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Acute ischemic stroke and heparin treatments
M M Samama1, P C Desnoyers, J Conard
1Service d'Hématologie Biologique, Hôtel-Dieu, Paris, France.
Thrombosis and Haemostasis
|July 1, 1997
Summary
Heparin treatment for acute ischemic stroke shows conflicting results. While it prevents venous thromboembolism, its effectiveness for neurologic outcomes and mortality remains uncertain, pending large trial results.
Area of Science:
- Neurology
- Hematology
Background:
- Case-control studies suggest altered platelet activity and coagulation in acute ischemic stroke patients.
- Conflicting findings hinder clear recommendations for heparin therapy in stroke.
Purpose of the Study:
- To evaluate the efficacy of heparin in stroke patients.
- Objectives include preventing thromboembolic complications, improving neurologic outcomes, reducing mortality, and preventing early recurrence.
Main Methods:
- Review of clinical trials, emphasizing those conducted post-CT era for accurate neurologic outcome assessment.
- Comparison of unfractionated heparin (UFH) and low-molecular-weight heparins (LMWHs).
Main Results:
- Heparin's efficacy in preventing venous thromboembolic complications is confirmed.
- Data on neurologic outcomes and mortality remain conflicting, with LMWHs showing some promise over UFH.
- Ongoing large-scale trials are expected to provide more definitive results.
Conclusions:
- Heparin is primarily effective in preventing venous thromboembolic complications in stroke patients.
- Current evidence is insufficient to recommend heparin for improving neurologic outcomes or reducing mortality.
- Heparin is generally indicated for preventing early recurrence in cardioembolic stroke.