Enoxaparin (Lovenox) reduces the risk of blood clots in partially paralyzed stroke patients to a greater extent than unfractionated heparin, according to a large-scale multinational study.

Researchers at several centers here and abroad randomized 1,762 patients either to enoxaparin (a single daily injection) or unfractionated heparin, which requires two injections a day. All the patients (mean age 66 years) had experienced an ischemic stroke within 48 hours and were unable to walk unassisted.

Enoxaparin, an expensive form of low-molecular-weight heparin, reduced the risk of venous thromboembolism (VTE) by 43%, results showed. Ten percent (68) of the enoxaparin patients developed a VTE compared with 18% (121) of those who took unfractionated heparin. Internal or external cranial bleeding were rare, affecting only 1% of the patients in each group, although the rate of major extracranial bleeding was slightly higher among those taking enoxaparin.

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“Enoxaparin is preferable to unfractionated heparin for VTE prophylaxis in view of its better clinical benefits-to-risk ratio and the convenience of once daily administration,” the researchers concluded (Lancet. 2007;369:1347-1355). The study was funded by Sanofi-Aventis, which manufactures Lovenox.