Study of the Efficacy, Safety and Tolerability of Low Molecular Weight Heparin vs. Unfractionated Heparin in Stroke
Embolic Stroke
About this trial
This is an interventional prevention trial for Embolic Stroke focused on measuring ischemic stroke, atrial fibrillation, bridging therapy
Eligibility Criteria
Inclusion Criteria:
- confirmed diagnosis of acute ischemic stroke purely due to AF
- AF confirmed by ECG or 24 hour holter monitoring
- patients who need initiation of anticoagulation for prevention of recurrent stroke
Exclusion Criteria:
- ages less than 18 or more than 75
- no cooperation
- CNS hemorrhage
- major bleeding
- infarction size of more than one third of middle cerebral artery territory
- National Institutes of Health Stroke Scale (NIHSS) more than 20
- hypersensitivity to IV UFH or LMWH
- no informed consent
- other causes for stroke except AF
- pregnancy
- breast feeding
- uncontrolled hypertension (BP more than 220/120)
- renal, hepatic, respiratory or cardiac failure
- myocardial infarction
- infectious endocarditis
- coma
- vasculitis
- dissection
Sites / Locations
- Nemazi hospitalRecruiting
- Faghihi hospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Low molecular-weight heparin
unfractionated heparin
these patients will receive 1 mg of enoxaparin (clexane) per kilogram of body weight subcutaneous every 12 hour with warfarin 5mg QD and both drugs will be continued until the target INR level (2.5) is reached then clexane will be discontinued.
This group will receive continuous intravenous unfractionated heparin sodium infusion 1000 unit per hour initially and then the dose will be adjusted to maintain a therapeutic aPTT level (two times to baseline) then warfarin will be started (5 mg QD).