A. Rodenjullig et al., ANTITHROMBIN-III ACTIVITY AND THE EFFICACY OF HEPARIN IN PROGRESSING ISCHEMIC STROKE, Clinical and applied thrombosis/hemostasis, 4(2), 1998, pp. 129-132
Heparin is often used in progressing ischemic stroke. However, a subst
antial part of the patients continue to progress while on treatment. T
he purpose of this study was to evaluate if antithrombin (AT) III acti
vity before treatment could predict patients at risk for continued pro
gression or if heparin-induced reduction in AT-III activity during tre
atment is related to continued progression. The study included 42 acut
e stroke patients with heaprin treatment for progression of ischemic s
troke. The patients were continuously supervised for progression. intr
avenous heparin therapy was started as soon as possible after the prog
ression was noticed. Antithrombin-III activity was assessed before ini
tiation of treatment and daily during the treatment period. Nine (21%)
of the 42 patients continued to progress while on treatment. There wa
s no statistically significant difference in AT III activity before tr
eatment between patients who continued to progress and those where the
progression ceased when treatment was initiated. Nor were there any d
ifferences in the mean AT III activity levels during treatment for pat
ients with more or less favorable clinical course. The individual chan
ges (Delta AT III) were similar in both patient groups as was the prop
ortion of patients with their lowest AT III activity in the thrombogen
ic range (continued: 22% vs. ceased: 27%). No clinically relevant infl
uence of AT III activity on heparin efficacy in progressing ischemic s
troke was found.