Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Export

@article{citeulike:5104438, abstract = {BACKGROUND AND PURPOSE: Treatment of cerebral sinus thrombosis with heparin is controversial. We conducted a double-blind, placebo-controlled multicenter trial to examine whether anticoagulant treatment improves outcome in patients with sinus thrombosis. METHODS: Patients were randomized between body weight-adjusted subcutaneous nadroparin (180 anti-factor Xa units/kg per 24 hours) and matching placebo for 3 weeks (double-blind part of trial), followed by 3 months of oral anticoagulants for patients allocated nadroparin (open part). Patients with cerebral hemorrhage caused by sinus thrombosis were also included. RESULTS: Sixty patients were enrolled, and none were lost to follow-up. In 1 patient the diagnosis proved wrong after randomization. After 3 weeks, 6 of 30 patients (20\%) in the nadroparin group and 7 of 29 patients (24\%) in the placebo group had a poor outcome, defined as death or Barthel Index score of <15 (risk difference, -4\%; 95\% CI, -25 to 17\%; NS). After 12 weeks, 4 of 30 patients (13\%) in the nadroparin group and 6 of 29 (21\%) in the placebo group had a poor outcome, defined as death or Oxford Handicap Score of >/=3 (risk difference, -7\%; 95\% CI, -26\% to 12\%; NS). There were no new symptomatic cerebral hemorrhages. One patient in the nadroparin group had a major gastrointestinal hemorrhage, and 1 patient in the placebo group died from clinically suspected pulmonary embolism. CONCLUSIONS: Patients with cerebral sinus thrombosis treated with anticoagulants (low-molecular-weight heparin followed by oral anticoagulation) had a favorable outcome more often than controls, but the difference was not statistically significant. Anticoagulation proved to be safe, even in patients with cerebral hemorrhage.}, author = {de Bruijn, S. F. and Stam, J.}, citeulike-article-id = {5104438}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/10066840}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=10066840}, comment = {Fink}, issn = {0039-2499}, journal = {Stroke; a journal of cerebral circulation}, keywords = {stroke, syllabus}, month = {March}, number = {3}, pages = {484--488}, posted-at = {2009-07-10 10:53:06}, priority = {2}, title = {Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/10066840}, volume = {30}, year = {1999} }

TY - JOUR ID - citeulike:5104438 L3 - citeulike-article-id:5104438 N2 - BACKGROUND AND PURPOSE: Treatment of cerebral sinus thrombosis with heparin is controversial. We conducted a double-blind, placebo-controlled multicenter trial to examine whether anticoagulant treatment improves outcome in patients with sinus thrombosis. METHODS: Patients were randomized between body weight-adjusted subcutaneous nadroparin (180 anti-factor Xa units/kg per 24 hours) and matching placebo for 3 weeks (double-blind part of trial), followed by 3 months of oral anticoagulants for patients allocated nadroparin (open part). Patients with cerebral hemorrhage caused by sinus thrombosis were also included. RESULTS: Sixty patients were enrolled, and none were lost to follow-up. In 1 patient the diagnosis proved wrong after randomization. After 3 weeks, 6 of 30 patients (20%) in the nadroparin group and 7 of 29 patients (24%) in the placebo group had a poor outcome, defined as death or Barthel Index score of <15 (risk difference, -4%; 95% CI, -25 to 17%; NS). After 12 weeks, 4 of 30 patients (13%) in the nadroparin group and 6 of 29 (21%) in the placebo group had a poor outcome, defined as death or Oxford Handicap Score of >/=3 (risk difference, -7%; 95% CI, -26% to 12%; NS). There were no new symptomatic cerebral hemorrhages. One patient in the nadroparin group had a major gastrointestinal hemorrhage, and 1 patient in the placebo group died from clinically suspected pulmonary embolism. CONCLUSIONS: Patients with cerebral sinus thrombosis treated with anticoagulants (low-molecular-weight heparin followed by oral anticoagulation) had a favorable outcome more often than controls, but the difference was not statistically significant. Anticoagulation proved to be safe, even in patients with cerebral hemorrhage. IS - 3 JF - Stroke; a journal of cerebral circulation SN - 0039-2499 EP - 488 TI - Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. VL - 30 SP - 484 KW - stroke KW - syllabus N1 - Fink AU - de Bruijn, SF AU - Stam, J PY - 1999/03// UR - http://view.ncbi.nlm.nih.gov/pubmed/10066840 ER -