scholarly journals Clinical Use of the Low-Molecular-Weight Heparins in Cancer Patients: Focus on the Improved Patient Outcomes

Thrombosis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Bo H. Chao ◽  
Lisa Lepeak ◽  
Ticiana Leal ◽  
H. Ian Robins
Keyword(s):  
Molecular Weight ◽  
Vitamin K Antagonists ◽  
Therapeutic Index ◽  
Spiral Ct ◽  
High Risk Population ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Diagnostic Technology

Patients with malignant neoplastic diseases represent a high-risk population relative to thromboembolic disease. With the advent of improved and accessible diagnostic technology, for example, ultrasound and/or spiral CT scans, timely diagnosis of venous thromboembolic events (VTE) is readily accomplished. The introduction of low-molecular-weight heparin (LMWH) approximately two decades ago (in contrast to unfractionated heparin and vitamin K antagonists) has provided a class of agents with a favorable therapeutic index. In the review to follow, the literature regarding the use of LMWH in oncologic patient populations is summarized. Topics addressed include prophylaxis, and treatment as well as consideration of the potential anti-neoplastic properties of this class of drugs.

scholarly journals USE OF BEMIPARIN IN PATIENTS UNDERGOING MAJOR SURGERY FOR ESOPHAGEAL AND GASTRIC CANCER

2017 ◽  
pp. 104-111
Author(s):  
R. A. Khvavstunov ◽  
S. E. Tolstopyatov
Keyword(s):  
Gastric Cancer ◽  
Molecular Weight ◽  
Major Surgery ◽  
Low Molecular Weight ◽  
Thromboembolic Events ◽  
Low Molecular Weight Heparins ◽  
Short Term ◽  
Increased Risk ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

The purpose of our study is to evaluate our own experience in the use of low molecular weight heparins, in particular bemiparin, in a group of patients with an increased risk of venous thromboembolic events undergoing major surgery for esophageal and gastric cancer. The study presents a comparative analysis of these groups and short-term results of the use of bemiparin in cancer patients.

scholarly journals Modern low-molecular-weight heparins in the prevention and treatment of venous thromboembolic complications in oncourologic patients

2018 ◽  
pp. 106-112
Author(s):  
N. V. Vorobyev ◽  
S. V. Popov
Keyword(s):  
Molecular Weight ◽  
Impaired Renal Function ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Antithrombotic Effect ◽  
Low Molecular Weight Heparins ◽  
Prevention And Treatment ◽  
Venous Thromboembolic

Oncourologic diseases are accompanied by a risk for subsequent venous thromboembolic complications, which are rated the most dangerous in terms of thrombogenic effect. The article presents a review of the clinical studies of efficacy and safety, and the experience in using of modern low-molecular-weight heparins in clinical practice - drugs of choice for the prevention of venous thromboembolic complications in cancer patients. Particular attention is paid to Bemiparin - a new second-generation low-molecular-weight heparin with a significant antithrombotic effect and improved pharmacological parameters that allow it to be successfully used in patients with impaired renal function in oncourological practice.

scholarly journals Rivaroxaban: An Affordable and Effective Alternative in Cancer-Related Thrombosis?

2017 ◽  
Vol 3 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Flávia Dias Xavier ◽  
Paulo Marcelo Gehm Hoff ◽  
Maria Ignez Braghiroli ◽  
Ana Carolina Carvalho Rocha Paterlini ◽  
Karla Teixeira Souza ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Retrospective Analysis ◽  
Vitamin K ◽  
Low Income ◽  
Low Molecular Weight Heparin ◽  
Vitamin K Antagonists ◽  
Attractive Alternative ◽  
Low Molecular Weight ◽  
Oncologic Patients ◽  
Venous Thromboembolic Events

Background Venous thromboembolic events (VTEs) are common and potentially fatal complications in cancer patients, and they are responsible for the second most common cause of death. Low molecular weight heparin (LMWH) is the gold-standard treatment, but the costs involved limit its use, especially in developing countries. Recently, the oral anticoagulant rivaroxaban, which directly inhibits factor Xa, was approved for VTE treatment. Methods We conducted a retrospective analysis from January 2009 to February 2014 with patients who had cancer and VTE who were receiving rivaroxaban. We compared the efficacy, safety, and cost of rivaroxaban and low molecular weight heparin (LMWH) alone or followed by vitamin K antagonists. Results Forty-one patients were identified, with a median age of 62.5 years. The most frequent tumor histology was adenocarcinoma (78%), which was most often found in the colon (26.8%). Most participants had advanced disease and an implanted central venous catheter. Patients’ VTE risk-assessment scores were low (12.5%), intermediate (50%), and high (35.5%). Pulmonary thromboembolism was reported in 41.4% of patients, but inferior limb thrombosis was reported only in 14.6%; 43.9% of patients received enoxaparin before starting rivaroxaban. Rivaroxaban was used for a median time of 5.5 months. Nonmajor bleeding was reported in 12.2% of patients, and rethrombosis was reported in 12.2%. In our study, rivaroxaban was as safe and effective as enoxaparin/vitamin K antagonists ( P = .54 and P = .25, respectively) or LMWH ( P = .46 and P = .29, respectively). Conclusion Although our study was a retrospective analysis, our results suggest that in this cohort of oncologic patients, rivaroxaban was safe and effective. Its oral route and lower cost make it an attractive alternative to LMWH, improving management of patients with cancer in low-income countries. Additional studies are necessary to confirm our data.

scholarly journals Terapia antitrombótica en pacientes con hemorragia intracraneal. ¿Revertimos?

2018 ◽  
Vol 10 (8) ◽  
pp. 6
Author(s):  
Jose Vicente Catalá Ripoll ◽  
Jose Ángel Monsalve Naharro ◽  
Esther Domingo Chiva ◽  
Pablo Cuesta Montero ◽  
Jose María Jiménez Vizuete
Keyword(s):  
Molecular Weight ◽  
Clinical Practice ◽  
Intracranial Hemorrhage ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Fibrinolytic Therapy ◽  
Low Molecular Weight ◽  
Low Molecular Weight Heparins ◽  
Direct Acting ◽  
Direct Acting Oral Anticoagulants

Realizamos una revisión de la guía de práctica clínica de la reversión de la terapia antitrombótica en pacientes con hemorragia intracraneal que hayan recibido terapia antiagregante, anticoagulante o fibrinolítica. Se analizan recomendaciones para la reversión de antagonistas de vitamina K, anticoagulantes orales de acción directa, heparinas no fraccionadas y de bajo peso molecular, trombolíticos y antiagregantes plaquetarios, en el contexto de una hemorragia intracraneal.  ABSTRACT Review the clinical practice guidelines for the reversal of antithrombotic therapy in patients with intracranial hemorrhage with antiplatelet, anticoagulant or fibrinolytic therapy. We analyzed the most important recommendations for the reversal of vitamin K antagonists, direct-acting oral anticoagulants, unfractionated and low-molecular-weight heparins, thrombolytics and platelet antiaggregants, in the context of an intracranial hemorrhage.

scholarly journals Anticoagulation in Patients with Liver Cirrhosis (Literature Review)

2019 ◽  
Vol 4 (2) ◽  
pp. 23-28
Author(s):  
E. S. Eniseeva
Keyword(s):  
Atrial Fibrillation ◽  
Molecular Weight ◽  
Liver Cirrhosis ◽  
Venous Thrombosis ◽  
Vitamin K Antagonists ◽  
Coagulation Cascade ◽  
Low Molecular Weight ◽  
Thromboembolic Complications ◽  
Low Molecular Weight Heparins ◽  
Increased Risk

Liver cirrhosis is accompanied by complex hemostatic disorders with an increase in the risk of both hemorrhagic and thrombotic complications. Reduced coagulation protein synthesis, such as factors II, VII, IX, X and thrombocytopenia are associated with an increased risk of bleeding. Reducing the synthesis of such anticoagulants as protein C, protein S, antithrombin III is accompanied by increased generation of thrombin, which leads to procoagulant status, increased risk of venous thrombosis, pulmonary embolism, and portal vein thrombosis. Activation of the coagulation cascade increases the risk of thrombosis, and also plays an important role in liver damage, contributing to the progression of fibrosis. Cirrhosis increases the risk of thromboembolic complications of atrial fibrillation.Anticoagulants are necessary for the prevention of thrombosis and thromboembolic complications. However, there are no large prospective studies. There is insufficient data on the safety of anticoagulant therapy in cirrhosis. There are difficulties in monitoring anticoagulation in the application of vitamin K antagonists and low molecular weight heparins.The review presents the available data on the use of warfarin, unfractionated heparin, low molecular weight heparins and direct oral anticoagulants in patients with liver cirrhosis, indicating the need for prevention of venous thrombosis in patients with risk factors, the possibility of preventing decompensation of cirrhosis, reducing the frequency of cardioembolic strokes in patients with atrial fibrillation.

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