Featured Research

from universities, journals, and other organizations

Administering Heparin Soon After Stroke Can Increase Risk Of Serious Bleeding

Date:
July 16, 2008
Source:
JAMA and Archives Journals
Summary:
The common practice of administering heparin soon after cardioembolic stroke is associated with an increased risk for serious bleeding, according to an article in the Archives of Neurology. However, it appears that anticoagulation with warfarin therapy may safely begin shortly after stroke.

The common practice of administering heparin soon after cardioembolic stroke is associated with an increased risk for serious bleeding, according to a new article. However, it appears that anticoagulation with warfarin therapy may safely begin shortly after stroke.

Related Articles


Cardioembolic stroke, in which blood flow to the brain is interrupted by a clot or other substance originating within the heart, account for 20 percent of strokes involving reduced blood flow to an area of the brain (ischemic strokes), according to background information in the article. Current guidelines do not recommend giving anticoagulation (anti-clotting) therapy to patients shortly after cardioembolic stroke.

However, most patients who have this type of stroke eventually need anticoagulation therapy, and there is no consensus regarding the best way to begin this treatment. Warfarin sodium, commonly prescribed for this purpose, takes several days to reach therapeutic levels and so is often combined (bridged) with other therapies.

Hen Hallevi, M.D., of the University of Texas Health Science Center at Houston, and colleagues retrospectively studied 204 patients who had been admitted with cardioembolic stroke between 2004 and 2006. Of these, eight received no anti-clotting therapy; 88 received aspirin only; 35 were given aspirin and warfarin; 44 received intravenous heparin and warfarin; and 29 were treated with a full dose of enoxaparin, a low-molecular-weight-heparin, followed by warfarin. All patients who did not receive full doses of heparin or enoxaparin took low doses of enoxaparin to prevent deep vein thrombosis (blood clots in the thigh or legs).

Recurrent strokes occurred in two patients (1 percent). The most common serious adverse event was a progressive stroke, in which the patient's neurological condition continues to deteriorate following the acute phase of the stroke, seen in 11 patients (5 percent). All except one of these cases occurred in the aspirin-only group. Patients receiving only aspirin therapy were 12.5 times as likely to experience stroke progression compared with patients who received other anticoagulation therapies, and patients with progressive strokes were 18 times more likely to have a poor outcome.

Hemorrhagic transformation, which involves bleeding into brain tissue affected by the ischemic stroke, was observed in 23 cases (11 percent) but only three (1 percent) were symptomatic. All three of these cases occurred in patients taking full-dose enoxaparin. Systemic bleeding occurred in two patients (1 percent), both taking heparin.

"Our data may provide guidance as to the mode of starting long-term anticoagulation therapy in patients with cardioembolic stroke," the authors write. "Warfarin treatment appears to be safe and can be started at any point during the hospital stay along with deep vein thrombosis prophylaxis. Bridging with a full dose of enoxaparin or heparin may carry a high risk of intracranial and systemic bleeding. However, it may be considered in special circumstances."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Hen Hallevi; Karen C. Albright; Sheryl Martin-Schild; Andrew D. Barreto; Sean I. Savitz; Miguel A. Escobar; Nicole R. Gonzales; Elizabeth A. Noser; Kachi Illoh; James C. Grotta. Anticoagulation After Cardioembolic Stroke: To Bridge or Not to Bridge? Arch Neurol., 2008;0(2008):65.9.noc70105 [link]

Cite This Page:

JAMA and Archives Journals. "Administering Heparin Soon After Stroke Can Increase Risk Of Serious Bleeding." ScienceDaily. ScienceDaily, 16 July 2008. <www.sciencedaily.com/releases/2008/07/080714162603.htm>.
JAMA and Archives Journals. (2008, July 16). Administering Heparin Soon After Stroke Can Increase Risk Of Serious Bleeding. ScienceDaily. Retrieved November 27, 2014 from www.sciencedaily.com/releases/2008/07/080714162603.htm
JAMA and Archives Journals. "Administering Heparin Soon After Stroke Can Increase Risk Of Serious Bleeding." ScienceDaily. www.sciencedaily.com/releases/2008/07/080714162603.htm (accessed November 27, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, November 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins