HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Intravenous heparin started within the first 3 hours after onset of symptoms as a treatment for acute nonlacunar hemispheric cerebral infarctions.

AbstractBACKGROUND AND PURPOSE:
Heparin is widely used for acute stroke to prevent thrombus propagation and/or multiple emboli generation, although there is, as yet, no demonstrated efficacy. However, all of the available clinical studies allowed long intervals from stroke to treatment. The purpose of this study was to try an intravenous regimen of unfractionated heparin the acute cerebral infarction starting treatment within the first 3 hours of the onset of symptoms.
METHODS:
The study was an outcome evaluator-blind design trial. Patients had to display signs of a nonlacunar hemispheric infarction. Selected patients were randomly allocated to receive intravenous heparin sodium or saline. Heparin was infused at a rate to maintain activated partial thromboplastin time ratio 2.0 to 2.5 x control for 5 days. The primary end point was recovery of a modified Rankin score zero to 2 at 90 days of stroke at phone interview by a single physician blind to treatment. Safety end points were death, symptomatic intracranial hemorrhages, and major extracranial bleedings by 90 days of stroke.
RESULTS:
A total of 418 stroke patients were included. In the heparin group, there were more self-independent patients (38.9% versus 28.6%; P=0.025). In addition, in the same group, there were fewer deaths (16.8% versus 21.9%; P=0.189), more symptomatic brain hemorrhages (6.2% versus 1.4%; P=0.008), and more major extracerebral bleedings (2.9% versus 1.4%; P=0.491).
CONCLUSIONS:
Intravenous heparin sodium could be of help in the earliest treatment of acute nonlacunar hemispheric cerebral infarction, even keeping into account an increased frequency of intracranial symptomatic brain hemorrhages.
AuthorsMassimo Camerlingo, Pietro Salvi, Giorgio Belloni, Tiziano Gamba, Bruno Mario Cesana, Angelo Mamoli
JournalStroke (Stroke) Vol. 36 Issue 11 Pg. 2415-20 (Nov 2005) ISSN: 1524-4628 [Electronic] United States
PMID16224085 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Anticoagulants
  • Fibrinolytic Agents
  • Heparin
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants (pharmacology)
  • Atrial Fibrillation (pathology)
  • Brain (pathology)
  • Cerebral Infarction (drug therapy, pathology)
  • Female
  • Fibrinolytic Agents (administration & dosage, therapeutic use)
  • Heparin (administration & dosage, therapeutic use)
  • Humans
  • Infusions, Intravenous
  • Intracranial Hemorrhages (drug therapy, pathology)
  • Male
  • Middle Aged
  • Single-Blind Method
  • Stroke (pathology)
  • Time Factors
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: