An ischemic stroke is caused by a blood clot and is the most common type of stroke.
The statement, published in the July issues of Stroke: Journal of the American Heart Association, and Neurology, the scientific journal of the American Academy of Neurology, aims to define the roles of drugs such as aspirin which is in a class of drugs called antiplatelet agents that prevent blood clot formation and drugs such as heparin, a type of anticoagulant that slows blood clotting.
The authors conducted a systematic review of the literature, looking primarily for well-designed, large prospective studies in which patients were randomly selected and blinded (they didn't know what type of therapy they were receiving).
They found evidence from the published trials that giving 160 325 mg of aspirin within 48 hours of stroke onset offers a "small but statistically significant" decrease in death rates and disability from stroke. Recommendations on the use of other types of antiplatelet agents, such as clopidogrel and ticlopidine within the first 48 hours of onset could not be made due to insufficient data.
Conversely, anticoagulants have not been shown to reduce death or disability when used within 48 hours.
"There is some evidence that a fixed dose of heparin given subcutaneously might be helpful for preventing recurrent stroke, but the benefit is balanced against the complication of increased hemorrhage. With the net effect, there is no benefit to that treatment. Therefore, we are not recommending that one use a fixed dose of heparin given subcutaneously to prevent stroke recurrence," says neurologist Bruce Coull, M.D., chair of the Joint Stroke Guideline Development Commi
Contact: Bridgette Mc Neill
American Heart Association