AccScience Publishing / ITPS / Online First / DOI: 10.36922/itps.3250
SHORT COMMUNICATION

An observational study on the use of low-molecular-weight heparin for venous thromboembolism prophylaxis in acute stroke patients

Faizan A. Sandhu1* Revin Thomas1
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1 Department of Stroke Medicine, University Hospital North Durham, Durham, United Kingdom
INNOSC Theranostics and Pharmacological Sciences, 3250 https://doi.org/10.36922/itps.3250
Submitted: 25 March 2024 | Accepted: 24 July 2024 | Published: 7 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) are common complications post-stroke. The UK stroke guidelines recommend the early use of intermittent pneumatic compression devices (IPCDs). At our center, we noticed poor compliance with the use of these devices and sought to develop a pathway for early implementation of low-molecular-weight heparins (LMWH) instead. We retrospectively analyzed the data of 2351 patients in two separate groups and compared both groups to check the incidence of PEs and DVTs as stated on the discharge documentation. Group A consists of 1599 patients who used IPCDs as VTE prophylaxis, whereas Group B involved 752 patients who were placed on the new VTE prophylaxis protocol, which involved the early use of LMWH with enoxaparin delivered subcutaneously. It was observed that IPCDs were not well tolerated by patients, leading to poor compliance with VTE prophylaxis in Group A. VTE compliance was noted to be better in Group B in which the patients were given LMWH in the hospital. Furthermore, symptomatic DVT and PE were not found to be higher in Group B patients, but in fact, the incidence of these conditions was lower in this group. In conclusion, compared to IPCDs, LMWH appears to be well tolerated by patients during the admission period owing to acute stroke. It was observed that the incidence of VTE was reduced in patients who started on early LMWH in the post-stroke period. However, the long-term effects of LMWH prophylaxis, in terms of mortality and morbidity, need to be delineated. Therefore, an additional large trial on the early use of LMWH in comparison to IPCDs is warranted.

Keywords
Low-molecular-weight heparin
Venous thromboembolism
Deep vein thrombosis
Pulmonary embolism
Acute stroke
Blood clots
Intermittent pneumatic compression device
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Print ISSN: 2705-0734, Published by AccScience Publishing