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Improvement of Outcome in Patients with Acute Ischaemic Stroke Treated with Fragmin

Most ischaemic strokes are due to thromboembolic occlusion of an artery supplying the brain. Measures taken to restore or improve the blood supply are the most prescribed therapies for these patients. However, for acute ischaemic stroke (AIS), no specific treatment has been shown in randomized controlled trials to definitely improve outcome by reducing mortality and/or improving functional status. Anticoagulants are often used in the treatment of AIS, but their value in its treatment is not well established. Past attempts to use anticoagulants (mainly heparin) to improve outcome in patients with AIS have been largely unsuccessful. Low molecular weight heparins (LMWH) have been shown to be more effective than standard heparin in many thromboembolic diseases, and have no increase in the risk of bleeding, have better bioavailability and are simpler to administer. As suggested by some previous randomized trials [1, 2], LMWH could improve survival and functional status in AIS patients but, at present, their precise usefulness in improving outcome after AIS has not yet been determined. The aim of this open prospective study was to assess whether the treatment of AIS with a LMWH, dalteparin sodium (Pharmacia), has a positive impact on the outcome.