Prophylaxis of thrombotic and embolic events in acute ischemic stroke with the low-molecular-weight heparin Certoparin

• Verfasst von: Diener, Hans-Christoph [VerfasserIn]
• Verfasst von: Ringelstein, Erich B. [VerfasserIn]
• Verfasst von: Kummer, Rüdiger von [VerfasserIn]
• Verfasst von: Landgraf, Helmut [VerfasserIn]
• Verfasst von: Koppenhagen, Klaus [VerfasserIn]
• Verfasst von: Harenberg, Job [VerfasserIn]
• Verfasst von: Rektor, Ivan [VerfasserIn]
• Verfasst von: Csányi, Attila [VerfasserIn]
• Verfasst von: Schneider, Dietmar [VerfasserIn]
• Verfasst von: Klingelhöfer, Jürgen [VerfasserIn]
• Verfasst von: Brom, Joachim [VerfasserIn]
• Verfasst von: Weidinger, Gottfried [VerfasserIn]
• Titel: Prophylaxis of thrombotic and embolic events in acute ischemic stroke with the low-molecular-weight heparin Certoparin
• Verf.angabe: Hans-Christoph Diener, Erich B. Ringelstein, Rüdiger von Kummer, Helmut Landgraf, Klaus Koppenhagen, Job Harenberg, Ivan Rektor, Attila Csányi, Dietmar Schneider, Jürgen Klingelhöfer, Joachim Brom, Gottfried Weidinger
• Jahr: 2006
• Umfang: 6 S.
• Fussnoten: Published online November 23, 2005 ; Gesehen am 14.04.2022
• Titel Quelle: Enthalten in: Stroke
• Ort Quelle: New York, NY : Association, 1970
• Jahr Quelle: 2006
• Band/Heft Quelle: 37(2006), 1, Seite 139-144
• ISSN Quelle: 1524-4628
• DOI: doi:10.1161/01.STR.0000195182.67656.ee
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cerebrovascular accident
• Sach-SW: heparin
• Sach-SW: venous thrombosis
• K10plus-PPN: 1799626946

Abstract

Background and Purpose— Patients with stroke are at substantial risk of thromboembolic complications and therefore require antithrombotic prophylaxis. To show the noninferiority of the low-molecular-weight heparin certoparin to unfractionated heparin (UFH) for the prevention of thromboembolic complications, we performed a randomized, double-blind, active-controlled multicenter trial in patients with acute ischemic stroke. - - Methods— Overall, 545 patients were randomized within 24 hours of stroke onset to treatment with certoparin (3000 U anti-Xa OD; n=272) or UFH (5000 U TID; n=273) for 12 to 16 days. Patients with paresis of a leg and an National Institutes of Health Stroke Scale score of 4 to 30 points were included. The primary end point was a composite outcome of proximal deep vein thrombosis, pulmonary embolism, or death related to venous thromboembolism during treatment. Computed tomography was performed at trial entry, after 7 days, and when clinical deterioration occurred. - - Results— The per-protocol analysis revealed 17 (7.0%) primary events in the certoparin group compared with 24 (9.7%) in the UFH group, thereby demonstrating noninferiority (P=0.0011), confirmed by intention-to-treat analysis (6.6% versus 8.8%; P=0.008). Major bleeding occurred during treatment in 3 patients allocated to certoparin (1.1%) and 5 patients allocated to UFH (1.8%). - - Conclusions— Certoparin (3000 U anti-Xa OD) is at least as effective and safe as UFH (TID) for the prevention of thromboembolic complications in patients with acute ischemic stroke.