Clinical Trials of Anticoagulation in Stroke

Recently Published Clinical Trials

• International Stroke Trial (IST)
  Lancet 1997; 349: 1569-1581
• Hong Kong Nadroparin Trial (HK)
  New England Journal of Medicine 1995; 333:1588-1593
• Trial of ORG 10172 in Acute Stroke Treatment (TOAST)
  Journal of the American Medical Association 1998; 279: 1588-1593

Trial Format

	IST	HK	TOAST
Entry	<48 hrs	<48 hrs	<24 hrs
Endpoint	Dead/Dependent	Dead/Dependent	Good
Duration	6 months	6 months	3 months
Drug	Heparin	Nadroparin	ORG 10172
Class		LMWH	Heparinoid
Dose	5000 SC BID 12,500 SC BID	4100 SC QD 4100 SC BID	7200 IV/day
Time	14 days	10 days	7 days

Recurrent Ischemic Stroke

Percent with Poor Outcome

Intracranial Hemorrhage   

Major Extracranial Hemorrhage   

	IST	HK	TOAST
Time	14 days	10 days	10 days
HD	2%	0%	5%
LD	0.6%	0%
Control	0.4%*	1%	1.6%
	*p<.05 HK data for major GI hemorrhages only

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This presentation was written by Dr. William J. Powers, co-director of the Stroke Center at Barnes-Jewish Hospital and the Washington University School of Medicine.

Last Revised: March 26, 2001