Trials of Heparin in Acute Ischemic Stroke

Placebo-Controlled Trials of UFH, LMWH, and Heparinoids The International Stroke Trial (1ST)8 was a randomized, placebo-controlled trial of UFH (5000 or 12,500 IU twice daily) and aspirin (300 mg) in 19,435 unselected patients with acute stroke within 48 hours of symptom onset. Because of limited availability of neuroimaging, 33% of participants were enrolled with suspected but not proven ischemic stroke, some of whom may have suffered primary intracerebral hemorrhage (ICH).

TABLE 7.1 Commonly used LMWHs and Heparinoids.

Main LMWHs

Method of Preparation

Enoxaparin sodium

Benzylation followed by alkaline depolymerization

Dalteparin sodium

Nitrous acid depolymerization

Tinzaparin

Enzymatic depolymerization with heparinase

Nadroparin sodium

Nitrous acid depolymerization

Ardepatrin

Peroxidative depolymerization

Main heparinoid

Method of preparation

Danaparoid sodium

Prepared from animal gut mucosa; contains heparin sulfate

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