Condition 1: ischemic stroke. Condition 2: persistent atrial fibrillation. Condition 3: chronic atrial fibrillation. Condition 4: paroxysmal atrial fibtillation. A disorder characterized by a sudden loss of sensory function due to an intracranial vascular event. A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to brain ischemia or intracranial hemorrhages Atrial fibrillation and flutter Continuous or recurrent bouts of atrial fibrill
Conditions
Interventions
Intervention 1: Experimental: Low molecular-weight heparin( enoxaparin
Clexane, Sanofi, Paris)
these patients will receive 1 mg of enoxaparin (clexane) per kilogram of body weight subcutaneous every 12 hour with warfarin 5mg QD and both drugs will be continued until the
Treatment - Drugs
Experimental: Low molecular-weight heparin( enoxaparin
Clexane, Sanofi, Paris)
these patients will receive 1 mg of enoxaparin (clexane) per kilogram of body weight subcutaneous every 12 hour with warfarin 5mg QD and both drugs will be continued until the
Active Comparator: unfractionated heparin (alborz darou,Tehran)
This group will receive continuous intravenous unfractionated heparin sodium infusion 1000 unit per hour initially and
Sponsors
Shiraz University of Medical Scienses
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: Inclusion Criteria: confirmed diagnosis of acute ischemic stroke purely due to AF AF confirmed by ECG or 24 hour holter monitoring Patients who need initiation of anticoagulation for prevention of recurrent stroke /// Exclusion Criteria: ages less than 18 or more than 75 no cooperation CNS hemorrhage major bleeding infarction size of more than one third of MCA territory NIHS score more than 20 hypersensitivity to IV UFH or LMWH no informed consent other causes for stroke except AF pregnancy breast feeding uncontrolled HTN (BP more than 220/120) renal, hepatic, respiratory or cardiac failure myocardial infarction infectious endocarditis coma vasculitis dissection
Exclusion criteria
Exclusion criteria:
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mortality. Timepoint: 7 days and 90 days after stroke. Method of measurement: close observation in hospital and telephone interview after discharge.;Ischemic stroke. Timepoint: 7 days and 90 days after stroke. Method of measurement: CT scan and daily physical examination.;Hemorrhagic stroke. Timepoint: 7 days and 90 days after stroke. Method of measurement: CT scan and daily physical examination. | — |
Secondary
| Measure | Time frame |
|---|---|
| Symptomatic CNS hemorrhage. Timepoint: 7 days and 90 days after stroke. Method of measurement: CT scan.;Non-CNS hemorrhage. Timepoint: 7 days and 90 days after stroke. Method of measurement: CT scan.;Asymptomatic CNS_hemorrhage. Timepoint: 7 days and 90 days after stroke. Method of measurement: CT scan.;Time to reach target INR. Timepoint: average time is 7 to 10 days (it is variable between individuals). Method of measurement: laboratory.;Tolerability of drugs. Timepoint: during hospital admission while the patient is receiving anticoagulant. Method of measurement: daily physical exam. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactAfshin Borhani-Haghighi
Shiraz University of Medical Sciences
Outcome results
None listed