October 1, 2001Stroke
Risk of Early Death and Recurrent Stroke and Effect of Heparin in 3169 Patients With Acute Ischemic Stroke and Atrial Fibrillation in the International Stroke Trial
Why the study?
Does subcutaneous unfractionated heparin reduce early recurrent stroke or death in patients with acute ischemic stroke and atrial fibrillation?
Population
3,169 patients with acute ischemic stroke and atrial fibrillation from the International Stroke Trial, mean…
Comparison
Subcutaneous unfractionated heparin 12,500 IU SC… vs No heparin. Half of the group was randomly…
Design
RCT, randomly assigned
Follow-up
14 days and 6 months
Authors
Discussion
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Member takes
Implication
Early UFH does not reduce stroke or death but increases hemorrhage; challenges routine use in acute ischemic stroke with AF.
Structured PICO
Does subcutaneous unfractionated heparin reduce early recurrent stroke or death in patients with acute ischemic stroke and atrial fibrillation?
P
Population
3,169 patients with acute ischemic stroke and atrial fibrillation (AF) from the International Stroke Trial, mean age 78, 56% female.
I
Intervention
Subcutaneous unfractionated heparin (UFH) 12,500 IU SC BID or 5,000 IU SC BID started within 48 hours and continued until 14 days after stroke onset. Half of each group was randomly assigned to aspirin 300 mg once daily.
C
Comparator
No heparin. Half of the group was randomly assigned to aspirin 300 mg once daily.
O
Outcome
Major clinical events within 14 days (including ischemic stroke, hemorrhagic stroke, and any stroke or death)hard clinical
In patients with acute ischemic stroke and atrial fibrillation, early intensive heparin treatment does not reduce the combined risk of any stroke or death and significantly increases the risk of hemorrhagic stroke.
Cite This Study
Saxena et al. (2001) studied this question.