A Cochrane review [Abstract] 1 included 8 trials with 5701 patients. The patients had definite or possible ischaemic stroke.Six trials tested ancrod and two trials defibrase, patients were treated for less than 3 hours to less than 48 hours. The duration of follow-up was 3 months in 4 trials and one year in the other 4 trials. Fibrinogen depleting agents marginally reduced the proportion of patients who were dead or disabled at the end of follow-up (RR 0.95, 95% CI 0.90 to 0.99; 6 trials, n=5354). There was no statistically significant difference in death from all causes during the scheduled treatment or follow-up period. There were fewer stroke recurrences in the treatment group than in the control group (RR 0.67, 95% CI 0.49 to 0.92; 4 trials, n=2674). However, symptomatic intracranial haemorrhage was about twice as common in the treatment group compared with the control group (RR 2.42, 95% CI 1.65 to 3.56; 8 trials, n=5404).In absolute terms, for every 1000 patients treated in the acute phase, death or dependency would be avoided in about 30 people after three months and 20 symptomatic intracranial haemorrhages would be caused.
Primary/Secondary Keywords