Enoxaparin appears as safe as, but more effective than, unfractionated heparin.
Without prophylaxis, up to 75% of acute stroke patients with hemiplegia develop deep venous thrombosis (DVT), and 20% develop pulmonary embolism (PE). Small studies have suggested that low-molecular-weight heparin reduces the risk for DVT and PE more than unfractionated heparin does, without increasing the risk for bleeding.
In this manufacturer-sponsored, unblinded trial, 1762 patients in 15 countries who were unable to ambulate after an acute ischemic stroke were randomized within 48 hours of symptoms to receive either enoxaparin (40 mg once daily) or unfractionated heparin (5000 U every 12 hours) for 10 days. Platelet inhibitors were used in similar proportions in both groups. All patients had contrast venography (86%) or ultrasonography …