Emergent use of anticoagulation for treatment of patients with ischemic stroke

Harold P Adams Jr

doi:10.1161/hs0302.104628

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Emergent use of anticoagulation for treatment of patients with ischemic stroke

Journal article

Open access

Peer reviewed

Emergent use of anticoagulation for treatment of patients with ischemic stroke

Harold P Adams Jr

Stroke (1970), Vol.33(3), pp.856-861

03/2002

DOI: 10.1161/hs0302.104628

PMID: 11872915

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https://doi.org/10.1161/hs0302.104628View

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Abstract

Several clinical trials have tested the potential utility of emergent anticoagulation for acute ischemic stroke. Rather than performing a meta-analysis that combines the data from several trials, this review focuses on individual studies. Although these trials do have inherent limitations, they demonstrate that emergent use of an anticoagulant is associated with a modest but significantly increased risk of hemorrhagic transformation of the ischemic stroke or serious nonneurological bleeding. The trials do not demonstrate a benefit from emergent anticoagulation in improving outcome, reducing mortality, and preventing early recurrent stroke. These results suggest that most patients with acute stroke should not be treated with unfractionated heparin or other rapidly acting anticoagulants after stroke. Prevention of deep vein thrombosis and pulmonary embolism among bedridden patients is the only established indication for early anticoagulation after acute ischemic stroke.

Brain Ischemia - complications

Humans

Cerebral Hemorrhage - mortality

Stroke - complications

Anticoagulants - therapeutic use

Clinical Trials as Topic

Secondary Prevention

Stroke - drug therapy

Anticoagulants - adverse effects

Disease Progression

Brain Ischemia - drug therapy

Emergency Treatment - adverse effects

Cerebral Hemorrhage - prevention & control

Brain Ischemia - mortality

Stroke - mortality

Cerebral Hemorrhage - etiology

Details

Title: Subtitle: Emergent use of anticoagulation for treatment of patients with ischemic stroke
Creators: Harold P Adams Jr - Department of Neurology, University of Iowa College of Medicine, Iowa City 52242, USA. harold-adams@uiuowa.edu
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.33(3), pp.856-861
DOI: 10.1161/hs0302.104628
PMID: 11872915
NLM abbreviation: Stroke
ISSN: 0039-2499
eISSN: 1524-4628
Publisher: United States
Language: English
Date published: 03/2002
Academic Unit: Neurology; Iowa Neuroscience Institute
Record Identifier: 9984020775102771

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