ABSTRACT
The significance of low-molecular-weight heparins [LMWHs] in the management of acute stroke remains controversial. Investigating the effect of early administration of Enoxaparin [ENOX] on risk reduction of early recurrent ischemic strokes compared with Unfractionated Heparin [UFH]. Besides, exploring whether these benefits of ENOX might lead to reduction in death and disability. One hundred patients with acute ischemic stroke in evolution were enrolled [with symptoms of stroke within eight hours randomization]. Patients were randomized to receive UFH or ENOX for ten days. National Institutes of Health Stroke Scale [NIHSS] and Computed Tomography [ct] scan were performed at the time of admission, and after 48 hours of randomization. The mean baseline of [NIHSS] were 9.14 +/- 0.62 and 7.86 +/- 0.54 among patients randomized to UFH and ENOX respectively [P-value 0.2]. At discharge, the mean NIHSS showed a statistically significant difference in favor of the ENOX group [7.9 +/- 0.82 vs 4.96 +/- 0.54 for ENOX and UFH respectively [P-value = 0.002]] The mean NIHSS after therapy in patients who demonstrated neurological improvement was 5.6 +/- 0.46 in the UFH arm compared to 3.65 +/- 0.39 in the ENOX arm [P-valne=0.001]. A deterioration in the clinical neurological condition [progressive stroke symptoms] inspite of treatment with anticoagulant therapy was seen in 20% [n=10] of the patients in the UFH treatment arm compared to none [n=0] in the ENOX treatment arm [P-value=0.005]. ENOX + aspirin was superior to UFH + aspirin in reducing adverse neurological disability after acute ischemic stroke in evolution