Abstract
Objectives
A systematic review of the trials directly comparing low-molecular-weight heparins (LMWH) or heparinoids with unfractionated heparin (UFH) in people with acute confirmed or presumed ischemic stroke.
Search Strategy
We searched the Cochrane Stroke Group trials register and MedStrategy (1995). We also contacted pharmaceutical companies. Date of most recent search: May 2001.
Selection Criteria
Randomized trials comparing heparinoids or LMWH with standard UFH in people with acute ischemic stroke. We included only trials in which treatment was started within 14 days of stroke onset.
Data Collection and Analysis
The 2 reviewers independently selected studies for inclusion, assessed trial quality, and extracted the data.
Main Results
We included 5 trials involving 705 people. Four trials compared a heparinoid (danaparoid), and 1 compared an LMWH (enoxaparin) with standard UFH (Figures 1 and 2). Overall, 55/414 (13%) of the patients allocated danaparoid or enoxaparin had deep vein thrombosis (DVT) compared with 65/291 (22%) of those allocated UFH. This reduction was significant (odds ratio [OR] 0.52, 95% CI 0.56 to 0.79). However, the number of more major events (pulmonary embolism, death, intracranial or extracranial hemorrhage) was too small to provide a reliable estimate of more important benefits and risks. No data on recurrent stroke or functional outcome in survivors were available
A systematic review of the trials directly comparing low-molecular-weight heparins (LMWH) or heparinoids with unfractionated heparin (UFH) in people with acute confirmed or presumed ischemic stroke.
Search Strategy
We searched the Cochrane Stroke Group trials register and MedStrategy (1995). We also contacted pharmaceutical companies. Date of most recent search: May 2001.
Selection Criteria
Randomized trials comparing heparinoids or LMWH with standard UFH in people with acute ischemic stroke. We included only trials in which treatment was started within 14 days of stroke onset.
Data Collection and Analysis
The 2 reviewers independently selected studies for inclusion, assessed trial quality, and extracted the data.
Main Results
We included 5 trials involving 705 people. Four trials compared a heparinoid (danaparoid), and 1 compared an LMWH (enoxaparin) with standard UFH (Figures 1 and 2). Overall, 55/414 (13%) of the patients allocated danaparoid or enoxaparin had deep vein thrombosis (DVT) compared with 65/291 (22%) of those allocated UFH. This reduction was significant (odds ratio [OR] 0.52, 95% CI 0.56 to 0.79). However, the number of more major events (pulmonary embolism, death, intracranial or extracranial hemorrhage) was too small to provide a reliable estimate of more important benefits and risks. No data on recurrent stroke or functional outcome in survivors were available
| Original language | English |
|---|---|
| Pages (from-to) | 1925-1926 |
| Number of pages | 1 |
| Journal | Stroke |
| Volume | 33 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 1 Jul 2002 |