The safety and efficacy of Heparin and Nadroparin compared to placebo in acute ischemic stroke - pilot study

Abstract

Aims. This study aimed to compare the efficacy and safety of heparin and nadroparin in order to provide an additional therapeutic option for patients with acute ischemic stroke in, whom systemic thrombolysis was excluded, or thrombectomy could not be performed. Methods. We describe a prospective randomized double-blind placebo-controlled pilot study in acute ischemic stroke. The therapeutic window was between 4.5 and 24 h after the onset of stroke. During the first 24 h of treatment, the patients divided into 3 groups received placebo, heparin or nadroparin (in therapeutic doses). During the following 48 h, each patient received nadroparin in the therapeutic dose. 24 h after start of treatment they began taking 100 mg aspirin daily. The primary safety indicator was incidence of complications such as intracerebral or systemic hemorrhage, or death. Efficacy was primarily monitored by the neurological modified Rankin Scale (mRS) at 90 days.Results. There were no signs of intracerebral or systemic bleeding in the cohort of 87 patients. Two patients died -one (3.7%) in the heparin and one (3.8%) in the placebo group due to causes not connected with the treatment. There was a statistically significant difference in mRS on the 90 th day between the heparin and placebo groups (21 (80%) vs 13 (50%), P=0.0350) and between the nadroparin and placebo groups (29 (85%) vs 13 (50%), P=0.0031). Conclusion.The results show that the treatment with heparin and nadroparin is safe and effective. Trial registration: Trial is registered in ClinicalTrials.gov: NCT01862978.

Epigenome-Wide Analyses Identify Two Novel Associations With Recurrent Stroke in the Vitamin Intervention for Stroke Prevention Clinical Trial

“…Heparin, a commonly prescribed anticoagulant, is used in ischemic stroke prevention. Studies focusing on the efficacy and safety of heparin alone or in combination therapies have demonstrated that heparin is safe and effective in ischemic attacks ( Yi et al, 2014 ; Dluha et al, 2016 ); however, novel therapeutics are becoming more promising and could soon be implemented more regularly in favor to traditional heparin treatment ( Douketis et al, 2015 ; Han et al, 2015 ). The ontology terms that were suggestively associated with ASB10 and TTC37 included signal transduction.…”