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Paper Information

Journal:   SCIENTIFIC JOURNAL OF FORENSIC MEDICINE   SUMMER 2003 , Volume 9 , Number 30; Page(s) 94 To 102.
 
Paper: 

UNFRACTIONATED HEPARIN AND LOW MOLECULAR WEIGHT HEPARIN IN THE TREATMENT OF ACUTE ISCHEMIC STROKE

 
 
Author(s):  ABOU ALFAZLI R., JANATI A., AHMADI KARVIGH S., NOURIAN A.R.
 
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Abstract: 

Background: In spite of using anticoagulant drugs such as unfractionated heparin (UFH) and low molecular weight heparin (LMWH) in the treatment of acute ischemic stroke, the efficacy of them has not been documented. Regarding to the frequent administration of these drugs, the evaluation of efficacy, advantages, and hazard of them is much important.
Methods: We reviewed articles about this type of treatment including randomized clinical trials, meta-analyses, original articles, systematic reviews and review articles published in MEDLINE and EMBASE during 1997-2003.
Results: In the short- and long- term follow up, UFH and LMWH don't result in considerable decreasing mortality, progression of stroke and early relapse risk. They don't result in considerable improvement in clinical and functional status of patients. In spite of considerable decreasing of deep vein thrombosis (DVT) and pulmonary emboli (PE) by administration of UFH and LMWH, it is established that they increase risk of intra- or hemorrhage. There is no valid document that immediate administration of anticoagulants (particularly intravenous and high dose) has helpful outcome.
Conclusion: UFH and LMWH are not recommended in the majority of cases with stroke particularly during the first 24-48 hours of attach. Subcutaneous administration of UFH and LMWH is helpful in preventing DVT and PE, while they increase risk of systemic and intracranial hemorrhages. Immediate treatment is not recommended in any type of cerebrovascular accident (CVA).

 
Keyword(s): UNFRACTIONATED HEPARIN (UFH), LOW MOLECULAR WEIGHT HEPARIN (LMWH), ACUTE ISCHEMIC STROKE, CEREBROVASULAR ACCIDENT (CVA)
 
References: 
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