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@article{766858,
author = {Mikulík, Robert and Dufek, Michal and Goldemund, David and Reif, Michal},
article_number = {13},
keywords = {anticoagulants;low molecular weight heparin;stroke;thrombolysis},
language = {eng},
issn = {1351-5101},
journal = {European Journal of Neurology},
title = {A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke},
volume = {10},
year = {2006}
}
TY - JOUR
ID - 766858
AU - Mikulík, Robert - Dufek, Michal - Goldemund, David - Reif, Michal
PY - 2006
TI - A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke
JF - European Journal of Neurology
VL - 10
IS - 13
SP - 1106-1111
EP - 1106-1111
SN - 13515101
KW - anticoagulants;low molecular weight heparin;stroke;thrombolysis
N2 - Low molecular weight heparin (LMWH) administered immediately after intravenous thrombolysis (IT) may reduce the risk of arterial reocclusion. Its benefit, however,may not outweigh the risk of intracranial hemorrhage (ICH). We sought preliminary data regarding safety of this combined therapy in an openlabel, nonrandomized study. The patients received either a standard anticoagulation (AC) starting 24 h after IT (the standard AC group) or AC with 2850 IU of nadroparin, given every 12 h immediately after IT (the early AC group). Sixty patients received IT treatment: 25 in the standard AC group [mean age 66, median National Institutes of Health Stroke Scale (NIHSS) 13, 64% men] and 35 in the early AC group (mean age 68, median NIHSS 13, 69% men). Symptomatic ICH occurred in one patient (4%) in the standard AC group and three patients (8.6%) in the early AC group [odds ratio (OR) 1.8;95%CI 0.2;12.8]. At 3 months, nine patients in the standard AC group (36%) and 16 patients in the early AC group (45.7%) achieved a modified Rankin scale 0 or 1 (OR 1.2; 95%CI 0.5;3.2). Our study suggests that treatment with LMWH could be associated with higher odds of ICH, although it may not necessarily lead to a worse outcome. This justifies larger clinical trials.
ER -
MIKULÍK, Robert, Michal DUFEK, David GOLDEMUND a Michal REIF. A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke. \textit{European Journal of Neurology}. 2006, roč.~10, č.~13, s.~1106-1111, 5 s. ISSN~1351-5101.
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