Heparin use in acute ischaemic stroke: does evidence change practice?

摘要

The answer to the question of whether the evidence from the many trials of heparin in acute ischaemic stroke has had any effect on practice seems to be mixed. Since the publication of a series of randomized controlled trials indicating the absence of benefit from heparin anticoagulation, there has been some change in practice, with a decline in heparin use for the management of non-cardioembolic stroke, but the overwhelming (and unchanged) majority of neurologists persist in their use of heparin for cardioembolic stroke, and a significant minority continue to use heparin for both anterior and posterior circulation stroke as well as transient ischaemic attacks and stroke-in-evolution. These practices would seem to run counter to the available evidence.