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Intravenous heparin is frequently used to treat thromboembolic disease,but the consequences of stopping heparin have not been studied systematically. To determine whether discontinuing heparin poses a clinical risk,we examined the charts of 378 patients treated with heparin for transient ischaemic attack(TIA),reversible ischaemic neurological deficit,or ischaemic stroke from October 1979 to June 1985.Clinical deterioration,or a new TIA or stroke was more likely(p=0.01)during the 24 hours after heparin was stopped in patients not already on aspirin or warfarin(10/143, 7%)than in patients receiving aspirin or warfarin before heparin withdrawal(3/215,1%).Stopping heparin in patients not receiving aspirin or warfarin appears to expose them to an increased risk for TIA,stroke,or clinical deterioration. |
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