PMID- 10493241
OWN - NLM
STAT- MEDLINE
DCOM- 19991105
LR  - 20071115
IS  - 0957-5235 (Print)
IS  - 0957-5235 (Linking)
VI  - 10 Suppl 2
DP  - 1999 Aug
TI  - Anticoagulation in acute ischaemic stroke: deep vein thrombosis prevention and 
      long-term stroke outcomes.
PG  - S123-7
AB  - Ischaemic stroke accounts for 70-85% of stroke incidence worldwide, causing 
      substantial morbidity and mortality. Antiplatelet agents and carotid 
      endarterectomy are effective in stroke prevention but active therapy for acute 
      stroke is limited at present. Treatments investigated to date include 
      thrombolysis and antiplatelet agents, both of which have been shown to modify the 
      effects of stroke and provide a small long-term benefit in selected patients, and 
      anticoagulation with heparin derivatives and oral agents. The value of 
      unfractionated heparin (UFH) in modifying the acute effects of stroke has never 
      been clearly established, and the risk of intracranial bleeding has limited its 
      clinical application. However, disability and death following stroke stem from 
      both the acute cerebral event and the secondary development of venous 
      thromboembolism (VTE). Antithrombotic therapy may therefore, in principle, 
      provide the dual benefit of retarding ongoing cerebral thrombosis and preventing 
      secondary VTE. Low-molecular-weight heparins (LMWHs) and one heparinoid may have 
      an improved ratio of antithrombotic action to haemorrhagic effect compared with 
      UFH. Recent trials with these agents demonstrated a significant reduction in deep 
      vein thrombosis and pulmonary embolism. Evidence has also emerged of improved 
      long-term outcomes in terms of combined rates of death and residual disability, 
      but data from different studies are conflicting. The potential role of LMWHs and 
      heparinoids in acute stroke remains to be clarified.
FAU - Lensing, A W
AU  - Lensing AW
AD  - Centre for Vascular Medicine, University of Amsterdam, The Netherlands. 
      a.w.lensing@amc.uva.nl
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Blood Coagul Fibrinolysis
JT  - Blood coagulation & fibrinolysis : an international journal in haemostasis and 
      thrombosis
JID - 9102551
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Humans
MH  - Ischemia/complications/therapy
MH  - Stroke/complications/*therapy
MH  - Treatment Outcome
MH  - Venous Thrombosis/prevention & control
RF  - 29
EDAT- 1999/09/24 00:00
MHDA- 1999/09/24 00:01
CRDT- 1999/09/24 00:00
PHST- 1999/09/24 00:00 [pubmed]
PHST- 1999/09/24 00:01 [medline]
PHST- 1999/09/24 00:00 [entrez]
PST - ppublish
SO  - Blood Coagul Fibrinolysis. 1999 Aug;10 Suppl 2:S123-7.