Key result
In stroke patients, low-molecular-weight heparins and novel oral anticoagulants effectively reduce the risk of deep vein thrombosis and venous thromboembolism without increasing hemorrhagic risk.
Why the study?
Do mechanical and pharmacological prevention strategies reduce the risk of venous thromboembolism in acute stroke patients?
Do mechanical and pharmacological prevention strategies reduce the risk of venous thromboembolism in acute stroke patients?
Pharmacological prophylaxis with LMWH or novel oral anticoagulants is effective and safe for preventing high rates of VTE in immobilized acute stroke patients.
May support LMWH/NOAC VTE prophylaxis in acute stroke; hypothesis-generating, needs prospective RCTs before practice change.
Stroke patients among all patients with somatic diseases are at one of the highest risks for venous thromboembolism (VTE). The proven risk factors for venous thrombosis in stroke are prolonged immobilization, elderly age, obesity, diabetes mellitus, and inherited coagulopathies. If no drug prevention is done, the course of stroke is complicated by deep vein thrombosis (DVT) in 75% of the immobilized patients and pulmonary thromboembolism develops in 20%. At present there are mechanical, pharmacological, and combined DVT prevention strategies that may considerably lower the rate of pulmonary embolism. In stroke patients, the use of low-molecular-weight heparins (LMWH) reduces the risk of DVT, without increasing the risk of hemorrhagic complications. Novel oral anticoagulants used to treat venous thrombosis and VTE in stroke patients are an equivalent alternative to LMWH therapy. Treatment with novel oral anticoagulants to prevent recurrent VTE is effective and safe and may be continued up to 1–2 years.
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Fonyakin et al. (2013) conducted a review in Acute stroke. VTE prevention strategies (LMWH, NOACs) was evaluated. In stroke patients, low-molecular-weight heparins and novel oral anticoagulants effectively reduce the risk of deep vein thrombosis and venous thromboembolism without increasing hemorrhagic risk.
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