PMID- 12842525
OWN - NLM
STAT- MEDLINE
DCOM- 20031006
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 76
IP  - 1
DP  - 2003 Jul
TI  - Effects of preoperative enoxaparin versus unfractionated heparin on bleeding 
      indices in patients undergoing coronary artery bypass grafting.
PG  - 124-8; discussion 128
AB  - BACKGROUND: We examined the effects of preoperative administration of enoxaparin 
      (ENOX), a low-molecular-weight heparin, on bleeding indices and transfusion rates 
      in patients undergoing coronary artery bypass grafting (CABG). METHODS: Patients 
      undergoing isolated CABG between 1997 and 2002 who received preoperative ENOX or 
      a continuous infusion of unfractionated heparin (UFH) were randomly divided into 
      three groups: continuous UFH, ENOX last administered more than 12 hours before 
      surgery (ENOX > 12), and ENOX administered less than 12 hours before surgery 
      (ENOX < 12). Perioperative hemoglobin values, transfusion rates, and bleeding 
      complications were compared. RESULTS: A total of 69, 58, and 34 patients 
      comprised the UFH, ENOX > 12, and ENOX < 12 groups, respectively. Preoperative 
      demographics and hematologic data were similar among the groups. Compared with 
      the UFH group, the ENOX < 12 group had significantly lower postoperative 
      hemoglobin values (9.6 +/- 1.3 g/dL versus 10.4 +/- 1.2 g/dL, p < 0.05), higher 
      transfusion rates (73.5% versus 50.7%, p < 0.05), and required more total packed 
      red cells per patient (882 +/- 809 mL versus 472 +/- 626 mL, p < 0.05). A 
      nonsignificant increase was noted in the risk of returning to the operating room 
      for bleeding in patients who had received ENOX compared with patients receiving 
      UFH (6.5% versus 2.9%). CONCLUSIONS: The preoperative use of ENOX less than 12 
      hours before CABG is associated with lower postoperative hemoglobin values and 
      higher rates of transfusion than continuous UFH.
FAU - Kincaid, Edward H
AU  - Kincaid EH
AD  - Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, 
      Winston-Salem, NC 27157, USA. tkincaid@wfubmc.edu
FAU - Monroe, Michelle L
AU  - Monroe ML
FAU - Saliba, David L
AU  - Saliba DL
FAU - Kon, Neal D
AU  - Kon ND
FAU - Byerly, Wesley G
AU  - Byerly WG
FAU - Reichert, Marc G
AU  - Reichert MG
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - 0 (Enoxaparin)
RN  - 0 (Hemoglobins)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Blood Transfusion/*statistics & numerical data
MH  - Coronary Artery Bypass/*methods/mortality
MH  - Coronary Disease/diagnosis/mortality/*surgery
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Enoxaparin/*administration & dosage/adverse effects
MH  - Female
MH  - Hemoglobins/*analysis
MH  - Heparin/administration & dosage/adverse effects
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/adverse effects
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Postoperative Hemorrhage/*etiology/*therapy
MH  - Preoperative Care/methods
MH  - Probability
MH  - Prognosis
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2003/07/05 05:00
MHDA- 2003/10/08 05:00
CRDT- 2003/07/05 05:00
PHST- 2003/07/05 05:00 [pubmed]
PHST- 2003/10/08 05:00 [medline]
PHST- 2003/07/05 05:00 [entrez]
AID - S0003497503001905 [pii]
AID - 10.1016/s0003-4975(03)00190-5 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2003 Jul;76(1):124-8; discussion 128. doi: 
      10.1016/s0003-4975(03)00190-5.