Anticoagulants for acute ischaemic stroke

Millions of people around the world have strokes every year. Most strokes take place when a blood clot blocks a blood vessel leading to the brain. Without a proper blood supply, the brain quickly suffers damage, which can be permanent. The damage from a stroke can cause arm or leg weakness, or difficulties with language or vision. Strokes are sometimes fatal, but will more often leave the survivor unable to do the things that they used to do. Because strokes are common and cause such damage, researchers are trying to find ways to get rid of the blood clot soon after the stroke happens. One way to do this is with blood thinning drugs called anticoagulants. If anticoagulants work, the bad effects of the stroke might be avoided. The main problem with anticoagulants is that they can cause bleeding, which can sometimes be very serious. This systematic review was designed to find out whether people treated with anticoagulants early after stroke got better or not, and whether they had problems with bleeding. There is a lot of information in this systematic review - 23,748 people with stroke have been involved in 24 included randomised trials to answer this question. People treated with anticoagulants had less chance of developing blood clots in their legs and in their lungs following their stroke, but these benefits were offset by an increased risk of bleeding. More research is needed to find out if there are ways to select the people with stroke who will benefit from anticoagulants without suffering the bleeding complications. This review did not provide any evidence that the early use of anticoagulants is of overall benefit to people with strokes caused by blood clots. Anticoagulants did not reduce disability, and caused more bleeding.