PMID- 15213839
OWN - NLM
STAT- MEDLINE
DCOM- 20050131
LR  - 20141120
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 92
IP  - 1
DP  - 2004 Jul
TI  - Thromboprophylaxis in medical patients: the role of low-molecular-weight heparin.
PG  - 3-12
AB  - Many hospitalised medical patients are at increased risk of venous 
      thromboembolism (VTE). Consensus statements recommend that such patients be 
      assessed for risk of VTE on admission to hospital and receive thromboprophylaxis 
      where appropriate. However, VTE prophylaxis is not widely used in medical 
      patients. One explanation is that assessing medical patients' risk of VTE is 
      complicated. The risk depends not only on the current illness but also on 
      multiple intrinsic factors, and a variety of strategies for identifying patients 
      who should receive thromboprophylaxis have been suggested. Thromboprophylaxis 
      with unfractionated heparin (UFH) has proved to be effective in reducing the 
      incidence of deep-vein thrombosis and overall mortality in medical patients. 
      Clinical trial evidence, including a meta-analysis, suggests that 
      thromboprophylaxis with low-molecular-weight heparin (LMWH) is at least as 
      effective as with UFH, and also has the advantage of fewer bleeding 
      complications. In particular, two large, randomised clinical trials--Prophylaxis 
      in Medical Patients with Enoxaparin (MEDENOX) and Prospective Evaluation of 
      Dalteparin Efficacy for Prevention of VTE in Immobilized Patients Trial 
      (PREVENT)--showed that thromboprophylaxis with the LMWHs enoxaparin (40 mg s.c. 
      once daily) or dalteparin (5,000 IU once daily) is more effective than placebo 
      and well tolerated in medical patients. In addition, the 
      Thromboembolism-Prevention in Cardiopulmonary Diseases with Enoxaparin 
      (THE-PRINCE) trial showed that enoxaparin treatment was as effective as UFH. 
      These studies provide solid evidence for the widespread use of thromboprophylaxis 
      in medical patients.
FAU - Turpie, Alexander G G
AU  - Turpie AG
AD  - Hamilton Health Sciences, Hamilton General Hospital, 237 Barton Street East, 
      Hamilton, Ontario, Canada, L8L 2X2. turpiea@mcmaster.ca
FAU - Norris, Timothy M
AU  - Norris TM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Administration, Oral
MH  - Anticoagulants/administration & dosage/therapeutic use
MH  - Aspirin/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Factor Xa Inhibitors
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/economics/*therapeutic use
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Thromboembolism/economics/*prevention & control
MH  - Venous Thrombosis/economics/*prevention & control
RF  - 67
EDAT- 2004/06/24 05:00
MHDA- 2005/02/03 09:00
CRDT- 2004/06/24 05:00
PHST- 2004/06/24 05:00 [pubmed]
PHST- 2005/02/03 09:00 [medline]
PHST- 2004/06/24 05:00 [entrez]
AID - 04070003 [pii]
AID - 10.1160/TH03-07-0469 [doi]
PST - ppublish
SO  - Thromb Haemost. 2004 Jul;92(1):3-12. doi: 10.1160/TH03-07-0469.