Pharmacologic therapy for the management of thrombosis: Unfractionated heparin or low-molecular-weight heparin?

Clinical Cornerstone

Volumn 7, Issue 4, 2005, Pages 39-48

  Spyropoulos, Alex C ^a,b,c  

^a Lovelace Sandia Health Systems   (United States)

^b UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER   (United States)

^c UNIVERSITY OF NEW MEXICO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ANTITHROMBIN; CERTOPARIN; CY 222; DALTEPARIN; EMBOLEX; ENOXAPARIN; HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; MONOEMBOLEX; NADROPARIN; PARNAPARIN; REVIPARIN; TINZAPARIN; WARFARIN; ANTICOAGULANT AGENT;

ACUTE CORONARY SYNDROME; ANTICOAGULATION; ARTICLE; BLEEDING; CLINICAL TRIAL; COST BENEFIT ANALYSIS; COST CONTROL; COST EFFECTIVENESS ANALYSIS; DEEP VEIN THROMBOSIS; DRUG BIOAVAILABILITY; DRUG CHOICE; DRUG CONTRAINDICATION; DRUG COST; DRUG DOSE REGIMEN; DRUG EFFICACY; DRUG INFUSION; DRUG SAFETY; GENERAL SURGERY; HEALTH CARE COST; HUMAN; LUNG EMBOLISM; ORTHOPEDIC SURGERY; OUTPATIENT CARE; PATIENT MONITORING; PATIENT SELECTION; PREDICTION; ST SEGMENT; TREATMENT OUTCOME; VENOUS THROMBOEMBOLISM; AMBULATORY CARE; CONTROLLED CLINICAL TRIAL; META ANALYSIS; METHODOLOGY; POSTOPERATIVE COMPLICATION; RANDOMIZED CONTROLLED TRIAL; REVIEW; THROMBOEMBOLISM; VEIN THROMBOSIS;

AMBULATORY CARE; ANTICOAGULANTS; HEPARIN; HEPARIN, LOW-MOLECULAR-WEIGHT; HUMANS; META-ANALYSIS; POSTOPERATIVE COMPLICATIONS; RANDOMIZED CONTROLLED TRIALS; THROMBOEMBOLISM; VENOUS THROMBOSIS;

EID: 33745228923     PISSN: 10983597     EISSN: None     Source Type: Journal    
DOI: 10.1016/S1098-3597(05)80102-4     Document Type: Article

References (27)

1. Bick R.L., Frenkel E.P., Walenga J., et al. Unfractionated heparin, low molecular weight heparins, and pentasaccharide: Basic mechanism of actions, pharmacology, and clinical use. Hematol Oncol Clin N Am 19 (2005) 1-51
2. Merh G. Anticoagulants in the treatment of deep vein thrombosis. Am J Med 1188A (2005) 13S-20S
3. Nuteschu E.A. Emerging options in the treatment of venous thromboembolism. Am J Health-Syst Pharm 61 Suppl 7 (2004) 512-517
4. Califf R.M., Petersen J.L., Hasselblad V., et al. A perspective on trials comparing enoxaparin and unfractionated heparin in the treatment of non ST-elevation acute coronary syndromes. Am Heart J 149 (2005) S91-S99
5. Rocha E., Martínez-González M.A., Montes R., and Panizo C. Do the low molecular weight heparins improve efficacy and safety of the treatment of deep venous thrombosis? A meta-analysis. Haematologica 85 (2000) 935-942
6. Koch A., Ziegler S., Breitschwerdt H., and Victor N. Low molecular weight heparin and unfractionated heparin in thrombosis prophylaxis: Meta-analysis based on original patient data. Thrombosis Res 102 (2001) 295-309
7. Dolovich L.R., Ginsberg J.S., Douketis J.D., et al. A metaanalysis comparing low-molecular-weight heparins with unfractionated heparin in the treatment of venous thromboembolism. Arch Intern Med 160 (2000) 181-188
8. Siragusa S., Cosmi B., Piovella F., et al. Low-molecularweight heparins and unfractionated heparin in the treatment of patients with acute venous thromboembolism: Results of a meta-analysis. Am J Med 100 (1996) 269-277
9. Cohen M., Demers C., Gurfinkel E.P., et al. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events Study Group. A comparison of lowmolecular weight heparin with unfractionated heparin for unstable coronary artery disease. N Engl J Med 337 (1997) 447-452
10. Antman E.M., Cohen M., Radley D., et al. TIMI 11B (Thrombolysis In Myocardial Infarction) and ESSENCE (Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events) Investigators. Assessment of the treatment effect of enoxaparin for unstable angina/non -Q-wave myocardial infarction. TIMI 11B-ESSENCE Meta-analysis. Circulation 100 (1999) 1602-1608
11. McGarry L.L., Thompson D., Weinstein M.C., and Goldhaber S.Z. Cost effectiveness of thromboprophylaxis with a lowmolecular-weight heparin versus unfractionated heparin in acutely ill medical inpatients. Am J Manag Care 10 (2004) 632-642
12. Mark D.B., Cowper P.A., Berkowitz S.D., et al. Economic assessment of low-molecular-weight heparin (enoxaparin) versus unfractionated heparin in acute coronary syndrome patients. Results from the ESSENCE randomized trial. Circulation 97 (1998) 1702-1707
13. Geerts W.H., Pineo G.F., Heit J.A., et al. Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126 (2004) 3385-4005
14. Braunwald E., Antman E.M., Beasley J.W., et al., Committee on the Management of Patients with Unstable Angina, ACC/AHA Task Force on Practice Guidelines. ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: Executive summary and recommendations. Circulation 102 (2000) 1193-1209
15. Schiff R.L., Kahn S.R., Shrier I., et al. Identifying orthopedic patients at high risk for venous thromboembolism despite thromboprophylaxis. Chest 128 (2005) 3364-3371
16. Kleber F.-X., Witt C., Vogel G., et al., THE PRINCE Study Group. Randomized comparison of enoxaparin with unfractionated heparin for the prevention of venous thromboembolism in medical patients with heart failure or severe respiratory disease. Am Heart J 154 (2003) 614-621
17. [abstract]. Spyropoulos A.C., Dunn A.S., Graham A., et al. Perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin in patients with mechanical heart valves on long-term oral anticoagulants: Results from the REGIMEN registry. Abstract 1016-47. J Am Coll Cordial (2005) 352A Abstract 1016-47
18. Spyropoulos A.C., Jenkins P., and Bornikova L. A disease management protocol for outpatient perioperative bridge therapy with enoxaparin in patients requiring temporary interruption of long-term oral anticoagulation. Pharmacotherapy 24 (2004) 649-658
19. Leizorovicz A. Comparison of the efficacy and safety of low molecular weight heparins and unfractionated heparin in the initial treatment of deep venous thrombosis. An updated meta-analysis. Drugs 52 Suppl 7 (1996) 30-37
20. Gould M.K., Dembitzer A.D., Doyle R.L., et al. Lowmolecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis: A meta-analysis of randomized, controlled trials. Ann Intern Med 130 (1999) 800-809
21. Segal J.B., Bolger D.T., Jenckes M.W., et al. Outpatient therapy with low molecular weight heparin for the treatment of venous thromboembolism: A review of efficacy, safety, and costs. Am J Med 115 (2003) 298-308
22. Spyropoulos A.C. The use of a protocol for the treatment of deep vein thrombosis. Am J Manag Care 7 (2001) S553-S558
23. Levine M., Gent M., Hirsh J., et al. A comparison of lowmolecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. New Engl J Med 334 (1996) 677-681
24. O'Brien B., Levine M., Willan A., et al. Economic evaluation of outpatient treatment with low-molecular-weight heparin for proximal vein thrombosis. Arch Intern Med 159 (1999) 2298-2304
25. Spyropoulos A.C., Hurley J.S., Ciesla G.N., and de Lissovoy G. Management of acute proximal deep vein thrombosis: Pharmacoeconomic evaluation of outpatient treatment with enoxaparin vs inpatient treatment with unfractionated heparin. Chest 122 (2002) 108-114
26. Spinier S.A., Inverso S.M., Cohen M., et al., ESSENCE and TIMI 11B Investigators. Safety and efficacy of unfractionated heparin versus enoxaparin in patients who are obese and patients with severe renal impairment: Analysis from the ESSENCE and TIMI 11B studies. Am Heart J 146 (2003) 33-41
27. Mahaffey K.W., Cohen M., Garg J., et al. High-risk patients with acute coronary syndromes treated with low-molecular-weight or unfractionated heparin: Outcomes at 6 months and 1 year in the SYNERGY Trial. JAMA 294 (2005) 2594-2600