PMID- 38529544
OWN - NLM
STAT- Publisher
LR  - 20240326
IS  - 1525-1489 (Electronic)
IS  - 0885-0666 (Linking)
DP  - 2024 Mar 26
TI  - Incidence of Symptomatic Venous Thromboembolisms in Stroke Patients.
PG  - 8850666241242683
LID - 10.1177/08850666241242683 [doi]
AB  - Venous thromboembolism (VTE) is a common but preventable complication observed in 
      critically ill patients. Deep vein thrombosis (DVT) is the most common type of 
      VTE, with clinical significance based on location and symptoms. There is an 
      increased incidence of DVT and pulmonary embolism (PE) in ischemic stroke 
      patients using unfractionated heparin (UFH) for VTE prophylaxis compared with 
      those using enoxaparin. However, UFH is still used in some patients due to its 
      perceived safety, despite conflicting literature suggesting that enoxaparin may 
      have a protective effect. The current study aimed to determine the incidence of 
      VTEs in patients with acute ischemic strokes on UFH versus enoxaparin for VTE 
      prophylaxis, subclassifying the VTEs depending on their location and symptoms. It 
      also aimed to examine the safety profile of both drugs. A total of 909 patients 
      admitted to the Neuro-ICU with the diagnosis of acute ischemic stroke were 
      identified, and 634 patients were enrolled in the study-170 in the enoxaparin 
      group and 464 in the UFH group-after applying the exclusion criteria. Nineteen 
      patients in the UFH group (4.1%) and 3 patients in the enoxaparin group (1.8%) 
      had a VTE. The incidence of DVT in the UFH group was 12 (2.6%), all of which were 
      symptomatic, compared with 3 (1.8%) in the enoxaparin group, wherein one case was 
      symptomatic. Nine patients (1.9%) in the UFH group developed a PE during the 
      study period, and all of them were symptomatic. No patients in the enoxaparin 
      group developed PE. No statistically significant difference was found between 
      both groups. However, 18 patients in the UFH group (3.9%) experienced 
      intracranial hemorrhage compared with none in the enoxaparin group, and this 
      difference was statistically significant. Enoxaparin was found to be as effective 
      as and potentially safer than UFH when used for VTE prophylaxis in stroke 
      patients.
FAU - Al Turk, Mostafa
AU  - Al Turk M
AUID- ORCID: 0000-0001-9180-0369
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, KS, 
      USA. RINGGOLD: 167073
FAU - Abraham, Michael
AU  - Abraham M
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, KS, 
      USA. RINGGOLD: 167073
AD  - Department of Radiology, University of Kansas Medical Center, Kansas City, KS, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20240326
PL  - United States
TA  - J Intensive Care Med
JT  - Journal of intensive care medicine
JID - 8610344
SB  - IM
OTO - NOTNLM
OT  - acute ischemic stroke
OT  - deep vein thrombosis
OT  - enoxaparin
OT  - low-molecular-weight heparin
OT  - neuro-ICU
OT  - pulmonary embolism
OT  - unfractionated heparin (UFH)
OT  - venous thromboembolism (VTE) prophylaxis
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2024/03/26 06:45
MHDA- 2024/03/26 06:45
CRDT- 2024/03/26 03:54
PHST- 2024/03/26 06:45 [medline]
PHST- 2024/03/26 06:45 [pubmed]
PHST- 2024/03/26 03:54 [entrez]
AID - 10.1177/08850666241242683 [doi]
PST - aheadofprint
SO  - J Intensive Care Med. 2024 Mar 26:8850666241242683. doi: 
      10.1177/08850666241242683.