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- Title
A low-molecular-weight heparinoid compared with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke. A randomized, double-blind study.
- Authors
Turpie, A G; Gent, M; Côte, R; Levine, M N; Ginsberg, J S; Powers, P J; Leclerc, J; Geerts, W; Jay, R; Neemeh, J
- Abstract
<bold>Objective: </bold>To compare the relative safety and efficacy of a low-molecular-weight heparinoid (ORG 10172) with unfractionated heparin in the prevention of deep vein thrombosis in patients with acute ischemic stroke.<bold>Design: </bold>Double-blind randomized trial.<bold>Setting: </bold>Seven Canadian university-affiliated hospitals.<bold>Participants: </bold>Eighty-seven patients with acute ischemic stroke resulting in lower-limb paresis.<bold>Intervention: </bold>Patients received either low-molecular-weight heparinoid, 750 anti-factor Xa units twice daily, or unfractionated heparin, 5000 units subcutaneously twice daily. Treatment was continued for 14 days or until hospital discharge if sooner.<bold>Measurements: </bold>Deep vein thrombosis was diagnosed using 125I-labeled fibrinogen leg scanning and impedance plethysmography. Venography was indicated if either test was positive. Overt hemorrhage, major or minor, was assessed clinically.<bold>Results: </bold>Venous thrombosis occurred in four patients (9%) given low-molecular-weight heparinoid and in 13 patients (31%) given heparin (relative risk reduction, 71%; 95% CI, 16% to 93%. The corresponding rates for proximal vein thrombosis were 4% and 12%, respectively (relative risk reduction, 63%; P greater than 0.2). The incidence of hemorrhage was 2% in both groups.<bold>Conclusion: </bold>Low-molecular-weight heparinoid, given in a fixed dose of 750 anti-factor Xa units subcutaneously twice daily, is more effective than subcutaneous low-dose heparin for the prevention of deep vein thrombosis in patients with acute ischemic stroke.
- Subjects
THERAPEUTIC use of fibrinolytic agents; VENOUS thrombosis prevention; FIBRINOLYTIC agents; ANTICOAGULANTS; CEREBRAL ischemia; CLINICAL trials; COMPARATIVE studies; GLYCOSAMINOGLYCANS; HEMORRHAGE; HEPARIN; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; VENOUS thrombosis; EVALUATION research; CHONDROITIN; RANDOMIZED controlled trials; CHONDROITIN sulfates; BLIND experiment; ACUTE diseases; DISEASE complications; PHARMACODYNAMICS; THERAPEUTICS
- Publication
Annals of Internal Medicine, 1992, Vol 117, Issue 5, p353
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-117-5-353