The risk of stroke among acutely ill hospitalized medical patients: lessons from recent trials on extended-duration thromboprophylaxis

Expert Rev Hematol. 2017 Aug;10(8):679-684. doi: 10.1080/17474086.2017.1343662. Epub 2017 Jun 21.

Abstract

Data from recent randomized controlled trials indicate that the incidence of stroke among acutely ill medical patients is unexpectedly high and approximates 1% at 90 days. Preliminary data suggest that betrixaban may reduce ischemic stroke in patients without atrial fibrillation. There is an unmet demand for stroke risk stratification schemes targeting hospitalized medical patients. The prognostic value of biomarkers such as natriuretic peptides and D-dimer in predicting short-term stroke remains uncertain. Future research should focus on identifying the high-risk subsets in which the benefit of anticoagulation significantly outweighs the associated hemorrhagic risk. Clinical trials: NCT00457002, NCT00571649, NCT01583218.

Keywords: Stroke; anticoagulant; betrixaban; thromboprophylaxis; thrombosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Benzamides / administration & dosage
  • Benzamides / therapeutic use
  • Female
  • Humans
  • Incidence
  • Inpatients / statistics & numerical data*
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • Pyridines / administration & dosage
  • Pyridines / therapeutic use
  • Randomized Controlled Trials as Topic
  • Risk
  • Stroke / epidemiology*
  • Stroke / etiology*
  • Thrombosis / complications
  • Thrombosis / prevention & control

Substances

  • Anticoagulants
  • Benzamides
  • Pyridines
  • betrixaban

Associated data

  • ClinicalTrials.gov/NCT00457002
  • ClinicalTrials.gov/NCT00571649
  • ClinicalTrials.gov/NCT01583218