Role of heparin and low-molecular-weight heparins in the management of acute ischemic stroke

UMMS Affiliation

Department of Neurology

Publication Date


Document Type



Acute Disease; Anticoagulants; Brain Ischemia; Heparin; Heparin, Low-Molecular-Weight; Humans; Intracranial Thrombosis; Recurrence; Stroke; Venous Thrombosis


Neurology | Neuroscience and Neurobiology


The numerous large-scale randomized clinical trials performed during the last decade on either unfractionated heparin, or low molecular weight heparin have not been able to demonstrate undisputed benefits in patients with acute ischemic stroke, compared with no treatment or aspirin. However, a large number of these trials, including the International Stroke Trial and Chinese Acute Stroke Trial, exhibit severe methodological limitations and need to be interpreted with caution. Knowledge of thromboembolism pathophysiology and clinical experience leads to the theory that heparins will prevent red thrombus formation, propagation and embolism. Heparins effectively prevent venous thrombosis and pulmonary embolism. More trials are needed to test heparins in patients whose cardiocerebrovascular lesions are better defined by newer neuroimaging techniques. The efficacy of heparins has not been adequately tested in patients with defined stroke subtypes and occlusive vascular lesions. Heparins should not be indiscriminately given to all patients with acute ischemic stroke. High-quality, randomized trials that adequately study heparin use in patients using modern technology for vascular lesions and stroke subtypes are lacking, and need to be performed.

DOI of Published Version



Expert Rev Cardiovasc Ther. 2006 May;4(3):405-15. Link to article on publisher's site

Journal/Book/Conference Title

Expert review of cardiovascular therapy

Related Resources

Link to article in PubMed

PubMed ID