Evaluation of anticoagulants in patients with cerebral infarction with slight to moderate neurological deficit

Abstract

In a non-randomized controlled study carried out on 238 hospitalized patients with cerebral infarction, anticoagulant treatment (AC) was compared with the natural course in the prevention of transient ischemic attacks (TIA), cerebral infarction, stroke, stroke or death. 137 patients were allocated to AC, mean follow-up 30.5 months, and 101 patients were allocated to the controls (untreated group), mean follow-up 25.2 months. There were no statistically significant differences among the patients in the group who had suffered TIA (AC treated group 10.2%, untreated group 5.9%), cerebral infarction (AC treated group 10.2%, untreated group 11.9%), stroke (AC treated group 14.6%, untreated group 12.9%), stroke or death (AC treated group 22.6%, untreated group 19.8%). Minor bleedings occurred significantly more frequently (P less than 0.01) in the treated group. Severe bleedings occurred in 8 patients in the treated group (5.8%) compared to 1 of the controls (1%). It is concluded from the trial that AC can only seldom be recommended as prophylactic against new strokes in patients with cerebral infarction due to arterial thromboembolism.

Survival and Recurrent Strokes in Patients with Different Subtypes of Stroke: A Fourteen-Year Follow-Up Study

“…In the Oxfordshire Community Stroke Project [9], the actuarial risk of recurrence was 13% at 1 year and 30% at 5 years, whereas Viitanen et al [24]reported a recurrent stroke rate of 14% in the first year and 37% after 5 years. Age [3, 14, 24, 25, 26], previously stroke [14, 27], stroke severity [28]and systolic blood pressure were all predictors of recurrent stroke as found in many other studies, whereas hyperglycemia or known diabetes did not reach a significant increase of recurrent stroke in our study contrary to others [14, 25, 26, 27, 28, 29, 30, 31, 32, 33]. Hypertension as a risk factor of stroke has been reported in several studies [5, 11, 12, 14, 27, 28, 31, 34, 35].…”

Secondary prophylactic treatment and long‐term prognosis after TIA and different subtypes of stroke. A 25‐year follow‐up hospital‐based observational study

“…Similar results have been reported for minor, moderate stroke patients (Coull et al., 2004) or considerably lower figures (Eliasziw et al., 2004; Eriksson, & Link, 1983). However, after 14–years follow up a cumulative risk of 63.2% (CI 55.6–71) of having a recurrent stroke was reported in a previous study that included different subgroups of stroke patients (Eriksson & Olsson, 2001).…”

Oral anticoagulants and non-cardioembolic stroke prevention

“…Of the 19 studies, seven were excluded because of failure to address the appropriate clinical question, lack of randomization, or because interventions were given for less than 3 months. [28][29][30][31][32][33][34] Twelve studies (n = 6310 patients) met the inclusion criteria (Appendix). 13,[15][16][17][18][19][20][21][24][25][26][27] The mean age of patients was 63.1 (SD ± 3.57) years.…”

“…Nineteen studies were selected for in-depth review. 13,[15][16][17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][34] This list was circulated among experts in the field in an effort to identify missed studies. Our experts were not able to suggest additional relevant studies.…”