Low-molecular-weight heparins or heparinoids versus standard unfractionated heparin for acute ischemic stroke (Cochrane review)

Carl Edward Counsell, P. Sandercock

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)


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 languageEnglish
Pages (from-to)1925-1926
Number of pages1
Issue number7
Publication statusPublished - 1 Jul 2002


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