PMID- 27403222
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160712
LR  - 20200928
IS  - 1941-5893 (Print)
IS  - 1944-141X (Electronic)
IS  - 1941-5893 (Linking)
VI  - 9
IP  - 1
DP  - 2016 Jun
TI  - Study of the Efficacy, Safety and Tolerability of Low-Molecular-Weight Heparin 
      vs. Unfractionated Heparin as Bridging Therapy in Patients with Embolic Stroke 
      due to Atrial Fibrillation.
PG  - 35-41
AB  - BACKGROUND: Anticoagulation with adjusted dose warfarin is a well-accepted 
      treatment for the prevention of recurrent stroke in patients with atrial 
      fibrillation. Meanwhile, using bridging therapy with heparin or heparinoids 
      before warfarin for initiation of anticoagulation is a matter of debate. We 
      compared safety, efficacy, and tolerability of low-molecular-weight heparin 
      (LMWH) and unfractionated heparin (UFH) as a bridging method in patients with 
      recent ischemic stroke due to atrial fibrillation. METHOD: This study was a 
      randomized single-blind controlled trial in patients with acute ischemic stroke 
      due to atrial fibrillation who were eligible for receiving warfarin and were 
      randomly treated with 60 milligrams (mg) of LMWH (enoxaparin) subcutaneously 
      every 12 h, or 1000 units/h of continuous intravenous heparin. The primary 
      efficacy endpoints were recurrence of new ischemic stroke, myocardial infarction 
      and/or death. The primary safety endpoint was central nervous system and/or 
      systemic bleeding. RESULTS: Seventy-four subjects were recruited. Baseline 
      demographic and clinical characteristics of two groups were matched. Composite 
      endpoint outcome of new ischemic stroke, myocardial infarction, and/or death in 
      follow-up period was seen in 10 subjects (27.03%) in UFH group and in four 
      subjects (10.81%) in LMWH group (p value: 0.136). All hemorrhages and symptomatic 
      central nervous system (CNS) hemorrhages in follow-up period were in 7 (18.9%) 
      and 4 (10.8%) patients in UFH group, in 5 (13.5%), and 3 (8.1%) patients in LMWH 
      group (p values: 0.754 and 0.751), respectively. Drop out and major 
      adverse-effects such as heparin-induced thrombocytopenia and drug 
      hypersensitivity were not seen in any patient. CONCLUSION: Enoxaparin can be a 
      safe and efficient alternative for UFH as bridging therapy.
FAU - Feiz, Farnia
AU  - Feiz F
AD  - Clinical Neurology Research Center, Shiraz University of Medical Sciences, 
      Shiraz, Iran; These authors contributed equally to this work.
FAU - Sedghi, Reyhane
AU  - Sedghi R
AD  - Clinical Neurology Research Center, Shiraz University of Medical Sciences, 
      Shiraz, Iran; These authors contributed equally to this work.
FAU - Salehi, Alireza
AU  - Salehi A
AD  - Research Center for Traditional Medicine and History of Medicine, Shiraz 
      University of Medical Sciences, Shiraz, Iran.
FAU - Hatam, Nahid
AU  - Hatam N
AD  - School of Management and Information Sciences, Shiraz University of Medical 
      Sciences, Shiraz, Iran.
FAU - Bahmei, Jamshid
AU  - Bahmei J
AD  - School of Management and Information Sciences, Shiraz University of Medical 
      Sciences, Shiraz, Iran.
FAU - Borhani-Haghighi, Afshin
AU  - Borhani-Haghighi A
AD  - Clinical Neurology Research Center, Shiraz University of Medical Sciences, 
      Shiraz, Iran; Department of Neurology, Shiraz University of Medical Sciences, 
      Shiraz, Iran.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Vasc Interv Neurol
JT  - Journal of vascular and interventional neurology
JID - 101511381
PMC - PMC4925764
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - embolic
OT  - low-molecular-weight heparin
OT  - stroke
OT  - unfractionated heparin
EDAT- 2016/07/13 06:00
MHDA- 2016/07/13 06:01
PMCR- 2016/06/01
CRDT- 2016/07/13 06:00
PHST- 2016/07/13 06:00 [entrez]
PHST- 2016/07/13 06:00 [pubmed]
PHST- 2016/07/13 06:01 [medline]
PHST- 2016/06/01 00:00 [pmc-release]
AID - jvin-9-1-7 [pii]
PST - ppublish
SO  - J Vasc Interv Neurol. 2016 Jun;9(1):35-41.