PMID- 9822840
OWN - NLM
STAT- MEDLINE
DCOM- 19990126
LR  - 20190915
IS  - 0303-8467 (Print)
IS  - 0303-8467 (Linking)
VI  - 100
IP  - 3
DP  - 1998 Sep
TI  - Subcutaneous low molecular weight heparin in place of heparin infusion during 
      warfarin dose optimisation in cerebral ischaemia.
PG  - 193-5
AB  - We explored the feasibility of using subcutaneous low-molecular-weight-heparin 
      (LMWH) injections in place unfractionated heparin (UFH) while anticoagulating 
      patients with cerebral ischemia. In this open-labeled, prospective study, 
      patients admitted to our hospital with transient ischemic attacks or stroke 
      requiring anticoagulation who were otherwise medically fit for discharge home 
      were enrolled. The LMWH nadroparin (Fraxiparine) 4100 antiXa BID was 
      administered. In those on UFH, this was stopped after the first dose of LMWH. 
      Patients were sent home and LMWH was administered on an outpatient basis with 
      simultaneous oral warfarin titration till INR reached 2.0. Fifteen patients (13 
      inpatients, two outpatients) were enrolled; 12 had stroke, one each had crescendo 
      transient ischaemia attacks (TIAs) while on aspirin, TIAs and intracranial 
      arterial stenosis, TIA and atrial fibrillation. Inpatients were discharged home 
      within a median of 1 day (range 1-3 days). Median duration of LMWH therapy was 9 
      days (range 4-47 days); nine required LMWH for 10 days or less. Two patients 
      reported bruising at the injection site. There was no death, cerebral ischaemia 
      recurrence or major hemorrhage. Using LMWH in place of UFH in patients with 
      cerebral ischaemia is a feasible and safe way of achieving optimal oral 
      anticoagulation and can be done on an outpatient basis.
FAU - Venketasubramanian, N
AU  - Venketasubramanian N
AD  - Department of Neurology, Tan Tock Seng Hospital, Singapore. 
      ramani_nv@notes.ttsh.gov.sg
FAU - Chua, H C
AU  - Chua HC
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Netherlands
TA  - Clin Neurol Neurosurg
JT  - Clinical neurology and neurosurgery
JID - 7502039
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*administration & dosage
MH  - Brain Ischemia/prevention & control
MH  - Feasibility Studies
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Ischemic Attack, Transient/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Outpatients
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Warfarin/*administration & dosage
EDAT- 1998/11/21 00:00
MHDA- 1998/11/21 00:01
CRDT- 1998/11/21 00:00
PHST- 1998/11/21 00:00 [pubmed]
PHST- 1998/11/21 00:01 [medline]
PHST- 1998/11/21 00:00 [entrez]
AID - S0303846798000390 [pii]
AID - 10.1016/s0303-8467(98)00039-0 [doi]
PST - ppublish
SO  - Clin Neurol Neurosurg. 1998 Sep;100(3):193-5. doi: 10.1016/s0303-8467(98)00039-0.