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Controversies in Neurology
September 1999

Is There Still a Role for Intravenous Heparin in Acute Stroke?No

Author Affiliations

From the Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland.



Arch Neurol. 1999;56(9):1160-1162. doi:10.1001/archneur.56.9.1160

THERE IS NO evidence to support the routine use of intravenous (IV) heparin in the treatment of any type of patient with acute ischemic stroke. The first randomized trial, undertaken by the Cerebral Embolism Study Group, stopped prematurely when there was a nonsignificant trend in favor of treatment, after only 45 (of a planned 140) patients with presumed cardioembolic stroke had been randomized.1Three years later, a randomized trial in 225 patients showed that there was no evidence of benefit from IV heparin in preventing stroke progression.2A quantitative systematic review of the data from these 2 trials also did not provide any evidence of net benefit.3

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