Early intravenous heparin improves 90-day outcomes after nonlacunar stroke, Dr. Massimo Camerlingo and colleagues concluded.
Dr. Camerlingo of Ospedali Riuniti, Bergamo, Italy, and associates randomized 418 stroke patents (mean age 71 years) to either saline or heparin initiated within 3 hours of stroke; 208 received heparin and 210 received saline. The therapies were continued for 5 days, at which time both groups received 100 mg/day oral aspirin or other anticoagulants to obtain prothrombin times of 2.0–3.0 (Stroke 2005;36:2415–20).
Compared with those receiving intravenous saline, patients who got unfractionated heparin within 3 hours of their stroke were significantly more likely to be independent 3 months later (39% vs. 29%). There were fewer deaths (35 vs. 46) but more symptomatic brain hemorrhages (13 vs. 3) and fatal brain hemorrhages (7 vs. 1) in the heparin group.