Use of Heparin in Acute Ischemic Stroke: Is There Still a Role?

Ilana Marie Ruff Treiber*, Jenelle A. Jindal

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Heparin has long been a contested therapy in acute ischemic stroke (AIS). In current practice, heparin is considered on a case-by-case basis, but there is no consensus as to the appropriate timing of anticoagulation or for which ischemic stroke subtypes heparin may be beneficial. To provide better clarity on this issue, we review current research focusing on the use of heparin in AIS in each stroke subtype and subsequently make recommendations to provide readers with a systematic approach to managing complex stroke patients for which acute anticoagulation may be valuable. We conclude that there are certain subpopulations of ischemic stroke patients that may derive benefit from heparin when given acutely, including patients with symptomatic large artery stenosis >70 %, non-occlusive intraluminal thrombus, and in patients with high-risk cardiac conditions including left ventricular thrombus, left ventricular assist devices, and mechanical heart valves.

Original languageEnglish (US)
Article number51
JournalCurrent atherosclerosis reports
Volume17
Issue number9
DOIs
StatePublished - Sep 25 2015

Keywords

  • Acute ischemic stroke
  • Anticoagulants/adverse events
  • Anticoagulants/therapeutic use
  • Anticoagulation
  • Brain ischemia/drug therapy
  • Cerebrovascular disorders/drug therapy
  • Clinical protocols
  • Hemorrhage
  • Heparin
  • Heparin/administration and dosage
  • Heparin/therapeutic use
  • Intracranial hemorrhages/drug therapy
  • Randomized controlled trials as topic
  • Stroke
  • Stroke/drug therapy
  • Thromboembolism
  • Time factors
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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