Enoxaparin is more effective than unfractionated heparin at stopping fatal blood clots in the veins of the legs and lungs following an acute ischaemic stroke, according to an Article published in this week's edition of The Lancet.
The clots – termed venous thromboembolisms (VTEs) – are common but preventable complications of acute ischaemic strokes (strokes in which the blood supply to the brain has been cut off by a clot).
VTEs often form in patients following a stroke as many are left with paralysis of varying degrees leaving them unable to walk. The inactivity, along with a highly activated clotting process, reduces the rate of blood flow through the legs, and clots then form which can eventually end up in the lungs and cause death.
Professor David Sherman of the University of Texas Health Science Centre, Texas, USA and colleagues reported their figures as part of the PREVAIL study.
The researchers looked at 1,762 patients who were unable to walk unaided after suffering acute ischaemic stroke. Half the group were given enoxaparin injections once a day, the rest unfractionated heparin which required two injections per day.
They found that enoxaparin was 43% more effective at preventing VTEs than unfractionated heparin. This result was consistent regardless of the severity of the stroke. The side effects of internal and external brain bleeding as a result of the drugs were rare in both patient groups – rates of internal bleeding were similar for both drugs, whilst rates of external brain bleeding were slightly higher in the group taking enoxaparin.
The authors conclude: "Enoxaparin is preferable to unfractionated heparin for venous thromboembolism prophylaxis in this high-risk medically ill patient population in view of its better clinical benefits to risk ratio and convenience of once daily administration."
Journal
The Lancet