We have located links that may give you full text access.
English Abstract
Journal Article
[Perioperative Bridging with Enoxaparin. Results of the Prospective BRAVE Registry with 779 Patients].
Medizinische Klinik 2007 October 16
BACKGROUND AND PURPOSE: Oral anticoagulant (OAC) therapy should be temporarily interrupted for an elective procedure or surgery, and perioperative prophylaxis with heparins should be initiated in patients who face a high or moderate risk of thrombosis. To date, the optimal heparin dose has not been established. The authors investigated the efficacy and safety of a risk-adapted regimen with the low-molecular-weight heparin enoxaparin in two different, body weight-adapted regimens.
PATIENTS AND METHODS: In the own institution, adult patients were consecutively documented in the prospective BRAVE registry, if they required bridging therapy. Patients with moderate thromboembolic risk (35.7%) received, after interruption of OAC and reaching an International Normalized Ratio (INR) of 1.5, enoxaparin 1 mg/kg body weight daily, those with high risk (64.3%) enoxaparin 1 mg/kg body weight twice daily (in case of compromised renal function half this dose, respectively). Events were recorded at 30 days post intervention by on-site examination of the patient or telephone follow-up.
RESULTS: Of 779 patients, none had a thromboembolic event. Enoxaparin was well tolerated. A total of four major bleedings in three patients (0.5%, all in the high-risk group), 46 minor bleedings (5.9%), and twelve cases of thrombocytopenia (1.5%, however, no heparin-induced thrombocytopenia [HIT] II) were noted.
CONCLUSION: The absence of thromboembolic events confirms the efficacy of enoxaparin in perioperative bridging. The rate of major bleedings was low and, of note, no cases of HIT II were noted. Reducing the dose to half the standard was shown to be effective and well tolerated in patients with moderate risk. Likewise, enoxaparin in a reduced dose can be safely used in patients with renal insufficiency who require bridging.
PATIENTS AND METHODS: In the own institution, adult patients were consecutively documented in the prospective BRAVE registry, if they required bridging therapy. Patients with moderate thromboembolic risk (35.7%) received, after interruption of OAC and reaching an International Normalized Ratio (INR) of 1.5, enoxaparin 1 mg/kg body weight daily, those with high risk (64.3%) enoxaparin 1 mg/kg body weight twice daily (in case of compromised renal function half this dose, respectively). Events were recorded at 30 days post intervention by on-site examination of the patient or telephone follow-up.
RESULTS: Of 779 patients, none had a thromboembolic event. Enoxaparin was well tolerated. A total of four major bleedings in three patients (0.5%, all in the high-risk group), 46 minor bleedings (5.9%), and twelve cases of thrombocytopenia (1.5%, however, no heparin-induced thrombocytopenia [HIT] II) were noted.
CONCLUSION: The absence of thromboembolic events confirms the efficacy of enoxaparin in perioperative bridging. The rate of major bleedings was low and, of note, no cases of HIT II were noted. Reducing the dose to half the standard was shown to be effective and well tolerated in patients with moderate risk. Likewise, enoxaparin in a reduced dose can be safely used in patients with renal insufficiency who require bridging.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app