Aspirin and heparin in acute ischaemic stroke in older patients.

Over four-fifths of all strokes are due to thrombotic or embolic occlusion of cerebral arteries. There is a strong rationale for considering antithrombotic therapy for the treatment of patients with acute ischaemic stroke. Antiplatelet therapy with 150 to 300mg of aspirin (acetylsalicylic acid) star...

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Publicado en:Drugs & Aging Vol. 15; no. 1; pp. 29 - 37
Autores principales: Gubitz G, Sandercock P
Formato: Journal Article
Publicado: Springer Nature 1999
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Aspirin and heparin in acute ischaemic stroke in older patients.
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          Gubitz G
          Sandercock P
      sug:
        subj:
          Anticoagulants Therapeutic Use
          Aspirin Therapeutic Use
          Cerebral Ischemia Drug Therapy
          Heparin, Low-Molecular-Weight Therapeutic Use
          Platelet Aggregation Inhibitors Therapeutic Use
          Acute Disease
          Aged
          Anticoagulants Adverse Effects
          Aspirin Adverse Effects
          Cerebral Hemorrhage Chemically Induced
          Cerebral Ischemia Prevention and Control
          Cerebrovascular Disorders Prevention and Control
          Geriatrics
          Heparin, Low-Molecular-Weight Adverse Effects
          Platelet Aggregation Inhibitors Adverse Effects
          Aged: 65+ years
      ab: Over four-fifths of all strokes are due to thrombotic or embolic occlusion of cerebral arteries. There is a strong rationale for considering antithrombotic therapy for the treatment of patients with acute ischaemic stroke. Antiplatelet therapy with 150 to 300mg of aspirin (acetylsalicylic acid) started within the first 48 hours of an ischaemic stroke improves patient outcome in the short and long term, with a low risk of adverse effects. Anticoagulants such as heparin may reduce the risk of developing deep venous thrombosis and pulmonary embolism in patients with stroke, but randomised controlled trials have demonstrated a significant and dose-dependent risk of intracranial haemorrhage. The routine use of parenteral anticoagulants, including unfractionated heparin, low-molecular-weight heparins and heparinoids in the acute phase of ischaemic stroke is not associated with any net short or long term benefit. Aspirin is, therefore, the antithrombotic drug of choice in the treatment of acute ischaemic stroke.
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