title: Use of antithrombotic drugs in the treatment of acute ischemic stroke: a survey of neurologists in practice in the United States.
abstract: In an attempt to determine the opinions and practices of neurologists regarding the use of antithrombotic drugs in the treatment of acute ischemic stroke, we conducted a survey of 349 randomly selected neurologists from throughout the United States. Responses were received from 247 (71%), and 219 identified themselves as primary or consulting physicians for patients with acute ischemic stroke. During the previous 12 months, these 219 physicians estimated that they had seen a total of 14,636 patients within 24 hours of acute ischemic stroke, and 22% of these patients were treated with heparin. The most frequently reported indications were prevention of recurrent cerebral embolism (82% of physicians) and progressing stroke (70%). Despite the frequent use of heparin, only 6.4% of neurologists felt that it has been shown to be effective, and 16.4% felt that it has been shown to be of no value. The primary concern about the use of heparin was lack of proven efficacy in 48% and safety concerns in 41%. Results of a future trial testing the efficacy of antithrombotic drugs would be useful for most neurologists in their management of patients with acute or progressing ischemic stroke.
authors.affiliation: Department of Neurology, University of Iowa College of Medicine, Iowa City.
authors.forename: E E
authors.initials: EE
authors.lastname: Marsh
authors.forename: H P
authors.initials: HP
authors.lastname: Adams
authors.forename: J
authors.initials: J
authors.lastname: Biller
authors.forename: P
authors.initials: P
authors.lastname: Wasek
authors.forename: K
authors.initials: K
authors.lastname: Banwart
authors.forename: V
authors.initials: V
authors.lastname: Mitchell
authors.forename: R
authors.initials: R
authors.lastname: Woolson
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000188:drug therapy*; D002544:Cerebral Infarction / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D003625:Data Collection; D005069:Evaluation Studies as Topic; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D009462:Neurology / Q000379:methods*; D014481:United States
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin