The safety and usefulness of low molecular weight heparins and unfractionated heparins in patients with acute stroke.
Stroke is a common cause for morbidity and mortality, causing substantial economic costs. Because thrombosis plays a key role in the pathogenesis of ischaemic stroke, heparins, platelet inhibitors and anticoagulants have been used in stroke management. There were high hopes that patients might benefit from the use of heparins. Unfortunately, these expectations have not been met. Instead, thrombolytics have been shown to result in an improvement of outcome in a considerable fraction of patients with ischaemic stroke. Yet, in other areas of stroke management, such as the prevention of venous thromboembolism after stroke, heparins have found their niche. In this review, we report on the currently available literature on heparins for the reduction of stroke-related morbidity and mortality, the prevention of recurrent stroke as well as the prevention of venous thromboembolism in both ischaemic and haemorrhagic stroke with respect to their risks, such as the haemorrhagic transformation of ischaemic strokes.
Kiphuth
Ines C
IC
University of Erlangen, Department of Neurology, Schwabachanlage 6, 91054 Erlangen, Germany.
Köhrmann
Martin
M
Huttner
Hagen B
HB
Schellinger
Peter D
PD
D000208:Acute Disease; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D004311:Double-Blind Method; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012008:Recurrence; D012306:Risk; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin