Antithrombotic Therapy for DVT/PE

1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Therapeutic Agents ◽  
Great Promise ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

Skin Grafting Followed by Low-Molecular-Weight Heparin Long-Term Therapy in Chronic Venous Leg Ulcers

2012 ◽  
Vol 26 (2) ◽  
pp. 190-197 ◽  
Author(s):  
Raffaele Serra ◽  
Gianluca Buffone ◽  
Andrea de Franciscis ◽  
Diego Mastrangelo ◽  
Tiziana Vitagliano ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Skin Grafting ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Long Term Therapy

Long-term therapy with low-molecular-weight heparin in cancer patients with venous thromboembolism

2012 ◽  
Vol 107 (01) ◽  
pp. 37-43 ◽  
Author(s):  
Pablo Marchena ◽  
José Nieto ◽  
María Guil ◽  
Ferrán García-Bragado ◽  
Ramón Rabuñal ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thromboembolism ◽  
Propensity Score ◽  
Cancer Patients ◽  
Major Bleeding ◽  
Low Molecular Weight Heparin ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Long Term Therapy

SummaryLong-term therapy with low-molecular-weight heparin (LMWH) is the treatment of choice for cancer patients with venous thromboembolism (VTE). However, the ideal doses of LMWH have not been thoroughly studied. We used the RIETE Registry data to assess the influence of the daily LMWH dosage on outcome during the first three months after VTE. We used propensity score-matching to compare patients who received <150 vs. those receiving ≥150 UI/kg/day LMWH. Up to July 2010, 3,222 cancer patients with VTE received long-term therapy with fixed doses of LMWH. Of these, 1,472 (46%) received <150 IU/kg/day (mean, 112 ± 28), and 1,750 received ≥150 IU/kg/day (mean, 184 ± 32). Results of the propensity score matching involved 1269 matched pairs. During follow-up, the incidence of pulmonary embolism (PE) recurrences was similar (1.2% vs. 1.9%), but patients receiving <150 IU/kg/day LMWH had a lower incidence of fatal PE than those treated with ≥150 IU/kg/day (0.2% vs. 1.0%; p=0.004). Multivariate analysis confirmed that patients receiving <150 IU/kg/day LMWH had a lower risk for fatal PE (odds ratio [OR]: 0.2; 95% confidence interval [CI]: 0.06–0.8) and for major bleeding (OR: 0.6; 95% CI: 0.3–1.0) than those treated with ≥150 IU/kg/day. In real life, one in every two cancer patients with VTE received lower doses of LMWH than those used in randomised trials, with large variations from patient to patient. Unexpectedly, patients treated with <150 IU/kg/day LMWH had fewer fatal PE cases and fewer major bleeding events than those receiving ≥150 IU/kg/day LMWH. This finding, however, should be validated in prospective clinical trials.

Homozygous Protein C Deficiency: Description of a New Mutation and Successful Treatment with Low Molecular Weight Heparin

1998 ◽  
Vol 79 (04) ◽  
pp. 756-761 ◽  
Author(s):  
Paul Monagle ◽  
Maureen Andrew ◽  
Jacqueline Halton ◽  
Richard Marlar ◽  
Lawrence Jardine ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Bone Density ◽  
Skin Necrosis ◽  
Protein C ◽  
Low Molecular Weight Heparin ◽  
Whole Body ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
New Mutation

SummaryWe present a kindred with a new mutation of the protein C gene, in which the proband had an unusual clinical presentation. The relationship between warfarin induced skin necrosis and level of anticoagulation was investigated. The pharmacokinetics of protein C concentrate was assessed to determine frequency of replacement therapy. The clinical and biochemical efficacy of therapy with low molecular weight heparin (LMWH) was assessed. The effect of long-term LMWH on bone density in the growing child was monitored using whole body densitometry.Warfarin therapy required an INR of greater than 3.5 to avoid skin necrosis. If protein C replacement was to be used, doses of 100 U/kg/day would have been required to maintain protein C levels consistently at or above 0.20 U/ml. While receiving prophylactic therapy with LMWH for almost 3 years, there were no episodes of recurrent thrombosis, no skin necrosis and no bleeding. Biochemical markers of in vivo thrombin generation were suppressed and within the normal range. Bone density continued to increase at the normal rate throughout the treatment period.LMWH is an effective form of long-term therapy for homozygous protein C deficient patients with measurable protein C levels.

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