PMID- 17727306
OWN - NLM
STAT- MEDLINE
DCOM- 20071109
LR  - 20181113
IS  - 1170-229X (Print)
IS  - 1170-229X (Linking)
VI  - 24
IP  - 9
DP  - 2007
TI  - Bleeding during enoxaparin treatment more common with age over 75 years and 
      severe renal insufficiency.
PG  - 777-9
AB  - BACKGROUND: Severe renal insufficiency, defined as a creatinine clearance <30 
      mL/min, increases the risk for bleeding in elderly patients receiving enoxaparin 
      (enoxaparin sodium) treatment. METHODS: The risk/benefit ratios of enoxaparin and 
      unfractionated heparin (UFH) in patients with acute myocardial infarction (AMI) 
      aged >75 years were determined by investigating the parameters of efficacy 
      (ischaemic event, lethal outcome), safety (bleeding events, renal insufficiency) 
      or both (composite endpoint: ischaemic event or lethal outcome or bleeding 
      event). RESULTS: The study included 113 patients (59 male, 52.2%) with AMI aged 
      >75 years; 36 of these patients received enoxaparin. In the patients who had 
      severe renal insufficiency, bleeding events were more frequent in those receiving 
      enoxaparin than in those patients who received UFH (3 vs 1, respectively; p = 
      0.024). Irrespective of the presence of renal insufficiency, bleeding events 
      occurred more often in patients who received enoxaparin than in those who 
      received UFH (13 vs 8, respectively; p = 0.007). The composite endpoint showed a 
      nonsignificantly better profile in patients who received enoxaparin than in those 
      who received UFH. CONCLUSION: Although the use of enoxaparin (compared with UFH) 
      and the presence of severe renal insufficiency significantly increased the 
      occurrence of bleeding in patients with AMI aged >75 years, the risk/benefit 
      difference in this population was not significant.
FAU - Despotovic, Nebojsa
AU  - Despotovic N
AD  - Gerontology Department, City Hospital Zvezdara, Belgrade, Serbia.
FAU - Erceg, Predrag
AU  - Erceg P
FAU - Nikolic-Despotovic, Maja
AU  - Nikolic-Despotovic M
FAU - Milosevic, Dragoslav P
AU  - Milosevic DP
FAU - Davidovic, Mladen
AU  - Davidovic M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Disease
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*adverse effects/therapeutic use
MH  - Endpoint Determination
MH  - Enoxaparin/administration & dosage/*adverse effects/therapeutic use
MH  - Female
MH  - Hemorrhage/*chemically induced/epidemiology
MH  - Heparin/administration & dosage/adverse effects/therapeutic use
MH  - Humans
MH  - Male
MH  - Myocardial Infarction/complications/drug therapy
MH  - Prevalence
MH  - Renal Insufficiency/*complications
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
EDAT- 2007/08/31 09:00
MHDA- 2007/11/10 09:00
CRDT- 2007/08/31 09:00
PHST- 2007/08/31 09:00 [pubmed]
PHST- 2007/11/10 09:00 [medline]
PHST- 2007/08/31 09:00 [entrez]
AID - 2495 [pii]
AID - 10.2165/00002512-200724090-00005 [doi]
PST - ppublish
SO  - Drugs Aging. 2007;24(9):777-9. doi: 10.2165/00002512-200724090-00005.