Author/Authors :
Ghandehari, Kavian mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Nikkhah, Karim mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Boroumand, Amir Reza mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Hosseini Nejad, Javad mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Derakhshan, Siavosh mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Melat Ardakani, Ali mashhad university of medical sciences - School of Medicine - Department of Neurology, مشهد, ايران , Fatahzadeh, Ghasem mashhad university of medical sciences, مشهد, ايران
Abstract :
Introduction: Progressing stroke (PS) and Crescendo Transient Ischemic Attacks(CTIA) are generally accepted, though unproven, indications for urgentanticoagulation and there remains evidence-free practice of intravenous heparintherapy in these patients.Methods and Materials: Consecutive PS and CTIA patients admitted in MashhadGhaem hospital during 2007- 2008, enrolled in a prospective observational study. PSand CTIA patients underwent intravenous heparin therapy 1000 units per hour for 3days without bolus dose. PS and CTIA patients who had a contraindication ofintravenous heparin therapy received 80 mg Aspirin per day. Early clinical coursesincluding improvement, stabilization, deterioration and development of residualstroke were evaluated in two therapeutic groups of PS and CTIA patients..Results: 170 PS patients (103 males, 67 females) with mean age 60.4±12.3 years and88 CTIA patients (50 males, 38 females) with mean age 60.1± 6.8 years wereinvestigated. 141 PS and 64 CTIA patients received a short period of intravenousheparinization. The distribution of subtypes of early clinical course into twotherapeutic groups of PS and CTIA patients was significantly different; X2=10.487,df=2 , p=0.005 and X2=6.72, df=2 , p=0.035 respectively. Distribution of residualstroke in two therapeutic groups of PS and CTIA patients was not significantlydifferent; X2=1.443, df=1, p=0.23, OR=0.557 (0.212-1.462) and X2=1.01, df=1,p=0.315, OR=0.617 (0.24-1.587) respectively.Conclusion: PS and CTIA patients who received a short period of intravenousheparin therapy have significantly more probability of improvement and lessprobability of deterioration in their early clinical course.
