The efficacy of anticoagulants in acute stroke has not been established. Heparin is frequently administered to patients with acute ischemic stroke, but its value is unproved. Routine use of any type of anticoagulant in acute ischemic stroke is not recommended. Low molecular weight heparin has advantages over conventional heparin and is currently being investigated. Aspirin is a useful adjunct if administered within 48 hours of onset in patients that are not eligible for fibrinolytic therapy.
Anticoagulants are effective when administered in patients with TIAs to reduce the risk of a stroke.