A pilot study on systemic thrombolysis followed by low
molecular weight heparin in ischemic stroke

J 2006

A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke

MIKULÍK, Robert, Michal DUFEK, David GOLDEMUND and Michal REIF

Basic information

Original name

A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke

Name in Czech

Pilotní studie kombinované léčby nízkomolekulárním heparinem a systémovou tPA u mozkového infarktu

Authors

MIKULÍK, Robert (203 Czech Republic, guarantor), Michal DUFEK (203 Czech Republic), David GOLDEMUND (203 Czech Republic) and Michal REIF (203 Czech Republic)

Edition

European Journal of Neurology, 2006, 1351-5101

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30000 3. Medical and Health Sciences

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.437

Organization unit

Faculty of Medicine

UT WoS

000240631100014

Keywords in English

anticoagulants;low molecular weight heparin;stroke;thrombolysis

Abstract

ORIG CZ

V originále

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.

In Czech

Pilotní studie kombinované léčby nízkomolekulárním heparinem a systémovou tPA u mozkového infarktu

Citovat

MIKULÍK, Robert, Michal DUFEK, David GOLDEMUND and Michal REIF. A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke. European Journal of Neurology. 2006, vol. 10, No 13, p. 1106-1111, 5 pp. ISSN 1351-5101.

@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 and Michal REIF. A pilot study on systemic thrombolysis followed by low molecular weight heparin in ischemic stroke. \textit{European Journal of Neurology}. 2006, vol.~10, No~13, p.~1106-1111, 5 pp. ISSN~1351-5101.

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