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Updated: Jul 1, 2026
06:01
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Heparin in acute ischemic stroke revisited
1Functional Unit of Cerebrovascular Diseases, Hospital Clínic, Barcelona, Spain. achamorro@ub.edu
Revue Neurologique
|September 10, 2008
Summary
Current evidence on low molecular weight heparins (LMWHs) and subcutaneous unfractionated heparin (UH) in acute stroke is insufficient to guide intravenous, weight-adjusted UH. Further research is needed to confirm promising results from small studies.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Existing clinical trial data for low molecular weight heparins (LMWHs) and subcutaneous unfractionated heparin (UH) in acute stroke patients cannot be directly applied to intravenous, weight-adjusted UH.
- Recent small-scale studies suggest potential benefits of intravenous UH, but require further investigation due to confounding factors.
Purpose of the Study:
- To evaluate the efficacy and safety of intravenous, weight-adjusted unfractionated heparin (UH) in patients with acute ischemic stroke.
- To address the lack of robust evidence regarding the use of UH in the early phase of acute ischemic stroke.
Main Methods:
- The study emphasizes the need for large, randomized controlled trials to confirm preliminary findings.
- Future trials should consider the short therapeutic window, precise dose adjustment, intravenous administration, and close monitoring of biological effects of UH.
Main Results:
- Current recommendations against early anticoagulation with full-dose, weight-adjusted UH are based on extrapolation, not direct evidence.
- Small studies show encouraging but potentially confounded results for intravenous UH, necessitating confirmation.
Conclusions:
- Evidence supporting the use of intravenous, weight-adjusted UH in acute ischemic stroke is currently insufficient.
- Academic-driven, randomized controlled trials are essential to establish the role of UH, considering its orphan drug status and specific pharmacological considerations.
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