TY - JOUR
T1 - The efficacy and safety of anticoagulation in cerebral vein thrombosis
T2 - A systematic review and meta-analysis
AU - Al Rawahi, Bader
AU - Almegren, Mosaad
AU - Carrier, Marc
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/9
Y1 - 2018/9
N2 - Background: Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein thrombosis (CVT) with or without intracranial hemorrhage (ICH). Aim: We conducted a systematic review and meta-analysis to determine the efficacy and safety of LMWH compared to UFH for the treatment of acute CVT. Methods: An electronic search of MEDLINE, Pubmed, CENTRAL and Google Scholar was performed. Randomized controlled trials (RCT) reporting on the efficacy and safety of anticoagulation for acute treatment of CVT were included. Outcomes of interest included mortality, disability, new ICH and pulmonary embolism (PE). Results: Overall, 4 RCTs were included in the meta-analysis. Two trials compared anticoagulation (UFH (N = 1) and LMWH (N = 1)) to placebo. The use of anticoagulation therapy was associated with an odd ratio (OR) for mortality and disability of 0.31 (95% confidence interval (CI) 0.07 to 1.45; p = 0.14) and 0.3 (95% CI 0.09 to 1.01; p = 0.05), respectively. Three new ICHs were observed among patients receiving placebo and no patient had a PE complication. The other two trials compared LMWH to UFH. LMWH was associated with an OR for mortality and disability of 0.21 (95% CI 0.02 to 2.44, p = 0.21) and 0.5 (95% CI 0.11 to 2.23; p = 0.36), respectively. There were no new events of ICH or PE. Conclusion: LMWH seems to be safe and effective for the management of acute CVT.
AB - Background: Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein thrombosis (CVT) with or without intracranial hemorrhage (ICH). Aim: We conducted a systematic review and meta-analysis to determine the efficacy and safety of LMWH compared to UFH for the treatment of acute CVT. Methods: An electronic search of MEDLINE, Pubmed, CENTRAL and Google Scholar was performed. Randomized controlled trials (RCT) reporting on the efficacy and safety of anticoagulation for acute treatment of CVT were included. Outcomes of interest included mortality, disability, new ICH and pulmonary embolism (PE). Results: Overall, 4 RCTs were included in the meta-analysis. Two trials compared anticoagulation (UFH (N = 1) and LMWH (N = 1)) to placebo. The use of anticoagulation therapy was associated with an odd ratio (OR) for mortality and disability of 0.31 (95% confidence interval (CI) 0.07 to 1.45; p = 0.14) and 0.3 (95% CI 0.09 to 1.01; p = 0.05), respectively. Three new ICHs were observed among patients receiving placebo and no patient had a PE complication. The other two trials compared LMWH to UFH. LMWH was associated with an OR for mortality and disability of 0.21 (95% CI 0.02 to 2.44, p = 0.21) and 0.5 (95% CI 0.11 to 2.23; p = 0.36), respectively. There were no new events of ICH or PE. Conclusion: LMWH seems to be safe and effective for the management of acute CVT.
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U2 - 10.1016/j.thromres.2018.07.023
DO - 10.1016/j.thromres.2018.07.023
M3 - Article
C2 - 30056293
AN - SCOPUS:85050464746
SN - 0049-3848
VL - 169
SP - 135
EP - 139
JO - Thrombosis Research
JF - Thrombosis Research
ER -