Main Methods:

  • Prospective follow-up of 135 pediatric patients (aged 6 months to 18 years) with a first ischemic stroke.
  • Patients received either aspirin (n=49) or LMWH (n=86) as prophylactic antithrombotic therapy.
  • Median follow-up duration was 36 months, with recurrent stroke as the primary endpoint.

Main Results:

  • Recurrent ischemic stroke occurred in 9.6% of patients (13 out of 135) within a median of 5 months.
  • No significant difference in stroke recurrence rates was observed between aspirin and LMWH groups (P=0.76).
  • In most recurrent cases (84.6%), the same vascular territory was affected. No major drug-related side effects were reported.

Conclusions:

  • Low-dose LMWH is not superior to aspirin in preventing recurrent stroke in pediatric patients.
  • Current evidence suggests comparable efficacy between aspirin and LMWH for secondary stroke prevention in this population.
  • Larger, randomized controlled trials are necessary to definitively establish the safety and efficacy profiles of these antithrombotic medications.
Abstract

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