Current role of low molecular weight heparin in the treatment of acute ischemic stroke

Karan Singh


Background: Nevertheless, several studies of LMWH in acute ischemic stroke have been neutral with regard to their primary outcomes, and it remains unclear whether these drugs should be used routinely or not. Our present trial endeavors to study the efficacy of LMWH (low and high dose dalteparin) in patients with progressive ischemic stroke in terms of morbidity and mortality as compared to control group and to compare it with AS+CLOP, with respect to these event rates, at the end of treatment.

Methods: Our study was performed on 38 patients of acute ischemic stroke admitted to LLR and associated Hospitals, G. S. V. M. Medical College, Kanpur and who were assigned randomly to any of the four treatment groups (0.4ml dalteparin, 0.8ml of dalteparin, O ml of placebo and aspirin +clopidogrel 150+75 mg). The standard error of proportion method and Chi square test was applied.

Results: 70% of patients in group I, 62.5% in Group II and 60% Group III presented with stroke in evolution at presentation as compared to only 30% in the placebo group. 75% of patients in group I, 66.66% in group II, 50% in Group III and 33.34% in group IV had a complete recovery. 25% of patients in Group-I, 33.34% in Group-II, 50% in Group III and 66.66% in Group-IV had an incomplete recovery.

Conclusions: There is no significant reduction in the mortality and morbidity amongst LMWH groups at the end of treatment and end of trial as compared to the AS+CLOP, or placebo group or even amongst the low and high dose LMWH groups.


AS+CLOP, Ischemic stroke, Low and high dose dalteparin, Morbidity and mortality

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Trial TI. A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group. Lancet. 1997;349:1569-81.

Wolf PA, D'Agostino RB, O'Neal MA, Sytkowski P, Kase CS, Belanger AJ, et al. Secular trends in stroke incidence and mortality. The Framingham Study. Stroke. 1992;23(11):1551-5.

Brown RD, Whisnant JP, Sicks JD, O'Fallon WM, Wiebers DO. Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989. Stroke. 1996;27(3):373-80.

Albers GW, Easton JD, Sacco RL, Teal P. Antithorombotic And Thrombolytic Therapy for Ischemic Stroke. Chest. 1998;114(Suppl):315-324.

Whisnant JP. Effectiveness versus efficacy of treatment of hypertension for stroke prevention. Neurology. 1996;46(2):301-7.

US Preventive Services Task Force Guides to Clinical Preventive Services,1996. Available at

Gorelick PB. The status of alcohol as a risk factor for stroke. Stroke. 1989;20:1607-10.

Kay R, Wong KS, Yu YI, Chan YW, Tsoi TH, Ahuja AT, et al. Low molecular weight heparin for the treatment of acute ischemic stroke. N Eng J Med. 1995;333:15881-93.

Bath PM. Low molecular weight heparin in acute stroke. Expert opinion on investigational drugs. 1998;7(8):1323-30.