Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial.
Background: Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined.Methods: This randomised, double-blind, aspirin-controlled tria...
| Publicado en: | Lancet Vol. 358; no. 9283; pp. 702 - 711 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | clinical trial research randomized controlled trial Journal Article |
| Publicado: |
Lancet
9/1/2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=5090682&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 5090682 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 9/1/2001 vid: 358 iid: 9283 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 5090682 5090682 NLM11551576 5090682 10.1016/S0140-6736(01)05837-8 NLM11551576 5090682 ppf: 702 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. aug: au: Bath, Philip M W Lindenstrom, Ewa Boysen, Gudrun De Deyn, Peter Friis, Pal Leys, Didier Marttila, Reijo Olsson, Jan-Edwin O'Neill, Desmond Orgogozo, Jean-Marc Ringelstein, Bernd van der Sande, Jan-Jacob Turpie, Alexander G G Bath, P M Lindenstrom, E Boysen, G De Deyn, P Friis, P Leys, D Marttila, R affil: Centre for Vascular Research, University of Nottingham, Nottingham, UK sug: subj: Stroke Drug Therapy Heparin, Low-Molecular-Weight Therapeutic Use Fibrinolytic Agents Therapeutic Use Aspirin Therapeutic Use Stroke Mortality Dose-Response Relationship, Drug Aged, 80 and Over Male Venous Thrombosis Prevention and Control Aged Heparin, Low-Molecular-Weight Administration and Dosage Female Human Fibrinolytic Agents Administration and Dosage Treatment Outcomes Double-Blind Studies Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Scales Aged, 80 & over Aged: 65+ years Male Female ab: Background: Low-molecular-weight heparins and heparinoids are superior to unfractionated heparin in the prevention and treatment of venous thromboembolism, but their safety and efficacy in acute ischaemic stroke are inadequately defined.Methods: This randomised, double-blind, aspirin-controlled trial tested the safety and efficacy of treatment with high-dose tinzaparin (175 anti-Xa IU/kg daily; 487 patients), medium-dose tinzaparin (100 anti-Xa IU/kg daily; 508 patients), or aspirin (300 mg daily; 491 patients) started within 48 h of acute ischaemic stroke and given for up to 10 days. Primary intracerebral haemorrhage was excluded by computed tomography. Outcome was assessed, with treatment allocation concealed, by the modified Rankin scale at 6 months (independence [scores 0-2] vs dependence or death [scores 3-6]).Findings: Of 1486 randomised patients, two did not receive treatment and 46 were lost to follow-up. The proportions independent at 6 months were similar in the groups assigned high-dose tinzaparin (194/468 [41.5%]), medium-dose tinzaparin (206/486 [42.4%]), or aspirin (205/482 [42.5%]). There was no difference in effect in any predefined subgroup, including patients with presumed cardioembolic stroke. Other outcome measures were similar between the treatment groups (disability, case-fatality, and neurological deterioration rates). During the in-hospital treatment period no patient assigned high-dose tinzaparin developed a symptomatic deep-vein thrombosis compared with nine assigned aspirin. Conversely, seven patients assigned high-dose tinzaparin developed symptomatic intracerebral haemorrhage compared with one in the aspirin group.Interpretation: Treatment with tinzaparin, at high or medium dose, within 48 h of acute ischaemic stroke did not improve functional outcome compared with aspirin. Although high-dose tinzaparin was superior in preventing deep-vein thrombosis, it was associated with a higher rate of symptomatic intracranial haemorrhage. pubtype: Academic Journal doctype: clinical trial research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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