Correlation between anti-Xa and occurrence of thrombosis and haemorrhage in post-surgical patients treated with either logiparin® (LMWH) or unfractionated heparin

Bara, L.; Leizorovicz, Alain; Picolet, H.; Samama, M

doi:10.1016/0049-3848(92)90213-t

Cited by 55 publications

(37 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Levine et al [24] reported a highly significant association between anti-Xa levels and rates of venographically confirmed deep vein thrombosis and wound hematomas with LMWH prophylaxis following total hip arthroplasty. Other investigators have noted weaker associations between anti-Xa levels and deep vein thrombosis rates with LMWH prophylaxis following general surgery [19,22], but not for major orthopedic procedures [16,21,23,26].…”

Section: Discussionmentioning

confidence: 99%

Effect of Patient Weight on the Anticoagulant Response to Adjusted Therapeutic Dosage of Low-Molecular- Weight Heparin for the Treatment ofVenous Thromboembolism

Wilson

Wilbur

Burton

et al. 2001

Pathophysiol Haemos Thromb

View full text Add to dashboard Cite

Data evaluating the safety of using weight-based dosing of low-molecular-weight heparin (LMWH) in obese patients are limited. Some manufacturers have recommended a maximum daily dose of LMWH not to be exceeded. The purpose of this study was to determine if body weight influenced the anticoagulant response to a weight-based dose of LMWH for the treatment of venous thromboembolism. Patients with serum creatinine levels <150 µmol/l receiving the LMWH , dalteparin 200 anti-Xa IU/kg based on actual body weight subcutaneously once daily for the treatment of deep vein thrombosis or pulmonary embolism, were eligible for the study. Patients received a minimum of 5 days LMWH treatment. Patients had peak anti-Xa levels (IL Test Chromogenic assay) measured 3–4 h following their day 3 injection and trough anti-Xa levels measured immediately prior to injections on day 3 and 5. No dose adjustments were made on the basis of the anti-Xa levels. Patients were a priori stratified into three weight classes: (A) within 20% of ideal body weight (IBW) (n = 13); (B) 20–40% of IBW (n = 14), and (C) greater than 40% of IBW (n = 10). The largest patient weighed 190 kg and had a body mass index of 58. Mean daily LMWH doses were 14,030, 17,646 and 23, 565 IU for groups A, B and C, respectively. Mean (SD) trough anti-Xa levels on day 3 were 0.12 (0.05) anti-Xa IU/ml for group A, 0.11 (0.03) anti-Xa IU/ml for group B and 0.11 (0.03) anti-Xa IU/ml for group C (p > 0.2). Similar trough anti-Xa levels were observed on day 5. Mean (SD) peak anti-Xa levels on day 3 were 1.01 (0.20) anti-Xa IU/ml, 0.97 (0.21) anti-Xa IU/ml and 1.12 (0.22) anti-Xa IU/ml for groups A, B and C, respectively (p > 0.2). No thromboembolic or bleeding complications occurred during LMWH therapy in any patients. These findings suggest that body mass does not appear to have an important effect on the response to LMWH up to a weight of 190 kg in patients with normal or near normal renal function.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Patient Weight on the Anticoagulant Response to Adjusted Therapeutic Dosage of Low-Molecular- Weight Heparin for the Treatment ofVenous Thromboembolism

Wilson

Wilbur

Burton

et al. 2001

Pathophysiol Haemos Thromb

View full text Add to dashboard Cite

show abstract

“…In addition, the relevance of anti-factor Xa levels is unclear; several studies have failed to show a relationship between the anti-Xa levels and bleeding. [158][159][160] For patients treated with LMWH, the risk of bleeding was generally higher in patients with a creatinine clearance , 30 mL/min compared with patients with a creatinine clearance . 30 mL/min (5.0% vs 2.4%; OR, 2.25; 95% CI, 1.19-4.27; P 5 .013).…”

Section: Should the Therapeutic Dose Of Lmwh Be Modifi Ed For Decreasmentioning

confidence: 99%

Evidence-Based Management of Anticoagulant Therapy

Holbrook

Schulman

Witt

et al. 2012

Chest

1,097

353

View full text Add to dashboard Cite

“…In this context it needs to be born in mind that target ranges are different for different LMWHs, and that it is still unknown if targets derived from pharmacological studies in healthy volunteers are indeed applicable to the critically ill population with major, heterogeneous and unpredictable modifications in pharmacokinetics and pharmacodynamics, as well as changes in haemostatic competence. Another problem is the only weak relationship between anti-Xa activity and clinical occurrence of symptomatic and asymptomatic VTE [18][19][20]. However, determination of anti-Xa activity is recommended if renal elimination of LMWH is impaired [2].…”

Section: Discussionmentioning

confidence: 99%

Coagulation Day 2010: an Austrian survey on the routine of thromboprophylaxis in intensive care

et al. 2012

View full text Add to dashboard Cite

Purpose: Venous thromboembolism (VTE) is a common but often overlooked lifethreatening complication of critical illness. The aim of this cross-sectional survey was to assess current practice of thromboprophylaxis as well as adherence to international guidelines. Methods: After ethics committee approval, all intensive care units in Austrian hospitals treating adult patients were invited to participate in this web-based survey. Anonymized data on each patient treated at the participating intensive care units on Coagulation Day 2010 were collected using an electronic case report form. Risk assessment, choice and monitoring of anticoagulants, means of mechanical prophylaxis, and demographic data were recorded. Results: Data from 325 critically ill patients were collected. Patients had a median of four risk factors for thrombosis and 6 % suffered from VTE. Of the 325 patients, 80 % received low molecular weight heparins subcutaneously, 10 % received unfractionated heparin intravenously, 1 % received alternative anticoagulants and 9 % received no pharmacological prophylaxis. Mechanical prophylaxis was used in 49 % with a predominant use of graduated compression stockings. In 39 % a combination of pharmacological and mechanical prophylaxis was applied and 5 % received no prophylaxis at all. Overall guideline adherence was 40 % on Coagulation Day 2010. Conclusion: Current practice of thromboprophylaxis is predominantly based on the administration of low molecular weight heparins prescribed at rather arbitrary doses without a discernible relationship to drug monitoring, thromboembolic risk factors, vasopressor use or fluid balance. The use of mechanical prophylaxis, evaluation of risk scores and overall guideline adherence must be further encouraged by education, training and communication.

show abstract

Correlation between anti-Xa and occurrence of thrombosis and haemorrhage in post-surgical patients treated with either logiparin® (LMWH) or unfractionated heparin

Cited by 55 publications

References 7 publications

Effect of Patient Weight on the Anticoagulant Response to Adjusted Therapeutic Dosage of Low-Molecular- Weight Heparin for the Treatment ofVenous Thromboembolism

Effect of Patient Weight on the Anticoagulant Response to Adjusted Therapeutic Dosage of Low-Molecular- Weight Heparin for the Treatment ofVenous Thromboembolism

Evidence-Based Management of Anticoagulant Therapy

Coagulation Day 2010: an Austrian survey on the routine of thromboprophylaxis in intensive care

Contact Info

Product

Resources

About